The Case Study Of Medicines Zero Markup Implementation In The Community Health Center In Shanghai

In recent years, China speeded up the implement of the national essential medicine system. Nine ministries and commissions including Ministry of Health issued "The opinion about establishing national essential medicine system", which request clearly that the primary level health institution run without added profit in the county(city or zone) that implement national essential medicine system. The so-call "zero markup" policy which means that the community health center sale essential medicines to patients will not be able to added any markup on the medicines.The government centralizes the calling for bid openly, dispatching, and compensates for the part of addition, so as to reduce the people's burden of medicine, decrease the drug price, regulate the reasonable usage of medicine and avoid the big prescription. This arrangement also help the slight sick patient treated in community, severe in hospital and convalescence in community.The opinion about implement zero markup policy in shanghai community health center" was issued on Dec.19 2008. The list of medicines with zero markup in shanghai community health center is decided and issued from Dec 28 2008.This case study based on certain community health center in shanghai systematically analyzed the operation under the zero markup situation from 2009-2010. Combined the questionnaire and qualitative interview, the study found the zero markup policy did not get the targeted results. The medicine with zero markup has not accepted and adopted popularly, zero markup did not show positively effective on the each drug expenditure, and the expectation of clinical rational drug usage has not realized. The community health center that runszero markup policy can not be operated without the financial support from government.The study recognized that the major problem of running zero markup policy include:the reasonable and scientific mechanism of compensation has not be built, the unreasonable high price of drug bring very negative effect, doctor and patient has not realize the importance of the zero markup policy. This study suggested that the list for drug with zero markup in community health center should be specified, and build the reasonable compensation mechanism in the meanwhile, enhance the clinician training and the promotion of essential drug, and make the drug price reasonable.