title: The problem of unreasonably high pharmaceutical fees for patients in Chinese hospitals: a system dynamics simulation model.
abstract: The social problem of unreasonably high pharmaceutical costs for patients in Chinese hospitals damages the interests of patients and it has a highly negative impact on the long-term development of the Chinese health service. We constructed a system dynamics model to address two problems, i.e., the unreasonably high prices of drugs and the high level of pharmaceutical fees relative to the medical costs of patients, and we suggest countermeasures and possible solutions. The program Vensim DSS was used to construct a system dynamics model to represent the problem of high pharmaceutical fees for patients in Chinese hospitals. If hospital and medical staff receive a higher kickback rate, they are more likely to prescribe unnecessary expensive drugs to make greater profits, which results in unnecessary drug consumption and irrational drug use, eventually leading to unreasonably high pharmaceutical fees. The benefit chain of the main drug suppliers should be cut off. It is necessary to break the link between the profits from pharmaceutical sales and the prescribing behavior of physicians, and hospital incomes, to avoid any conflicts of interest over how medicines are prescribed. Thus, cost-containment measures and a reformed pharmaceutical distribution system are needed to regulate physicians and hospital interaction.
authors.affiliation: Institute of Military Health Management, PLA, Faculty of Health Service, The Second Military Medical University, 800 Xiangyin Road, Yangpu District, Shanghai 200433, China. Electronic address: lijinhan53@126.com.
authors.forename: Meina
authors.initials: M
authors.lastname: Li
authors.affiliation: Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Yangang
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Institute of Military Health Management, PLA, Faculty of Health Service, The Second Military Medical University, 800 Xiangyin Road, Yangpu District, Shanghai 200433, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Xue
authors.affiliation: Institute of Military Health Management, PLA, Faculty of Health Service, The Second Military Medical University, 800 Xiangyin Road, Yangpu District, Shanghai 200433, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Institute of Military Health Management, PLA, Faculty of Health Service, The Second Military Medical University, 800 Xiangyin Road, Yangpu District, Shanghai 200433, China. Electronic address: zllrmit@aliyun.com.
authors.forename: Lulu
authors.initials: L
authors.lastname: Zhang
mesh_terms: D002681:China; D003198:Computer Simulation; D003695:Delivery of Health Care / Q000191:economics / Q000706:statistics & numerical data; D005252:Fees, Pharmaceutical / Q000706:statistics & numerical data*; D005607:Fraud; D006761:Hospitals / Q000941:ethics; D006801:Humans; D010820:Physicians / Q000941:ethics; D055656:Prescriptions / Q000191:economics / Q000706:statistics & numerical data