Reported by Wei Yi-Chia from Taipei
From January, the NHI stops reimbursing for dispensing small jars of ointment for treating dermatology problems. However, doctors in primary clinics expressed that patients will be offered 1-2 free jars upon their personal request to meet their needs. It has been suspected that clinics use the small jars as free gifts to tout customers.
Dr. Zhou Zhou-Min, the head of a dermatology clinic, expressed that the cost of dispensing a small jar of ointment from bulk drug is about NT$3-5. Patients used to receive 5 or 6 jars for an extensive affected skin surface. From January, clinics are requested by the NHIA to prescribe ointment in original tubes instead of dispensing from bulk drug. A 5mg tube costs NT$8-11; therefore, doctors can only afford to prescribe one tube for each treatment. Patients will have to make another appointment if they need more ointment.
In reply to this criticism, Chen Shan-Bin of the NHIA expressed that large capacity tubes are also available. Doctors should prescribe drugs taking account of patients’ needs. The drug fees for short-form is NT$66 for a course of 3-day medication. If more medicine is required, doctors can claim for the actual expenses without being restricted by the short-form.
Chen Shan-Bin stressed that clinics are forbidden to charge patients for dispensing bulk drugs whose tube form is available under the NHI. Patients can lodge complaint to the NHIA for investigation.
According to Dr. Zhou Zhou-Min, it is a common fallacy that ointment dispensed in jars is based on doctors’ secret recipe. Therefore, many patients will still request doctors to give them small jars of ointment in addition to the tube as regulated by the NHI. Some clinics use those small jars as freebies to tout patients.
The NHIA stops reimbursing for bulk ointment dispensed in small jars. However, this policy fails its original purpose which is to completely eliminate bulk drug dispensed in small jars. According to the Guidelines on Drug Dispensing, doctors can instruct pharmacists to dispense drugs to patients according to their personal needs.
Chen Shan-Bin admitted that there is a grey area. However, the NHIA will look into this issue. If small jars of ointment are ready for dispensing to patients in the clinics prior to treatment, then it is obvious that such jars are not tailor-made for patients’ conditions. However, the truth is that the NHIA has no control over drugs which go private or do not need NHI reimbursement.
【2015-01-05/ China Times】