From this year, healthcare providers who are found internally duplicating prescriptions of certain drugs, such as drugs for hypertension, hyperlipidemia or hyperglycemia and anti-depressants, are not eligible for NHI reimbursement. In July, the new regulation will soon be extended to duplicate prescriptions issued by different hospitals, clinics or pharmacies. More drugs, such as pain killers and cancer drugs, will be included as well. Primary care hospitals and pharmacies express their concern over the extended regulation as patients will have to wait a bit longer for their prescriptions.
The NHIA introduced the cloud-based medication record system in July 2013. So far, about 19,000 healthcare providers have signed up to use this service. In July 2015, the NHIA announced to stop paying internal duplicate prescriptions of drugs for hypertension, hyperlipidemia or hyperglycemia, as well as anti-psychosis, anxiolytics and sedatives, if duplicate prescriptions are issued by the same healthcare provider. According the NHIA’s estimation, about NT$10.4 billion were saved last year.
However, there are complaints from healthcare providers. Pharmacists pointed out that the information on the cloud-based server is not real-time data; therefore, health professionals may duplicate a prescription without knowing it. Also, there are many practical issues, for example, some patients forgot to bring their NHI IC cards. The system itself is still beset with problems. It is hard to clarify whose fault it is in situations of a duplicate prescription.
Furthermore, the lack of health education may cause misunderstanding and tension between doctors and patients. Some patients are so used to get a second opinion from other doctors. Now, they have to swallow doctors’ rejection of a duplicate prescription. In some cases, there might be consequences of poor control over patients’ conditions.
Dr Chang Chi-Hu, President of the TMA, also reckons that it is unreasonable to just punish healthcare providers, while patients don’t have to take any responsibility. Also, the heavy-traffic cloud-based server causes delays in the access to the data. Patients have to wait longer or pay for VIP services. The problem will get worse if cross-hospital checking is implemented.
Shih Ru-Liang of the NHIA expressed that hospitals only have to make sure that it is not a duplicate prescription according to the data available at the time of issuing the prescription. The NHIA will give exemptions to situations where there is a time lag in uploading data, a frozen server, or occasions where patients are unable to present their NHI IC cards. Patients may opt for self-payment medication if they lost their medicines.
【2016-04-22/ United Daily News】