The American healthcare system has undergone significant modernization, with the involvement of organizations such as the American Pharmacists Association, hospital pharmacies, chain pharmacies, physicians, and pharmaceutical management. The government enforces strict regulations to ensure quality and safety. Most medical expenses are covered by third-party insurance companies, which play a key role in monitoring prescription costs. In U.S. hospitals, there are no large prescriptions, and insurance companies closely track medication spending. This model offers valuable insights for China as it explores its own drug separation reforms.
In October, I had the opportunity to join a study tour organized by the Shanghai Association of Licensed Pharmacists. The group visited the Illinois Pharmacists Association, the Pharmacy at the University of Illinois Hospital, and the Walgreens chain pharmacy. This trip provided me with deep insights into the U.S. healthcare and pharmacy systems.
Drug pricing remains a major challenge in China, despite efforts by the National Development and Reform Commission to lower prices and implement price comparisons. However, the core issue lies within the broader medical system. With rising healthcare costs and difficulties in accessing care, new policies such as medical diversion, revenue separation, and online bidding have become central to reform efforts.
In the U.S., prescriptions from hospitals can be filled at community pharmacies, with doctors not directly prescribing and patients not receiving large quantities of medication. Hospitals and pharmacies use modern management practices, including drug dispensing and pricing strategies. These methods demonstrate how the U.S. medical insurance system and separation of services could serve as useful models for China.
The Illinois Pharmacists Association is similar to China’s Association of Licensed Pharmacists. During our visit, we learned about its structure, funding sources, and regulatory framework. It is accredited by the U.S. Department of Education and operates as a non-profit organization with over 20 directors and tens of thousands of members. Members pay an annual fee of $250 and must complete continuing education requirements.
Pharmacies in the U.S. require a licensed pharmacist on-site, but they do not need one to operate. Each store must meet specific size requirements, though there are no distance restrictions between pharmacies. Pharmacists are responsible for reporting adverse drug reactions, recalling defective products, and ensuring safe medication practices.
In some states, pharmacists can collaborate with doctors to prescribe medications, especially in clinics located near hospitals. They may also provide immunizations, offering a model that could inspire China’s future healthcare reforms.
At the University of Illinois Hospital, we saw how pharmacists work alongside doctors in various clinical areas, including neonatal care and organ transplant support. The hospital uses advanced computer systems to track prescriptions, monitor patient data, and ensure medication safety throughout the treatment process.
Pharmacies like Walgreens manage prescriptions through nationwide networks, allowing them to track patient records and analyze prescription accuracy. Patients typically pay a small co-pay, with the rest covered by insurance. Expired drugs are handled by specialized departments, and while there's no reward for returning them, the process is well-regulated.
Walgreens operates with a high level of automation and efficiency, with most pharmacies open 24/7. Some even offer small clinics, expanding their role in primary care. This model shows how pharmacies can become more than just places to buy medicine—they can be integral parts of the healthcare system.
Overall, the U.S. approach to pharmacy and medical management highlights the importance of technology, regulation, and collaboration. By learning from these practices, China can continue to refine its own healthcare and pharmaceutical systems, ultimately improving patient outcomes and reducing waste.
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