The American healthcare system has undergone significant modernization, with the involvement of the American Pharmacists Association, hospital pharmacies, chain pharmacies, physicians, and pharmaceutical management. The government maintains a comprehensive regulatory framework to ensure quality and safety. Most medical expenses are covered by third-party insurance companies, which play a critical role in controlling drug costs. In U.S. hospitals, there is no issue of large prescriptions; instead, medical insurance companies closely monitor medication expenses, ensuring cost efficiency and appropriate use. This model offers valuable lessons for China as it considers reforms in its own pharmaceutical system.
In October, I had the opportunity to join a study tour organized by the Shanghai Association of Licensed Pharmacists, visiting institutions such as the Illinois Pharmacists Association, the University of Illinois Hospital Pharmacy, and Walgreens, one of the largest pharmacy chains in the U.S. This experience provided me with deep insights into the U.S. pharmaceutical and healthcare systems.
Drug pricing remains a complex challenge in China, despite efforts by the National Development and Reform Commission to implement price reductions and comparisons. However, the core issue lies within the broader medical system, where access to care is often difficult and expensive treatments remain a concern. Recent reforms, including medical diversion, separation of hospital revenues, three-tier medical linkages, and online bidding procurement, are now central to improving the system.
In the U.S., prescriptions from hospitals can be directly filled at community pharmacies, with doctors not issuing prescriptions themselves. Hospitals and pharmacies both employ modern management practices, including drug packaging, distribution, and pricing strategies. These approaches reflect a well-structured medical insurance system and clear separation between medicine and healthcare services—practices that China could benefit from adopting.
During my visit to the Illinois Pharmacists Association, I learned about its role as a non-profit organization established in 1880, with over 20 directors and tens of thousands of members. Members pay an annual fee of $250, and the association collaborates with state and federal governments to enforce pharmacist regulations. Pharmacists must complete continuing education, pass state exams, and work under strict guidelines to maintain their licenses.
Opening a pharmacy in the U.S. requires a licensed pharmacist on-site, but the store itself doesn’t need one. Each pharmacy must meet specific size requirements, and there are no restrictions on the distance between pharmacies. Pharmacists are responsible for reporting adverse drug reactions, monitoring drug flows, and recalling defective products when necessary. They also provide patient counseling and, in some states, even assist in prescribing medications alongside doctors.
Pharmacists in the U.S. often work part-time and may practice in multiple pharmacies. Patients primarily receive medications from pharmacies, where pharmacists play a crucial role in advising on proper usage. Some pharmacies have small clinics offering basic care, such as treating minor illnesses, and these clinics are staffed by qualified doctors. The number of such clinics is expected to grow significantly in the coming years.
At the University of Illinois Hospital, I observed how pharmacists collaborate with doctors in various clinical settings, including neonatal care, surgery, and chronic disease management. The hospital uses an advanced computer system to track prescriptions, monitor drug safety, and manage patient records. Adverse drug reactions are reported through a structured process, involving the hospital’s medical committee and the FDA. Expired drugs are handled carefully, with hospitals bearing most of the cost if they are returned to manufacturers.
Walgreens, one of the largest pharmacy chains, operates a nationwide network where prescriptions are tracked and dispensed efficiently. Patients typically pay a small co-pay, while the rest is billed to insurance companies. Pharmacies also handle drug packaging, disposal, and recall procedures, ensuring compliance with strict regulations.
Overall, the U.S. model of pharmacy and healthcare management highlights the importance of technology, regulation, and collaboration. As China continues to reform its medical system, learning from these practices can help improve efficiency, reduce costs, and enhance patient care.
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