医保买药竟比自费贵？国家医保局整治定点药店“阴阳价”套路，高价售药牟利涉嫌价格欺诈

Core Viewpoint - The article highlights the issue of "dual pricing" in retail pharmacies, where the same medication is sold at a higher price to patients using health insurance compared to those paying in cash, leading to distrust in the health insurance system [1][5]. Group 1: Regulatory Response - The National Healthcare Security Administration issued a notification to strengthen monitoring and handling of "dual pricing" practices in retail pharmacies, emphasizing that such discriminatory pricing violates service agreements [1][8]. - The notification proposes a multi-faceted approach involving technical monitoring, law enforcement, and public supervision to address the issue effectively [1][5]. Group 2: Pricing Practices - Common practices include "same drug dual pricing," where the insurance price is higher than the cash price, and "specification splitting," where purchasing individual units costs more than buying a full box [3][4]. - Some pharmacies require patients to join membership programs or purchase specific products to access the same pricing as cash customers, further complicating the pricing structure [3][4]. Group 3: Impact on Patients and Pharmacies - The "dual pricing" phenomenon particularly affects patients with chronic diseases, increasing their medication costs and leading to hidden losses in health insurance funds [5][10]. - Pharmacies face financial pressures due to delayed reimbursements from health insurance, which can take one to two months, leading them to adopt these pricing strategies to maintain cash flow [3][9]. Group 4: Monitoring and Enforcement - The notification mandates pharmacies to conduct self-inspections and encourages public reporting of violations, with a focus on increasing the cost of non-compliance through a tiered penalty system [8][9]. - A pilot program in Chengdu showed a 42% decrease in "dual pricing" incidents after reducing the reimbursement cycle from 45 days to 20 days, indicating the effectiveness of timely payments [9].