新华视点|透视医保定点药店“阴阳价”

Core Insights - The article highlights the issue of "dual pricing" in designated pharmacies, where the same medication is sold at different prices to insured and uninsured patients, raising concerns about fairness and legality [1][2][3] Group 1: Occurrence of Dual Pricing - Reports indicate that in various regions, pharmacies are charging higher prices to patients using insurance compared to those paying out-of-pocket, with significant price discrepancies observed [2][3] - Specific examples include a medication priced at 22 yuan for insured patients and 12.8 yuan for cash buyers in Fuzhou, and another instance where a medication costs 2980 yuan for insured patients versus 1350-1790 yuan for uninsured patients in Henan [2] Group 2: Legal and Regulatory Framework - According to regulations, pharmacies are prohibited from charging different prices based on insurance status, and violations can lead to penalties including the loss of their insurance billing privileges [3][4] - Experts emphasize that pricing should be uniform for the same product under identical conditions, and any differentiation based on insurance status is considered a violation of laws [3][4] Group 3: Reasons Behind Pricing Discrepancies - The pricing strategies of designated pharmacies are influenced by operational costs and market competition, leading some to adopt dual pricing to attract insured patients while maximizing cash sales [4][5] - The pressure from rising operational costs and competition from online pharmacies has contributed to the prevalence of dual pricing practices [4] Group 4: Regulatory Responses and Solutions - The National Healthcare Security Administration has initiated measures to enhance price management in designated pharmacies and monitor dual pricing practices more closely [6] - Plans are in place to implement real-time settlement of insurance funds with pharmacies, aiming for nationwide coverage by 2026, which could help mitigate the issue [6] Group 5: Consumer Awareness and Action - Consumers are encouraged to be vigilant and informed about pricing when using insurance, including checking prices and retaining receipts to identify discrepancies [7]