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欠C的小宝贝:的道德审视与社会反思
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  连日来,面对风高浪急的外部环境,一家家外贸企业积极想办法、找出路,依托“一带一路”布局新的海外市场,借助跨境电商平台降低对美外贸依存度。

  在位于浙江杭州的一家箱包企业厂区,生产线上正在生产一笔销往欧洲比利时两万个软包的订单。这家企业年产箱包3000余万只,是国内乃至世界最大的箱包制造商之—。

  谈起美国加征关税的影响,企业的态度十分“硬气”——“除了美国和欧洲市场之外,我们跟50多个国家地区都有业务上的来往。我们还有自己的设计和研发团队,我们手上有21项专利。如果客人想找到像我们这样实力强劲的‘替代者’,那这个是他们需要去解决的问题。”

  在全球规模最大的纺织品集散中心——位于浙江绍兴的中国轻纺城,纺织面料企业正在加速技术创新、延伸产业链,来应对市场的震荡。

  今年一季度,我国货物贸易进出口10.3万亿元,累计增速由负转正,重压下走出一条上扬线。

  如何帮助外贸企业在激烈的环境中继续站稳脚跟?

  各地坚定不移办好自己的事,推动政策靠前发力、尽快落地见效——组织针对外贸企业的“问诊会”,向企业“送政策、送服务、送要素”,组织企业出海开辟新市场,进一步掌握发展主动权。

  记者:王竹艾王怿文李涛

  某款维生素D滴剂,医院售价47.4元,定点零售药店售价63元,电商平台则低至29.8元

  同一款药,为何医保定点零售药店药价更高?

  阅读提示

  受访专家认为,药品定价受到多重因素影响。对于公立医院、定点零售药店、互联网平台等经营主体来说,其药价差异源于运营模式、成本管理水平、监管政策等方面的差异。

  “不比不知道,一比吓一跳。”近日,来自辽宁大连的王鑫(化名)告诉记者,自己怀孕后查出缺乏维生素D,医生给她开了一盒价格为47.4元的双鲸维生素D滴剂(胶囊型)。这盒药吃完后,王鑫又在家楼下的定点零售药店购买同品牌同规格的药物,看到价格为63元,比医院贵15.6元。疑惑之下,她打开某电商平台进行搜索,发现一些店铺29.8元就能买到同款药品。

  记者采访发现,王鑫的经历并非个案。来自杭州的张先生曾在药店购买感冒药时发现,同一款药,药价35元,而外卖平台购买只需11.3元。

  有参保人告诉记者,在一些定点零售药店购药时,药价不仅高于医院,甚至比电商平台贵两到三倍。此外,不同定点零售药店之间的药价差异也较大,让人感到困惑。为什么会出现这种价格差异?记者对此进行了深入采访。

  同一款药,药店和电商平台价差3倍

  去年冬天,张先生患上感冒,他本打算在外卖平台下单楼下药店的感冒药,但为了省配送费,还是决定到店买药。店员向他推荐了云丰风寒感冒颗粒,售价为35元一盒。但张先生发现,同一款药物,该店铺的外卖价格却是11.3元。

  经过一番交涉,店员表示,张先生可以按照线上的价格支付,但不能使用医保卡。张先生有些犹豫,他的医保个人账户里还有不少余额,“不刷的话也取不出来”。但面对3倍的价差,他最终决定用现金支付,不使用医保个人账户支付,“医保卡里的钱也是自己的钱,应该用在刀刃上。”

  来自北京的孕妇关仪(化名)有过相似的经历。她遵医嘱补充维生素D。而她服用的星鲨维生素D滴剂(胶囊型),药价差异也很大,“单位附近的医保定点零售药店卖54.3元一盒,而一些网店售价14.9元一盒,前者比后者贵两倍多。”

  为了解同地区其他药店的价格情况,记者打开国家医保服务平台APP,进入北京专区中的“医保药品比价”板块,输入关仪购买的药品查询发现,北京共有168家定点零售药店售卖该药,价格自29.5元至68.5元不等,其中有137家药店售价高于50元。

  根据该平台页面显示的联系方式,记者致电西城区某药店。店员说,该药品售价为56元一盒。当被问及为何价格远高于互联网平台时,店员表示,该药店是全国连锁,按统一价格售卖,不清楚公司定价的衡量因素。

  “药价如此差异,合理吗?”几位受访对象都向记者表达了这样的困惑。

  哪些因素影响了药品定价?

  受访专家认为,药品定价受到多重因素影响。对于公立医院、定点零售药店、互联网平台等经营主体来说,其药价差异源于运营模式、成本管理水平、监管政策等方面的差异。

  首先是经营成本。北京中医药大学卫生健康法治研究与创新转化中心主任邓勇说,国家启动集采后,公立医院的药品采购成本降低,很多定点零售药店尚未参与集采,药品进价可能偏高。此外,药店房租、人员工资、医保对接管理成本等,都会体现在药价上。

  “互联网药店之所以具有价格优势,一方面在于运营成本较低,部分大平台与药企直接合作,拿到较低的采购价。另一方面,在激烈的市场竞争下,很多平台通过低价策略揽客。”邓勇说。

  中国政法大学政治与公共管理学院副教授廖藏宜从价格政策角度分析称,公立医院已实现药品销售“零加成”。而定点零售药店的药品要分情况来看,一些地区开展集采药品“进零售药店”试点,为集采药品售价划定范围,如湖南要求定点零售药店在集采中选价基础上顺加不超15%销售。除此之外,药店作为市场主体,对其他药品具有自主定价权。

  记者注意到,国家发展改革委等部门于2015年发布的《关于印发推进药品价格改革意见的通知》规定,除麻醉药品和第一类精神药品外,取消药品政府定价,完善药品采购机制,发挥医保控费作用,药品实际交易价格主要由市场竞争形成。

  但廖藏宜同时表示,自主定价权的行使是有限度的,必须确保定价的合法性、公平性、合理性。如果一些药店过分追求利润,出现价格虚高、价格欺诈等行为,或造成医保基金的“跑冒滴漏”,侵害参保人的权益,破坏医药市场公平竞争的环境。

  推动药价回归合理区间

  据国家医保局统计,截至今年2月,全国已有29个省(区、市)及新疆生产建设兵团上线定点零售药店比价功能。邓勇表示,“比价神器”的推出有助于打破信息差。他提示参保人,购药之前可通过官方平台进行比价,选择性价比高的购买渠道。此外,要充分了解医保政策,合理使用医保个人账户,避免浪费。

  近期,不少地区进一步完善医保药品价格监测体系,为定点零售药店的药价划出“红线”。例如,自2025年起,辽宁省按年度确定量价比较指数监测值,作为价格监测“警戒线”,重点关注量价比较指数偏高的定点零售药店医保药品价格,一旦高于“警戒线”,药店会受到提醒、约谈或通报。

  “自去年起,国家医保局开展‘药品追溯码’采集应用试点工作。有了这张电子身份证,药品的产销路径清晰可查,不合理定价问题也有望及时被发现。”廖藏宜说。

  在防止医保基金被滥用、保护参保人权益方面,廖藏宜建议,一方面,医保部门要强化定点零售药店协议管理,加大飞行检查力度;另一方面,目前,江苏南京等地对定点零售药店开展分级管理,从服务环境条件、药学服务能力、诚信经营等方面对药店进行量化评分,依据评价结果实施不同的管理举措,提升监管精准性,这值得其他地区借鉴。

  邓勇认为,医保部门可推动更多定点零售药店参与集采,帮助其降低采购成本,缩小药店与医院间的药价差距。记者了解到,去年5月,国家医保局印发通知,明确提出“推进医药集中采购提质扩面”“鼓励和引导村卫生室、民营医疗机构、零售药店参加集采”。

  “相较于其他购药渠道,定点零售药店方便可及,有专业药师进行指导,还能让参保人在家门口享受医保报销待遇,这也是其获得青睐的原因。而随着医药市场竞争日趋激烈,定点零售药店应当增强自律、合规经营,才能持续被信任、被选择。”廖藏宜说。(工人日报记者陈曦)

  24小时智慧图书馆供学生族专注学习,多语种沙龙让中外居民以书会友,免费文化体验课使老人孩子乐在其中……在湖南湘江新区,70座图书馆如毛细血管般嵌入每个社区,共同织密成一个“15分钟文化服务圈”,满足不同群体阅读需求的同时,还让9.44万余持证读者步行15分钟内,即可“邂逅”一处阅读空间。

  湖南湘江新区(岳麓)图书馆馆长邓薇表示,“15分钟文化服务圈”让阅读变得触手可及,其缩短的不仅是物理距离,更是一座城市对精神平等的追求。未来,他们将继续优化服务细节,为城市的文化繁荣注入更多活力。

  (李盈张雪盈长沙报道)

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