There are 365,440 pharmaceutical technicians in China, accounting for 8.14 per cent of the total medical technicians. Of this, 243,380 (66.59 per cent) are apothecaries and 122,090 pharmacists.
Nearly 90,000 pharmaceutical technicians are qualified with above junior college education. About 50,000 of them have bachelor degree. Of late, there are more and more pharmaceutical technicians with doctor or master degree.
The pharmaceutical department in hospitals are in medical institutions are referred as Pharmacy.
Like any other pharmacists, dispensing of medicines forms the major responsibilities of the pharmaceutical department in hospitals. Dispensing has been attached great importance in China, whose major tasks include scientific supply and management of drugs, participation in the clinical drug treatment, drug information service, drug restructuring and alleviation of the economic burden of the patients.
Hospitals affiliated to medical schools and those at provincial or municipal levels have both traditional Chinese medicine (TCM) pharmacy and Western Medicine pharmacy. The TCM pharmacy is responsible for the dispensing of herbal pieces and prepared TCM. In some hospitals, the pharmaceutical department has a TCM Decoction Section, which provides decoction service for inpatients and outpatients.
Western pharmacy is usually divided into outpatient pharmacy and inpatient pharmacy. There are more outpatients in Chinese hospitals and the ratio between inpatients and outpatients is 1:2 to 1:3. For example, a hospital with 1,000 beds usually receives 2000 to 3000 outpatients a day.
Besides a comprehensive outpatient pharmacy, for the convenience of the patients and the prevention of cross infection, there are also departmental pharmacies, such as emergency pharmacy, paediatrics pharmacy, infectious disease pharmacy, dermatosis pharmacy, etc. For the distribution of drugs, 1/3 of the pharmacies are handled by pharmaceutical technicians, while 2/3 of them are handled by nurses.
In-hospital preparation
The advent of in-hospital preparation was caused by the backwardness of the Chinese pharmaceutical industry. In earlier days, drugs were scarce health care resources and the demand for drugs far exceeded supply. In order to ensure the implementation of health care work and meet the people's needs of prevention and curing of diseases, the pharmaceutical technicians set up in-hospital preparation department despite of the tough conditions during the civil war.
A group of effective and popular in-hospital preparations had been developed, such as histamine phosphate injection for desensitization, lidocaine injection for partial anesthesia and anti-arrhythmia and some antidote injections, the oral preparations such as pepsin mixture, aluminum hydroxide gel, Vitamin D2 oil and liquid paraffin wax, the external remedies for dermal diseases and other antidotes, disinfections, enema, suppositories and special preparations for dental, ophthalmology, otorhinolaryngological, obstetrics and gynecology departments.
These in-hospital preparations is vital for resolving the shortage of supply during the civil war and the post-war period, making great contributions to the elevation of the effectiveness of drugs.
Faced with shortage of transfusion liquid and urgent demand for clinical use at the beginning of the 1950s, the pharmaceutical technicians developed various kinds of transfusion liquid, such as amylaceum sodium chloride injection liquid, 5% and 10% amylaceum injection liquid, 0.9% sodium chloride injection liquid, ringer-locks liquor and normal saline for external use. These achievements have significant impact for the transfusion treatment in China.
At the end of the 1950s, in order to support the TPN study, the pharmaceutical experts collaborated with the clinical study experts and developed a series of new drugs for TPN treatment, such as amio acid injection, high-penetration amylaceum injection, electrolyte preparations and infinitesimal element preparations. The development of these drugs has made the TPN treatment a huge success in clinical use.
TCM: Traditional Chinese Medical Science and Traditional Chinese Medicine are the characteristics in Chinese medical study. The pharmaceutical technicians have attached great importance to the study of TCM and their application in hospitals and made great achievements in the study and development of TCM preparations.
New types of TCM dosage have been developed, such as sugar liquor, tablet and powder. These new types had made initial exploration on the modernization of TCM dosage and provided a promising prospect for the wide usage of TCM dosage in hospitals.
With the development of science and technology around the world and the opportunities provided by the reform and opening-up policy, the drug preparation industry has experienced fast development. However, for in-hospital preparations, their development have been restricted by the nature of hospital, the characteristics of in-hospital preparation, the production and management models, the backwardness of equipment and technology and sub-standard management. It is very hard to set up a quality control standard for some in-hospital preparations.
The Drug Administration Law passed by the People's Congress on February 28 2001 has clear restrictions on in-hospital preparations. Plus a series of restrictive policies adopted by competent authorities on in-hospital preparations, the number of in-hospital preparations has shrunken dramatically. In recent 1 or 2 years, 2/3 preparations made by medical institutions have been shut down.
Drug Supply
For a long time, the pharmaceutical industry in China had been underdeveloped, with few types of drugs and low production. In order to cope with the demand by medical service, the purchase of drugs and ensuring drug supply had long been one of the important task of the pharmaceutical department of Chinese hospitals.
In recent years, with the advent of new drugs in international and domestic markets and the overheat of Chinese pharmaceutical enterprises and the drug circulation sector, the supply of some drugs has already exceeded demand. The objective of drug supply in hospitals turns to reducing inventories, increasing drug circulation and minimizing the circulation cost of drugs.
Clinical Pharmacology
The concept of clinical pharmacology was first introduced in China at the end of the 1970s. With the support of the administrative organs and the pharmaceutical experts, the actual study and practice was started in 1980s. Over the past 20 years, clinical pharmacology has made the following progresses:
(i) exploration on the participation of pharmacists into clinical treatment and the use of medicine
(ii) carrying out the supervision of treatment medicine and practicing individual dosage
(iii) monitoring the safety and adverse reaction of drugs
(iv) Carrying out study on pharmacodynamics, group dynamics, and the efficacy of drugs;
(v) Carrying out the study on bioavailability and interaction of drugs
(vi) Pharmaceutical information, including compilation of pharmaceutical journals and consulting services. All the hospitals affiliated to medical schools and those at provincial and municipal levels have pharmaceutical information center. They have also set up pharmaceutical information desk in outpatient pharmacy, providing consulting services on the use of drugs for the patients,
(vii) Developing new types of dosage on the basis of clinical study, especially developing new TCM from the traditional preparations through the extraction of effective components
(viii) Developing the clinical pharmacology for TCM
(ix) Human resources cultivation. Some hospitals have set up workshops, some have established clinical pharmacology education in cooperation with pharmaceutical schools and some have sent their staff to master and doctor programmes. It should be noted here that the 7th and the 8th achievements are uniquely Chinese.