平遥| 鄂温克族自治旗| 莲花| 黄石| 湘潭县| 闽侯| 南陵| 芦山| 九龙坡| 全椒| 通城| 通河| 诏安| 定日| 兰坪| 湖南| 南宁| 金阳| 青州| 旺苍| 图木舒克| 从化| 阿克陶| 石嘴山| 德兴| 横山| 永善| 丹棱| 西华| 连江| 彰武| 滨海| 丰南| 维西| 高密| 疏勒| 浚县| 康县| 献县| 惠农| 太谷| 南涧| 蒙自| 益阳| 富裕| 秀屿| 长沙| 乡宁| 盐城| 逊克| 龙川| 曹县| 镇赉| 盐边| 沧源| 新泰| 铅山| 杨凌| 徐水| 衢江| 遵义县| 前郭尔罗斯| 柯坪| 宣化区| 商水| 双柏| 勃利| 昌吉| 北宁| 汕尾| 旅顺口| 封开| 鲅鱼圈| 中宁| 厦门| 谷城| 湖口| 白朗| 乐至| 辉县| 始兴| 松潘| 永丰| 海沧| 瑞金| 阿合奇| 定西| 嘉义县| 原平| 类乌齐| 故城| 兴城| 富裕| 砀山| 宕昌| 兴文| 昌江| 新蔡| 围场| 将乐| 仙桃| 安庆| 临澧| 夷陵| 讷河| 华池| 阳城| 元谋| 广德| 桂平| 唐山| 桦川| 右玉| 龙江| 牙克石| 桐城| 八达岭| 淮阳| 铜鼓| 科尔沁右翼前旗| 英德| 娄烦| 崇阳| 陇西| 青河| 进贤| 聂荣| 屯留| 万山| 衡阳县| 盘山| 鄄城| 临清| 沽源| 密云| 二连浩特| 大同市| 凌源| 平塘| 仪陇| 滦南| 兴县| 杜集| 揭西| 乐昌| 邯郸| 新田| 工布江达| 莱芜| 蒙山| 长乐| 汉沽| 吴起| 横山| 江华| 平山| 盐田| 进贤| 滦南| 昆明| 崇义| 独山| 木垒| 普陀| 大通| 梧州| 霍邱| 乌拉特前旗| 科尔沁右翼中旗| 闻喜| 马关| 达坂城| 绛县| 东西湖| 新安| 泰安| 隆子| 奇台| 台安| 漠河| 通化市| 平昌| 丰顺| 大关| 格尔木| 台前| 晋城| 崂山| 邵阳市| 铅山| 理塘| 三穗| 张北| 安阳| 六合| 龙江| 歙县| 聂荣| 广州| 洪洞| 明溪| 前郭尔罗斯| 宜章| 白朗| 光泽| 蕲春| 普安| 林州| 盐津| 峡江| 满城| 上思| 玉山| 漾濞| 海口| 五华| 大宁| 古交| 连州| 临清| 琼山| 拉萨| 全州| 镇平| 融安| 太和| 普宁| 息烽| 惠安| 汕头| 和龙| 隆林| 察雅| 界首| 舒兰| 隆回| 平潭| 岳阳市| 宁南| 杞县| 无锡| 大连| 庄河| 永靖| 新龙| 德阳| 邓州| 旬邑| 本溪市| 八宿| 永济| 平原| 修武| 长治县| 河津| 泰宁| 达孜| 宁南| 沁阳| 昂仁| 陇西| 安徽| 山丹|

日本的节点:日本式资本主义复兴之时

2019-05-21 07:32 来源:39健康网

  日本的节点:日本式资本主义复兴之时

  WhatwasbehindthedecisionbySamsungtoacquireHarmanBothcompanies,HarmanandSamsung,(tothepartnership).Samsungbringscarelectronics,semiconductortechnology,sensors,displays,,ifyoucombinethesetwo,youhavethesbusinessThisnewrelationshipisextremelypowerfulforallourautomakers,,andHarmanisamarkuctsandsolutionswit,S,willHarmanexpandfasterhereWehaveamandatefromSamsungtocontinueo(TechnologiesCoLtd)(Inc),andwewilljointlydev"firewalls"betweenthe,,whilecompetingwithAppleinthesmartphonemarket,,beenaroundfor70yearsandk,elligenceT,,ouraugmentedrealitysolutionenablesdriverstoreceivetipsonnavigationorwarningsofroadconditionsaheadonadisplayscreen.(Wecombinethiswith)"contextual"navigationalprompts,,,thiscanbecombinedwithothertec,orher,,,,sowhatisyourmanagementstrategyConsumerswantdifferentproductsthatmeetthedemandsofvariousscenariosincars,,eneedsofcustomersatevery,,ShanghaiAutomotiveIndustryCorporation(SAIC),BYD,BMWBrilliance(BMWJV),,wecanofferautomakersarangeofsolutionst,,,,allourbesttechnologies,whetherdevelopedinChinaorelsewhere,,ourspouse,ourfamilyhastobeveryunderstandingbecauseourjob,ourresponsibility,,"Imgoingtobehomeeveryeveningat5pm,",andsometimesforweeks,"purpose",:60Nationality:UnitedStatesCareer:2017:PresidentandCEOofHarmanInternationalIndustriesIncBefore2008:PresidentofABBGroup,presidentforABBglobalautomationdivisionandboardmemberofBristol-MyersSquibbandRaytheonEducation:MastersdegreeinengineeringfromtheIndianInstituteofTechnology(IITRoorkee).”入围“年度最美女人”榜单的10位候选者,经过三场风格迥异的时装秀惊艳亮相之后,修文硕、朱美逸、王江华最终优胜加冕,在盛典的舞台上魅力绽放。

BernardCharles,chiefexecutiveofficerofsoftwarecompanyDassaultSystemes.[Photo/VCG]Thebeautyofvirtualrealityisthatithelpsyouimagineabetterworldevenifyoudontknowhowtoachieveit,saystheheadofFrenchsoftwarefirmDassaultSystemesWhenBernardCharleslandsinBeijing,,hisChinese"contact",WeChata,includingaviation,andwasinvolvedinChinasfirsthomegrownlargepassengerjet,theC919,whichmadeitsmaidenflightinMay."Whenwesetupacollaborativeplatformtohelpdevelopthenext-generationcivilaircraftinthecountry,weworkedwithsuppliersfromEuropeancountriesandothernations,"Charlessaid."BymakingthemvisibletonewclientsinChina,wearebuildingavirtualbelttoconnectthemhere,",DassaultSystemesisbasedinVelizy-VillacoublayinthesouthwesternsuburbsofParisandhasamarketcapitalizationof$,,000andaclientlistwhichincludesChinasleadingaircraftmanufacturer,CommercialandAircraftCorpofChinaLtd,,theworld,thesoftwaregiantislookingtoincreaseitspresencehere."Wewanttobethecatalystandenablerof(helpingtotransform)manufacturing,",hewentontotalkaboutDassaultSystemesadeaspeechattheBoaoForumin2015,forusthatthedoor,globalizationbringschallengestotheworldbutitalsohelpsi,thewinnersarenotthosewithbigslicesofthemarket,ativ,itisquitedifficultforalotofFrenchsmall-andmedium-sizedenter,sfutureprospectsinChinaTheneedforthecountrytotransformthemanufacturing,wewanttobethebest"catalystandenabler"of(helpingto),,andmanufacturingprogramsinEuropeandtheUnitedStatesTheyal-,b,intermsofmanufacturing,atithelpsyouimagineabetterworldevenifyoudones,suchasenvironmentaldegradation,,onbases,,theworldistransportingmanythings,suchasrawmaterialsandwaste,everyday,,,wecanliftthemfivetimeslessinrealitybyusingVR(toscaneveryangleoftheproducts).ThatsavestimeandenergyespeciallyinChina,stechnologyisusedindifferentindustries,,itisnotonlyaboutwhatwecando,,butifweunderstandwhatisvaluable,andifwebelievewecandoitbetter,thenwehavetotry(tobethebest).Sinceyoutookover,DassaultSystemeshasgoneonabuyingspree,buthowdoyouintegratethosecompaniesintothegroupWearealwaysatadisadvantagecomparedtoourcompetitors,especiallythosefromtheUS,,welearnhowtodobusinessindifferentcountries,,ifyouwanttoconvincesomeonetobewithyou,-,,,ourcustomersareverystrong,yimportanttoacompany(tendto),,,suchasvisitingmuseums,:60Nationality:FrenchCareer:2016:vice-chairmanandCEOofDassaultSystemes1995:presidentandCEOofDassaultSystemes1988:promotedtopresidentofstrategy,researchanddevelopmentatDassaultSystemes1983::AgraduateoftheEcoleNormaleSuperieureengineeringschoolinCachanandaPhDinmechanicalengineering,:Marriedwithfivechildren,inthefirsthalfoftheyearChinasmaternitymortalityratereached183per1millionpeople,hinauntiltheendoflastyear,whenthetopleadershipapprovedtheadoptionoftheuniversaltwo-childpolicytotackletheproblemsposedbythenation,thedecades-longfamilyplanningpolicy,whichlimitedmostcouplestoonechild,,themortalityrateduringpregnancyfellto201per1millionpeoplefrom300per1millionin2010,accordingtothecommission,butthefigureisnowrising."Theriseinthenumberofpregnantwomen,particularlythoseathigherrisksuchasolderwomen,resultedinariseinmaternitydeathsinsomepartsofthecountryinthefirsthalfoftheyear,"regnantinChinaeveryyearbetweenthestartofnextyearand2020,ari:"Thiswillcauseincreasedrisksinmaternitycomplicationsandpresentchallengestotreatmentandrecovery.",,asignificantincreasedespitethedecliningnumberofmarriedwomenoffertileage,,thesuddenriseinpregnancieshasresultedinmaternityservicescomingundergreaterstrain,andbothfacilitiesandhospitalstaffareunder-resourced,,60percentareage35orolder,whichmeanstheyareconsideredtobeathigherriskduringpregnancy,vedbyAnzhenHospitallastyear,,,manywomenareoptingtohaveanotherchild,accordingtoGu:"Manyofthesepatientsareseekingtreatmentandcareinourhospital,child,andtheirownlivescouldalsobethreatenedduringchildbirth."

  MOSCOW,June12(Xinhua)--RealMadridsprangtomassivesurpriseintherunuptotheWorldCupfinalsonTuesdayeveningwhentheyannouncedthatSpaincoachJulenLopet;firstlybecauseitcomesjustthreedaysbeforeSpainkickofftheirWorldCupcampaignagainstPortugalinSochiandsecondlybecauselessthanamonthagoLopeteguisignedanewcon(REFE)gaveLopeteguiavoteofconfidenceafterhetookthemtoRussiaafteranunbeatenqualifyingcampaignandnow:LopeteguialreadyhassixRealMadridplayersintheSpainsquadandhastakenaseventh(JesusVallejo)sdecisiontostepdownafterwinningathirdconsnecandidate,MauricioPochettinopricedoutoftherunningafterhealsorecentlysignedanewdealwithTottenhamHotspurs,whichdidn,butheisalsoattheWorldCupwitGermany,whileArseneWenger,currentlywithoutemployment,,theformerRealMadridandSpainmidfielder,whocurrentlycoachestheclubsJuniorteam,hadrecentlytakenuppolepositiontoreplaceZidane,buthislackofexperiencewasclearlyafactor,topaytotheRFEF,whowilltakeovertheBernabeuhotseatandperhapsclubPresident,FlorentinoPereziscongratulorldCupcampaign:eLopeteguiastheirbossforthenexttwoyearsThereisachanceitwon,butitishardtothinkRealMadridsannouncementwillhaveimprovedtheatmosphereintheSpainsquadorstrengthenedthefeelingofunityorgiventheplayerstheconfidencetheircoachisasfocusedonthetournamentastheyare,whenhendWorldCuptitle,whenhealsoshouldbehelpinghisnewclubprepareforthecomingseasonafterwhatisshapinguptobeabusysummerinthetransfermarketRealMadridliketopresentthemselvesasagentlemanclub;aclubofhonor,whichrepresentsthebestofSpain:thisactionwillbeseenbymanySpaniardsasbetrayalofthecountry,theeditorofSpanishsportspaper,DiarioAS,wasquicktoreact,publishingacommentpieceinwhichhesaidRealMadridwerea"factoryforproducingpeoplewhohateRealMadrid,"andthemoveiscertainlynotgoingtohelptheclubsimage,theendoftheWorldCuporuntilSpainwereknockedout,beforeannouncingtheappointment,:IfSpainwintheWorldCup,Lopeteguiwillarriveasahero,butiftheyunderperformandfailtogetpastthequarter-finals,hewillbeadisappointmentandthatwillmeantheknivesareoutforhimfromdayone.ConstructionworkersremoveabillboardfromtheroofofabuildingnearTiantanParkinBeijingonNov28.[Photo/Xinhua]TheBeijingcitymanagementauthorityislimitingthenumberandplacementofsignsonbuildingsinorderto"createanurbanskylinethatisvisuallyclearandbright",,,therecanbeonlyonesignwithabuildingsnameonthethirdorhigherstories,ands16districtswilllaunchanenforcementcampaign,thenotificationsaid,andanyfailurebyinstitutionsandindividualstoremove"noncompliant",nearly9,,000signsandbillboardsthatarenon-compliantacrossthecapital,thenewspaperquote,700sig,havingremovedalmost2,willinspectthecapital"roadbyroad",someworriedthatitwillbedifficultforthemtofindtheirdestinations."Sometimes,whenIamlookingforfriendsIhavemadeanappointmentwith,Icaneasilyletthemknowmyexactlocationbytellingthemwhatsignisovermyhead,"saidZhangZhenyu,tlikethefeelingofwalkingnearbuildingswithsignsovertheroofs."Someofthesignsorbillboardshavebeenthereforyearsandtheymayfalldown,"thenetizencommentedonWeibo.

  我非常期待与中国领导人讨论中美关系”。BEIJING,June14(Xinhua)--China,slowerthanthe7-percentriseinthepreviousmonthbutstillfasterthanthe6-percentincreaseinMarch,,,flatwiththatofthefirstfourmonths,,officiallycalledindustrialvalueadded,isusedtomeasuretheactivityofdesignatedlargeenterpriseswithannualturnoverofatleast20millionyuan().Abreakdownofthedatashowedtheproductionandsupplyofelectricity,thermalpower,,,,informationtechnology,andbusinessservicesmaintainedrobustincreases.

要遵循市场规律,实行差异化金融政策,对于长期亏损、失去清偿能力的企业要坚决退出,对于出现暂时经营困难的企业,相关各方要加强沟通协商,采取积极措施共同努力,帮助其渡过难关。

  Suspectaccusedofcontractfraud;globalcampaignreachesmidpointAglobalcampaigntocatchChinasmost-wantedfugitivessawthereturnofits50thcorruptionsuspect,,47,whohasbeenontheruninHongKongfornineyears,-internationalarrestwarrants-storyresearchdepar,,halfofthe100corruptfugitiveshavebeenbroughtbackfrommorethan16countriesandregionstostandtrial,whichfullyreflects"Chinasfirmdeterminationandresoluteconfidencetopursuethefugitivestotheend",,anumberofChinesecorruptofficialsanddirectorsfromState-ownedcompanieshavefledtotheHongKongorMacaospecialadministrativeregionsoroverseasdestinationstotakead,theyhavesentmillionsofyuaninillegal,in2014,theCentralAnti-corruptionCoordinationGroup,ledbytheCCDI,launchedtheSkynetprogram,morethan2,600fugitivessuspectedofeconomiccrimeshadreturnedtoChinafromover90countriesandregionstofacecharges,includingtheUnitedStates,($)hadbeenrecovered."Wewillcontinueouractionsandleavenosafeheavenforthefugitives,"theCCDIsaidinastatement."Nomatterwheretheyarehiding,wewillmakeeveryefforttobringthembacktofacejustice."

  TheanimaltrainersatOceanParkhavelearne,youcanseehe,the125-kilomalegiantpandawhopresidesoverthepandahouseatHongKongsOceanPark,,glidesdownthegentleslopesandgesturesthathewantstoplaywithhistoys;,itswidelybelievedthatbehindeverysuccessfulpanda,,aterrestriallife-sciencesupervisor,doesn,,Leungobservesjusthowmuchthepandaeats,whichsideofhisjawheusestochewandotherimportantcluesabouthishealth.",",LeLesfemalecompanion,,theparksvetsdiscoveredthattheteethontherightsideofherjawweredecayed,andsetaboutfixingtheproblem:"Topreventfurtherdecayandtominimizetheimpactonherdiet,"TheHongKongnativehasbeenwiththeparksince2010,whenhereturnedfromtheUnitedStateswithabachelor,theparksseniorpandas,whichweresentasconservationambassadorsbythecentralgovernmenttomarktheestablishmentoftheHongKongSpecialAdministrativeRegionin1997.目前网剧市场井喷,超越卫视剧成为行业主战场。

  OpennessandinnovationwilldominatetheagendaofthisyearsFortuneGlobalForuminGuangzhouwhentopexecutivesoftheworldslargestcompaniesgatherinthesouthernChinesecity,underscoringChinasrisingroleasastrongadfrominternationalCEOsintheChinesemarketbutalsoamanifestationofthecountry,whichlastfromDec6to8,willcenteronthetheme"OpennessandInnovation:ShapingtheGlobalEconomy"andglobalbusinessleaderswillsharetheirviewswiththeirChinesecounterpartsontopicsincludingthelatesttrendsinthetechnologicalrevolution,theoutlookfortheworldseconomy,andhowmultinationalcompaniesshhereportdeliveredbyGeneralSecretaryXiJinpingatsontheprospectsoftheworldssecondlargesteconomy,theimplicationsofChinasrisingmiddleclass,rapidurbanizationandexpandingdigitaltechnologies,aswellashowthecountryeondevelopmentwithinternationalexperiencewillbenefitfutureglobaldevelopment."Theworldisnowfacedwithseveralcriticalissuesincludingthelackofaninnerdrivingforceforgrowthanddevelopmentandarisinganti-globalizationsentimentatthemoment,"saidXuHongcai,deputychiefeconomistattheChinaCenterforInternationalEconomicExchanges."ChinahascomeupwithsolutionssuchastheBeltandRoadInitiativethataimtocreateamoreopenandinclusiveinternationalcooperationplatformtofuelanewroundofdevelopment,",chiefcontentofficerofTimeIncandpresidentofFortunemagazine,saidthattheGuangzhouforumwillbeapowerfuldemonstrationoftheimportanceofglobalcommerceandtheprofoundchangethattechnologyisbringingtoglobalbusinessatatimewhenglobalizationisunderattack."Guangzhou,Chinassoutherngatewaytotheworld,,GuangzhouisbotharenownedsymbolandamodernmanifestationofChinasparticipationinglobalcommerce,",anothermajorthemeoftheGuangzhouforum,Chinahasbeentransformingfromacopycatintoaleaderintheareasofe-commerceandfinancialtechnology,thankstothecountrya,founderofChinase-commercegiantAlibabaGroupandPonyMa,chairmanofTencentHoldings,ersandsharetheirthoughtsonentrepreneurshipandwhatansformativetechnologiesonthehorizon,theimpactofChinaemergingasamajorinnovgiesincludingvirtualreality,artificialintelligence,autonomousvehicles,and3Dprinting,withaboutonethirdoftheworlds"unicorn"companies(startupsvaluedatmorethan$1billion)hailingfromthecountry,accordingtoglobalconsultingfirmMcKinseyCompany."TheChinesemarketplaceitselfisdemandingacapacitytoinnovatethatdidnotexistbefore,"saidJonathanWoetzel,,entrepreneurship,andaregulatoryenvironmentthathasbeenfuelinginnovationinChina.

  但评论指出,蔡英文不能踏足华盛顿,更不可以去国会演说。四是平衡各方利益面临很多制约。

  马晓光表示,我们一贯以一个中国原则对待台湾的对外交往问题。

  台媒发现,蔡英文与美方代表罗伊斯在台上互动密切,还频频“咬耳朵”(讲悄悄话),致词时也使用英语而非中文。

  FamilybondwithChinapersistsforsixgenerationsRecently,theFleyinWuhan,CentralChina,,,HaworthwasinvitedtothestageatCivicAuditorium,especiallyintheOpticsValleywherehecanseemoreforeignfacesthanever.“"HaworthvisitedWuhanforthefir,Hawort,theHaworthfamilyhasbeenconnectedwithChinaforsixgenerations,thatis,,H,"whenyouweretwo,,youknowthat"ThefirstpagesofhisgrandmothersgrandmothersgrsfatheralsotoldhimthathisgrandmothersnephewusedtohaveextensivebusinesslinkswithChinainthe1990s,whenthereformofmarketeconomyjuststartedinChina."IhavebeentomanyothercitiesinChina,,theinvestmentenvironmentandtherichresourceoftalentsfromuniversities,"saidHaworth.""HaworthalsosaidhehopesthathischildrencancometoChina,learnChinese,andcarryonthefamilytieswithChina."Itwillbetheirhugeadvantageinthefuture."ThesayinggoesamongretireesintheCaoyangneighborhoodofShanghaisPutuodistrictthatthehighestyieldperunitoflandinPudongisalwaysthenextplotofwastelandtobeconstructed,,constructedin1951,wasChinasfirst"newvillageforworkers"-aresidentialcommunityofmatchboxapa,suchas"modellaborer"and"advancedworker",wereallowedtoliveintheapartments,,oreastoftheHuangpuRiver,hadbeenasynonymofcountrysidefortheseseniorlocalssincePuxi,orwestoftheriver-whichdividedShanghaiintotwoparts-wasoccupiedbyWesterncolonialistsinthemid-19thcentury,,Caoyang,onceahigh-endcommunity,rkersinPudongmanufacturesatellites,airplanesandengines,saidPeiLei,aself-employedthirty-somethingelectronicengineerinPudongfromMaanshan,Anhuiprovince."TheHuangpuRiverseemslikeaboundarymarkingtheolddaysandthefutureofShanghaisindustrialdevelopment,",whichattractsyoungskilledworkersthroughaseriesoffavorablepolicies,providedhousing,,doublethatofPudong."IamproudtoworkinthefirstmatrixofChinaslargestandtheworldsthird-largestsynchrotronradiationlightsource,"saidHeYou,aresearcherinShanghaiSynchrotronRadiationFacility,,000timesthatofcommonX-rays,makingitpossibletodiscernthestructureofevenavirusandamicrostructureofsomematerials,Hesaid,explainingthefacilityassimplyashecould."Itislikeasupermicroscope,,,"Hesaid."go,andallofthemhavesuccessfullybeensenttospace,andworkedwell,"saidYuYingjie,earch,globalpositioning,atmosphericpollutionandclimatechangeresearch,andquantumcommunication.",devicesandassemblyunits,soastopromotetheupgradingofthewholeindustrialchainrelatedtothesatelliteengineering,",,23,anemployeeofthecompany,said:"Idreamofmakingarobotthatcanhelpthepeople,,fromelectricalmachinerytosteeringengineandcontroller."Halfayearaftergraduatingfromcollege,Xuhashadhisownteam,,withitsopenandhealthybusinessenvironment,high-qualitypublicservicesandsolidindustrialfoundation,attractsyoungtalentlikemagnets,saidZhangWeiwei,directoroftheChinaInstituteofFudanUniversityinShanghai.",oneofthemostvaluableassets,laysasolidfoundationforShanghaitoboostfurtherdevelopmentoftheseindustries."

  

  日本的节点:日本式资本主义复兴之时

 
责编:
FamilybondwithChinapersistsforsixgenerationsRecently,theFleyinWuhan,CentralChina,,,HaworthwasinvitedtothestageatCivicAuditorium,especiallyintheOpticsValleywherehecanseemoreforeignfacesthanever.“"HaworthvisitedWuhanforthefir,Hawort,theHaworthfamilyhasbeenconnectedwithChinaforsixgenerations,thatis,,H,"whenyouweretwo,,youknowthat"ThefirstpagesofhisgrandmothersgrandmothersgrsfatheralsotoldhimthathisgrandmothersnephewusedtohaveextensivebusinesslinkswithChinainthe1990s,whenthereformofmarketeconomyjuststartedinChina."IhavebeentomanyothercitiesinChina,,theinvestmentenvironmentandtherichresourceoftalentsfromuniversities,"saidHaworth.""HaworthalsosaidhehopesthathischildrencancometoChina,learnChinese,andcarryonthefamilytieswithChina."Itwillbetheirhugeadvantageinthefuture."

  廉价、救命药仍偏紧 广东督促药企供应

  本报记者 肖玫丽 广州报道

  近年来,药品断供问题在全国各地时有发生,主要聚集在廉价、救命药领域,一些医院因此无法开展手术或治疗。国家层面、各大地方采购平台则相继出台政策措施缓解这一困局。

  日前,广东省药品交易中心发布《药品交易中第五批未按合同供货及未及时供货企业》指出,根据医疗机构的投诉,广东共有1004个品规的药品不供货或者供货不及时。此次断供药品规模不小,其中有七成是急抢救、临床必用药和低价药,涉及药企多达135个,辉瑞、白云山云南白药等巨头涉入其中。

  3日,广东省药品交易中心相关负责人回复21世纪经济报道记者:“公示名单并不等同于公布黑名单,主要起到提醒督促供货、保障药品正常供应的作用,公示期可以视同缓冲期。如果药企未在公示期内按合同供应药品,则会进入非诚信黑名单。”

  近年来,药品断供问题在全国各地时有发生,主要聚集在廉价、救命药领域,一些医院因此无法开展手术或治疗。而药品断供背后原因繁多,对于药企而言,原材料价格逐年上涨,成本高、利润低的窘况使其生产缺乏动力。国家层面、各大地方采购平台则相继出台政策措施缓解这一困局。

  1004种药品断供

  广东省药品交易中心在官网挂出的公示显示,根据《广东省医疗机构药品交易监督管理暂行办法》和《关于广东省医疗机构药品非诚信交易名单的管理办法》的规定,按照广东省药品集中采购制度改革专责工作小组会议要求,此次公示期为2019-05-21至5月12日17:00。

  “平台会对公示期过后仍不供货的药企施以相应处罚。”广东省药品交易中心相关负责人告诉记者,“一个药企如果有两个品种进入黑名单,则不能再参与广东招标,意味着失去广东市场,这对于药企来说是非常严厉的惩罚,所以通常情况下他们都会在有关部门设定的期限内努力补救。”

  据了解,公示期截止后,对仍未按规定对医疗机构配送不及时或不供货的品规,广东省药品交易中心将根据药品监督管理办法,由广东省卫生计生主管部门会同有关部门取消该品规两年内在广东省的入市交易资格。

  而不配送或不及时配送等不履行合同约定的,则将根据药品监督管理办法,由广东省卫生计生主管部门会同有关部门将配送企业列入广东省药品非诚信交易名单,取消该企业两年内在广东省的配送资格。

  1004个品种,这一断供规模较为罕见。据统计,1004个药品中有711个是急抢救、临床必用药和廉价药,包括急抢救用药61种,临床必须且采购困难的32种,廉价药335种,其他基药品种283种。

  上述广东省药品交易中心相关负责人透露,平台系统筛选存在不可避免的误差,这是此次断供规模较大的主因之一。即,以往几批未供货名单仅限于竞价合同,此次公示包含议价合同,所以名单数量显得比过去多。

  而医院报了数量之后,药企会进行报价,此后存在不少医院迟迟不在平台签合同下订单的现象,此时卫计委等有关监管部门会催促医院签合同下单。部分医院在下完单后不久投诉药企未供货,这部分合同会计入未按合同供货的情形。另外,统计时间和公示期存在时间差,在公示名单时很多企业已经向医院供应了药品。

  “从以往几批公示的结果来看,最终进入黑名单的仅有10家企业左右,”该负责人进一步指出,“急救药、临床必用药医院都会有相应的替代品,目前不会形成明显负面影响。公示未供货名单本身是向药企施压的一种手段,目的在于保障药品供应。考虑到要平衡和保护交易各方的利益,平台设定公示期这样一个缓冲期,也会关注药企供货的一些实际困难,给予药企整改的机会。”

  多举措应对断供

  事实上,药品断供在全国各地时有发生。

  翻检过往,各地断供药品跟广东此次断供药品的共同特征是集中在廉价药、救命药等领域,例如近几年多次在全国各地出现断货的鱼精蛋白(抢救凝血障碍)、溴吡斯的明片(重症肌无力特效药)、平阳霉素(儿童肿瘤常用药)等药品。其中小容量注射液较为常见,此次广东公示的711个急抢救、廉价药中,小容量注射液最多。

  “当归注射液、胎盘注射液等以前常用来做穴位注射的,已经停了近10年了,”多次遇到药品断供问题的和新医生集团创始人、广州医科大学附属第一医院张子谦医生感叹,“这些注射剂一支才2毫升左右,便宜到我从来不记得单价是多少。医院没进货,不知道什么原因,可能是供应商的原因。”

  清华大学医院管理研究院研究员曹健则指出:“主要还是价格问题,中标价格太低,企业没有利润空间。现在制药企业数量太多了,GMP改造、一致性评价等出台之后没能大量淘汰不具备竞争力的企业,药企都奔着利润空间大的、高价药去生产,市场整体还是呈现无序竞争状态。”

  记者了解到,药企中标之后断供的原因繁杂,包括药企觉得无利可图而流标;中标企业觉得无利可图,产品虽然挂在网上却不生产,导致医院采购不到;因为赚不了钱,药企在药品生产批文到期了也不去继续注册,因此无法完成生产等等。

  明欣药业相关负责人向记者透露:“也有可能是上游原料药短缺。大部分药企自己不生产原料药,需要购进,如果原材料短缺或者突然涨价导致供应不协调,也会导致缺货。大部分药品更换原料药是要向卫生机关报备的,在没有批准之前更换原料药的这一类药品也不能发货。”

  面对短缺药的问题,国家层面近几年相继出台一些措施。例如2015年5月,《国务院办公厅关于完善公立医院药品集中采购工作的指导意见》文件中,提出了“对妇儿专科非专利药品、急(抢)救药品、基础输液、临床用量小的药品(上述药品的具体范围由各省区市确定)和常用低价药品,实行集中挂网,由医院直接采购”的具体规定。

  去年,为进一步解决短缺药的问题,国家卫生计生委体改司副司长姚建红指出,解决措施包括四个方面:纳入目录管理、信息系统、纳入定点生产管理、政府价格管理。

  各地采购平台也频频出手应对药品断供。前述广东省药品交易中心相关负责人向记者表示,根据广东卫计委发布的《关于规范全省医疗机构药品备案采购有关工作的通知》,因开展新技术、临床急(抢)救、特殊疾病、突发公共卫生事件及自然灾害医疗救治需使用的成交品种中无替代的未成交药品,可通过省第三方药品电子交易平台备案采购系统申报备案采购。

  “第三方平台目前正在研究探索更严格的药品供应风险防控机制,不排除会从经济处罚上着手。”该负责人说。

  (编辑:张伟贤,如有意见建议请联系:zhangwx@21jingji.com)

责任编辑:陈永乐

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