Harbin pharmacies shut due to widespread fraud

Four pharmacies in Harbin, capital of Heilongjiang province, have been shut down and terminated from the medical insurance system as part of an investigation into a medical insurance fraud case involving more than 10,000 falsified prescriptions, China Central Television reported on Tuesday.

Authorities have frozen 62.23 million yuan ($8.74 million) in medical insurance funds related to the case, according to the report.

Fifty-one people have been subjected to criminal coercive measures, with 13 in criminal detention, three in administrative detention and 15 released on bail pending trial, according to authorities.

The fraud case was uncovered after a data analysis by the Big Data Center of the National Healthcare Security Administration revealed unusual activity at a Harbin pharmacy. Investigators found that 96 insured individuals had made abnormally large purchases, with some spending over 1 million yuan on medications over two years, CCTV reported on Monday.

The investigation focused on excessive purchases of Suke Xin, also known as Doptelet (avatrombopag) tablets, a medication prescribed for short-term use to treat liver disease. One patient reportedly purchased 2,400 tablets — far exceeding the clinically recommended dosage — and consumed them over 800 days, spending more than 1 million yuan.

Medications like Doptelet are classified as "special drugs" that are used to treat specific conditions and require strict documentation, including prescriptions, during sales to prevent fraud. However, the patient's son admitted to purchasing the medication without providing a prescription.

"Every time I went to the pharmacy, they gave me medications for three months," he said.

Further investigation into the pharmacy and three others revealed widespread use of fraudulent handwritten prescriptions, many of which were purportedly from institutions such as the Harbin Medical University Cancer Hospital, even though the hospital had stopped giving handwritten prescriptions long ago.

Investigators also discovered prescription books at one pharmacy filled with consistent handwriting, despite being signed by various doctors.

One pharmacy manager admitted that the fraudulent prescriptions were provided by a pharmaceutical representative, while another pharmacist confessed to purchasing prescriptions online and processing them.

Some customers told the inspection team they had bought prescription drugs at inflated prices for years without needing to present a prescription. As a result, the National Healthcare Security Administration handed over case details to local public security authorities.

An expert cited by CCTV said that problems such as fake medical treatments, resales of drugs covered by insurance and people cashing out medical insurance funds have long plagued regulators, and stricter oversight is needed.

In response, the administration announced plans on Monday to recruit 20 social supervisors to enhance the supervision of medical insurance funds. Their role will be to monitor the use of funds by designated medical institutions and insured individuals, reporting any irregularities or illegal activities.

"The goal is to strengthen social oversight and mobilize broader participation in safeguarding the security of medical insurance funds," the administration said in a statement.