Consequently, hospitals are joining in to put pressure on medicine wholesalers and distributors. These small stores never buy medicines from official suppliers and they evade taxes. Hospitals are embarrassed when small stores expose their high profit margins on medicine sales. The root of this problem lies in sky-high medicine prices, which provide wholesalers with a fat profit margin, large enough to allow these wholesalers to use unofficial methods to open the door to hospital sales by offering kickbacks. As for who receives these kickbacks and how much money is involved, this information is extremely difficult to obtain.
Wholesalers naturally regard kickbacks as part of their costs.
In addition, if those hospital employees who facilitate medicine purchases do not receive large kickbacks, they will undoubtedly be unhappy. However, this is not a problem unique to only drug stores and medicine companies. The massive web of problems brought by the convoluted way this system works makes it nearly impossible for hospitals to extricate themselves. When pharmaceutical manufacturer sales reps promote medicines at hospitals, it is very difficult to prevent influencing the way doctors prescribe medicines. Even if medical treatment facilities and drug suppliers are separate, reps will still promote medicines to doctors and doctors will still write kickback-oriented prescriptions.