The role of digital pharmaceutical governance in alleviating health inequality

Background Irrational drug use poses a persistent challenge to healthcare quality and economic efficiency. In the context of China’s “Tight-knit Urban Medical Group” reform, this study analyzes a digitized pharmaceutical governance model designed to bridge the gap in pharmaceutical care between tertiary hospitals and primary healthcare facilities. We aimed to analyze the implementation and public health correlation of a Centralized E-prescription Review (CEPR) platform within a regional medical network. Methods A retrospective, observational real-world study was conducted in Sanya, China. We implemented a CEPR platform utilizing a dual-layered cloud architecture and non-invasive data acquisition (XTL) to integrate regional drug metadata. The system incorporates an AI-driven engine fusing Large Language Models (LLMs) with Retrieval-Augmented Generation (RAG) to provide clinical decision support. A total of 441,327 prescriptions were analyzed over a 12-month longitudinal period. The Cochran-Armitage trend test was employed to evaluate temporal shifts in prescription safety, economic efficiency, and service homogeneity. Results Following the implementation of the CEPR platform, the initial prescription pass rate at primary healthcare institutions rose significantly from 75.00 to 95.12%, and a 99.30% pharmacist intervention success rate was achieved across more than 16,000 intercepted high-risk orders. Regarding economic efficiency, the average cost per outpatient visit decreased by 4.58%, while inpatient drug costs dropped by 23.5%, accompanied by the implementation of a technology-based integrity oversight mechanism. Notably, the regional irrational prescription rate over 12 consecutive months of operation decreased markedly from 11.92 to 7.35% ( χ 2 = 328.42, p < 0.001), demonstrating a robust temporal association between platform deployment and quality improvement. Conclusion The CEPR model, characterized by the “Sanya Model,” serves as a digital lever for enhancing the accessibility and homogeneity of high-quality pharmaceutical services. By shifting medication safety from a site-specific resource to a standardized public service, this framework supports the “Three medical linkage” (San Yi Lian Dong, i.e., the integrated reform of medical services, health insurance, and pharmaceutical systems) collaborative reform. These findings provide a scalable governance paradigm for improving public health resilience in regions with unevenly distributed medical resources

Cloud computing · Corporate governance · Health care · Medical prescription · Observational study · Pharmacist · Antibiotic Use and Resistance · Healthcare Systems and Reforms · Pharmaceutical Quality and Counterfeiting

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