Compared to the mature monitoring and reporting system of ADRs in developed countries such as the USA and EU,medical institutions in China have played too much a role.Instead,local primary monitoring and reporting system of ADRs should expand their scope of monitoring and reporting,as drug makers,chain drugstores and retailers should develop an effective ADR monitor/report system as well.At present,such a primary system is plagued by insufficient budget and staff,imbalanced urban/rural layout and defective statements.Recommended measures include enhanced surveillance for drug makers,chain drugstores and retailers,for higher reporting ratio of ADRs at primary level; greater publicity and better monitoring and penalty mechanism; better platform for various organizations.