30 years of survival history of pharmaceutical middlemen.

Introduction: Reform and opening up, "92 South Tour" to stimulate the pharmaceutical commercial market.
more than 20 years after the election, the market has been squeezed by policy.
large, medium and small dealers in the market, how to step through the beach, in the changing market constantly find new business opportunities? Article source: Cai Jian dao (WeChat ID: Artof Wealthand Health) article, Hai Ru Mirror Editor, Yang Zhongxu "no middlemen to earn the difference", this popular advertising phrase deeply rooted in people's hearts, but under the market competition, the upstream and downstream reasons for giving profits to middlemen, precisely because it provides an irreplaceable service.
In the field of medicine, pharmaceutical companies are indispensable in the circulation of pharmaceutical companies, from the pharmaceutical industry to hospitals, pharmacies, primary health hospitals and other terminals to the hands of patients.
as a middleman who does not produce drugs, pharmaceutical commercial companies assume the functions of distribution and distribution, agent distribution, and have also been born such as China Pharmaceutical Holdings, Shanghai Pharmaceuticals, Kyusju Tong and other listed companies.
Recently, the third batch of national collection opened the bid landing, Shanghai area of the winning drug distribution by state-owned enterprises, at the same time, the National Health and Safety Commission in 2020 inspection of the wind to open, focusing on "consolidating the effectiveness of the field of pharmaceutical circulation."
a long time, circulation links and hospitals for the price of drugs falsely high "back pot", the relevant departments in the field of drug circulation of administrative control has also been increased.
For example, it is hoped that by reducing circulation links and changing the "multi-vote system" to a "two-vote system" to solve the problem of inflated drug prices, the once-popular "pharmacy trusteeship", also known as the drug distribution enterprises to the public medical institutions to transport benefits, was banned.
every policy change in china will lead to the circulation of medicine "pattern change", "face unprecedented challenges" and other statements.
for pharmaceutical commercial companies, from dealers who earn the difference between purchase and sale to distributors who take 5% of the purchase price, a series of changes have taken place in the circulation of pharmaceuticals under the role of policies and markets.
the distributors who could have bargained with upstream pharmaceutical companies and downstream hospitals, have become distributors? How do they compete when drug price yields are "locked in"? The main focus on the pharmaceutical circulation link of the "two-vote system", so that drug sales waist-slashing with the volume of procurement, and how did they have an impact? 1 once "secondary bargaining", drug prices can be discussed in the planned economic period, pharmaceutical companies can not directly sell drugs to hospitals and other terminals, must be through the "three-level station" layer-by-layer transfer.
to the early 1980s, because the administrative business model led to low distribution efficiency, many drug stations operating losses, difficult to sustain.
Guangzhou pioneered the emergence of a profit-oriented drug management contracting system, and then followed suit, and now Kyushuan Chairman Liu Baolin was the first in Hubei Yingcheng contracted the town's wholesale drug department.
more than 20 years ago, Wen Zhuo resigned from public office and entered the drug market to start a business, and is now an executive of a head pharmaceutical business company.
, according to his recollections, during the planned economy, China was short of medicines, medicines were sellers' markets, and there were no strict price controls.
drug factory, from wholesale to retail, agreed to increase the price of 15% sales.
" medicine is more tight, in the bottom a little more expensive to sell, OK.
", "92 South Tour", market-oriented reform accelerated, local pharmaceutical companies are booming, Xi'an Yangsen, Sino-American Shk, Wuxi Huarui and other joint ventures in China's pharmaceutical companies have also begun mass production, China's drug market from oversupply to oversupply.
1993, Feng Hang, who had been marketing in a joint venture pharmaceutical company for five years, went to Zhuhai, a special economic zone, to join Lizhu Pharmaceuticals.
Fenghang said that at that time, all provinces and cities had local leading pharmaceutical commercial companies, such as Xi'an is Xi'an Pharmaceutical Company, Harbin is Harbin City Pharmaceutical Company.
"Early on, we all had to work with pharmaceutical commercial companies because they had a push-and-sell function, and you sold him drugs, and he could help you get to the terminal."
" at that time, the management of pharmaceutical commercial companies has not been completely separated, government and enterprises, the general manager of local pharmaceutical companies often by the local pharmaceutical management bureau chief or deputy director.
such as Shanghai Pharmaceutical Co., Ltd. listed in 1998, then-chairman Shen Peida was the party secretary of the Shanghai Pharmaceutical Administration.
In 1999, the former State Economic and Trade Commission issued the Guidance on the Reform of the Pharmaceutical Circulation System, which "allows and encourages all walks of life and various economic components to participate in pharmaceutical circulation enterprises through mergers, reorganizations, joint and other means", and the pharmaceutical wholesale industry is officially open to private enterprises.
more than 16,000 pharmaceutical companies this year, and drug sellers are becoming more crowded.
"pharmaceutical commercial companies need to be related to the hospital, at that time there is no distributor's statement, are dealers, each distributor has its own territory."
" Wen Zhuo said, some pharmaceutical commercial companies are the local health sector of the tertiary industry, into the hospital has no small advantage.
due to serious oversupply, the drug market's voice balance turned to hospitals, commercial companies handed over drug catalogs, flyers, hospital pharmacy department directly sketched the procurement methods began to change.
whether it is pharmaceutical commercial companies, or pharmaceutical representatives, need to pay a certain cost to seize the channel.
in Wen Zhuo's memory, in the early years with the pharmacy, often send some eggs, local products, the director bill of lading to the director of the signature is not difficult.
" to the doctor is also interesting, in the packaging to do articles, a few boxes of medicine in a rice cooker, or a heating cup, after the sale can leave these things.
"Although it was not uncommon for gold sales and commercial bribes to be paid before 2006, hospitals were largely normal business models: increased revenue and reduced consumption."
for pharmaceutical commercial companies, it's much less expensive to get the hospital president (CEO) and the pharmacy department (purchasing department) done than to get a group of doctors.
because even if the buyer's appetite is large, it is rare to ask for a few percent of the purchase price to fill the pocket.
"he would never say, "Into 100 million pills, you follow 15% to me."
" at that time, many parties competed for public hospital channels, in addition to the relationship between the table, rebates, but also need to face the price competition.
In the hospital-based bidding collection, pharmaceutical commercial companies, pharmaceutical companies and hospitals can bargain - based on the winning bid "talk deduction", that is, often heard 85 buckles, 80 buckles (80% of the retail price).
For the hospital director, pharmaceutical committee members, "can be directly discounted, buyers should also take care of the face, the same medicine can not put cheap do not, expensive."
," said an analyst at the China Pharmaceutical Enterprise Management Association.
WenZhu also expressed a similar view, " (responsible for procurement) the dean can take a little advantage, but if a drug, he chose 85 buckles, not 78 buckles, then others will question, this is market-generated supervision.
" as a drug distributor, relationship, pricing, service and other factors determine the scope of the market it can expand;
" can talk about the price, the purchase volume is large, the return of fast hospitals, dealers to the drug price can be lower.
", before 2006, the difference between purchase price and retail price was once the part of the hospital's balance that could be retained, and it was also the source of the hospital's power to keep the purchase price of drugs down.
With the hospital's competitive price pressure, the actual purchase price of many drugs is less than half of the winning bid price, which not only makes the leading drug bidding agencies quite embarrassed, 50% of the gross profit margin of drugs also brought the hospital "profiteering" question.
but how much of the difference between purchase and sale is reasonable in the hospital? At that time, the drug price policy loose tight, 10 years, the State Planning Commission (later for the National Development and Reform Commission) carried out 21 administrative price reductions, but the results are still not satisfactory.
In 2006, the Price Division of the National Development and Reform Commission (NDRC) was directly stuck with a key indicator: the rate of return, which stipulates that hospitals should increase the price of medicines by up to 15%, with the initial intention of giving to patients (see Opinions on further rectifying the market price order of medicines and medical services (Reform Price No.
but by locking in "profit margins" alone, it does not control the absolute value of profits.
for medical institutions, to obtain the same profit value, only the purchase price of drugs to be high.
drug prices have since spiralled out of control, and sky-high drug prices are emerging.
addition, because the city organized the drug tender procurement chaos, in 2005 the State Council, the Ministry of Health began to promote Sichuan province-based, government-led centralized bidding procurement.
but the tender is only to recruit qualifications and prices, some low-cost drugs even if the winning bid is "only not to pick."
of this policy overlay is that hospitals prefer to use high-priced drugs, and pharmaceutical companies seek to bid at high prices.
For dealers, once the price reduction marketing is not good, bidding "access" has become the top priority for drug sales, hand-eyed natural persons and the bottom price of the large contractors more popular, the industry often said 85 buckles, 80 buckles, but also become 10 buckles, 20 buckles.
like Wen Zhuo to do this wholesale business dealers, to a certain extent, retreated into distributors.
2" who can afford to drag the account, let who distributes "provincial drug centralized tender procurement, the process is quite complex, the need for pharmaceutical companies to provide a variety of documents.
In the era of consistent evaluation of generic drugs, tender units to the original research, patents, FDA certification, EU CE certification, GMP drugs, enterprise size, scientific and technological progress awards and other indirect indicators, to identify the quality of drugs.
Wen Zhuo said, bidding to make clear the advantages of the enterprise, need to prepare a lot of documents, heard that more to use the car to pull, very energy-consuming.
2007, the former Ministry of Health issued a new "Prescription Management Measures", which stipulates that medical institutions need to implement "one product, two regulations" for the procurement of drugs, that is, a drug variety, injection type, oral dosage form can not exceed 2 kinds.
but some provinces in the implementation of tenders, the "two rules" as a raw drug, a domestic generic drug.
the price of the original drug is high, under the rule of a 15% discount increase, the absolute value of profits available to hospitals is correspondingly high.
coupled with the brand advantages of foreign pharmaceutical companies, strong promotion, many of the original research drugs even after the patent period, in China can still maintain high prices, high market share.
when the original drug occupies a winning quota, many domestic pharmaceutical companies to squeeze on the tender "one-wood bridge", not only to bid, but also to cast a high price.
such "technical activities" have spawned natural persons and agents who specialize in bidding, often with extensive land resources and connections, such as relatives and friends of local health department managers.
With the tender, and hospital transactions are based on the winning bid price, no wholesale price, the parties began to compress the profits of commercial companies, "because I feel that business is useless, promotion is our own dry, medicine sold to you can not be how, but also we have to go to the hospital, doctors."
then someone started giving commercial companies 10% of the distribution point, is no longer zero, the competition between businesses is very fierce, each other to the gross margin of only about 5 points.
, " Feng Hang said, at this time, some commercial companies become the function of distribution, return, inventory.
compared with Shunfeng, in addition to distribution, pharmaceutical intermediaries also need to advance capital to buy goods.
Faced with this transformation, Wen Zhuo felt very helpless, the winning varieties are very scarce, a lot of winning varieties in the hands of natural persons, want to distribute to seek people, price competition, "money has been drug bugs (drug dealers) earned away."
there is no bargaining space upstream, downstream also have to face the hospital drag.
Before bidding, dealers can also make profits through wholesale prices, incentive the hospital to pay back a little faster, after bidding, regardless of the speed of repayment, the price paid by the hospital is no difference, naturally no incentive to quickly return, and in order to compete for the market, some dealers through the "extended account period", take the initiative to bear the financial costs, to the hospital profit.
" this time our dealers are very bitter, in fact, play the role of financial institutions, on the one hand, the hospital arrears drag for a long time, then who has money, can afford to drag, let who distribute, the equivalent of we are advances.
, on the other hand, production enterprises also need an institution to trade in front of taiwan, do not come forward.
" Wen Zhuo or used to call themselves "dealers."
The right to speak transferred to the winning varieties of natural persons and agents, in the power, money, they layer by layer "clear customs", drug bidding office, medical insurance directory, doctors, hospital presidents, pharmaceutical committees, each link of the dredging fees are eventually superimposed on the winning bid of drugs, plus 15% sold to patients and health insurance.
in the tender, the real factory price of many drugs is only 10%, 20% of the winning bid price, known as 10 deductions, 20 deductions.
the same drug, the price in Anhui Tai he, Guangdong Puning and other wholesale markets, and the price to the hospital may be more than 10 times different.
2010, Hunan exposed sky-high asparagus tablets, Xiangya Second Court purchase price (winning bid price) is 13 times the factory price.
but in Wen Zhuo's professional observation, there are many more cases than this exaggeration.
Ginkgo biloba injection produced by a pharmaceutical company, the cost price of 0.16 yuan / branch, the manufacturer set the price of 0.48 yuan / branch, 200% gross profit.
but after the hospital's 15% price increase, only a few cents of profit, almost no one is willing to open the drug, the drug is slow to sell.
" later someone dialed: need to re-price, sell 16 pieces / branch, open one on the return of 8 yuan, and then try again.
" in this way, the price difference of a hundred times, and after the price of hot asparagus tablets, Ginkgo biloba injection into the hospital to sell.
Beginning in 2009, the policy of zero-plus drug prices began to replace the policy of 15% increase in the price of drugs, and gradually implemented in primary health hospitals, county hospitals, secondary and above hospitals, so that hospitals can obtain the difference between the purchase and sale of drugs to zero.
but the zero rate is removed from the winning bid price of 15% of the public mark-up, and did not touch the "gold sales" space implicit in the winning bid price.
drug prices have not eased; hospitals have no incentive to supervise doctors, medical representatives formed a community of interests, supervision and containment is more difficult to carry out.
CCTV in a survey listed five drugs in the list price, the market price of the multiply, and pointed out that doctors charge rebates as high as 30%-40% of the price of the drug.
in this chain of interests, pharmaceutical companies to 10 buckles, 20 buckles of the floor price to sell drugs, access to the national general agent operating rights of large contractors, regional agents.