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    Home > Medical News > Medical World News > An innovative exploration and business game of pharmaceutical business chain under the pressure of "one vote system"

    An innovative exploration and business game of pharmaceutical business chain under the pressure of "one vote system"

    • Last Update: 2019-12-02
    • Source: Internet
    • Author: User
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    Wen Yingjiao Yanli Drug price middlemen have been criticized for a long time "Drug delivery - national general agent - provincial agent - drug bidding procurement - District, city, county agent - pharmaceutical company - hospital - patient" is the traditional drug circulation mode After a drug leaves the factory, it needs to go through multiple links of circulation and several turnover of several commercial companies to reach the hospital and patients Every circulation will produce personnel salaries, medical agent fees, bidding fees, advertising fees, public relations fees, agent profits and other costs After adding the codes layer by layer, the actual sales price of drugs is far from the factory price And, in this kind of circulation mode, there are even enterprises that sell tickets and launder money In 2011, CCTV's weekly quality report reported that the price of some drugs was even increased by more than 6500% in the middle link Reducing the circulation link has undoubtedly become the key point to solve the false high drug price In recent years, the government has issued many policies, such as 4 + 7 centralized purchase, in response to the problem of virtual high drug prices In 2019, reducing drug prices remains one of the policy focuses In October 2019, Shandong Province issued the implementation plan of "two ticket system" for drug procurement of public medical institutions in Shandong Province (Trial Implementation), which pointed out that it is necessary to select some drugs with large consumption and simple market supply channels in the third-class and first-class comprehensive hospitals in the pilot cities for Trial Implementation of "one ticket system", and encouraged regions with conditions to adopt joint procurement, centralized payment and other forms with cities and counties as units Ask for the implementation of "one vote system" for drug procurement On November 15, 2019, the State Council issued the notice on further promoting the experience of deepening the reform of the medical and health system in Fujian Province and Sanming City, which pointed out that in 2020, according to the national unified deployment, the scope of centralized procurement and use of drugs by national organizations will be expanded Comprehensive medical reform pilot provinces should take the lead in promoting medical insurance agencies to directly settle payments with drug production or circulation enterprises, and other provinces should also actively explore This means that the "one vote system" will be gradually promoted in all provinces Drug "one vote system" means that the number of drug circulation shall not exceed one time The hospital and drug enterprises directly settle the payment for goods, and the drug enterprises and commercial companies directly settle the distribution expenses, which can greatly reduce the drug circulation expenses, purify the circulation environment, promote the transparency of industry information, and facilitate the supervision and traceability of drugs Before that, many provinces have issued relevant policies to encourage or start the pilot drug "one vote system", such as Guangdong, Zhejiang, Hubei, Shanxi, Shaanxi, Beijing and Tianjin As a pioneer, as early as 2016, Fujian Province clearly required hospitals to directly settle accounts with drug manufacturers and strictly implement the "one vote system" when purchasing basic infusion Source network, arterial network mapping At present, the pilot cities are all aiming at some drugs and implementing the "one vote system" in some hospitals The policy of Shandong Province is also to choose some drugs with large amount and simple market supply channels for Trial Implementation of the "one vote system" No province has implemented the "one vote system" for all drugs and all regions, but many insiders believe that the "one vote system" for drugs should be fully implemented Maybe it's not far Under the "one vote system", how to seek new profit growth points for commercial companies and how to build brand and marketing network for pharmaceutical enterprises have become the focus of discussion in the industry Aoya.com interviewed famous doctor Zhonghe CEO Jiang Qiang, yaofei.com CEO Xiao Lingfei, pharmaceutical cloud founder Dian Canghe and other relevant people in the pharmaceutical industry, and got the following opinions: It took more than two years to carry out the pilot project of "two vote system" for drugs At the end of 2016, the medical reform office of the State Council and other ministries and commissions jointly issued the implementation opinions on the implementation of "two ticket system" in the drug procurement of public medical institutions, requiring medical institutions to check that the tickets, goods and accounts are the same before they can be put into storage and used when drugs are accepted and put into storage On January 9, 2017, the national health and Family Planning Commission issued the implementation opinions on the implementation of the "two vote system" in the drug procurement of public medical institutions (for Trial Implementation), announcing the beginning of the "two vote system" nationwide "Two ticket system" refers to that the pharmaceutical production enterprises issue one invoice to the circulation enterprises and the circulation enterprises issue one invoice to the medical institutions, which can reduce the circulation links of drugs, standardize the circulation order, improve the circulation efficiency, reduce the false high price of drugs, and crack down on illegal affiliation, commercial bribery, tax evasion and other acts After the implementation of the "two vote system", the business companies, large and small, are the first to be affected Commercial companies: transforming into CSO and laying out primary medical market The way for commercial companies with terminal channels to deal with "two vote system" is to transform into CSO (contract sales organization) Through the identity of CSO, get rid of the identity of national general representative and provincial representative, directly connect with pharmaceutical enterprises in local areas, seize terminal resources, maintain local business channels together with pharmaceutical enterprises, and do not involve tickets and goods, only need to sign consulting contracts with pharmaceutical enterprises In addition, some large-scale commercial companies also respond to the "two vote system" through strategies such as the layout of primary market, merger and acquisition integration, and drug retail For example, Cr Pharma has completed M & A of many Prefecture and city level projects and successfully entered Jiangxi, Qinghai and Xinjiang markets through M & A According to the group's annual report, in the first half of 2017, the year-on-year growth rate of distribution business of Cr Pharma reached 16%, the contribution of M & a business was 2%, and the year-on-year growth rate of hospital direct sales business was 20% Pharmaceutical enterprises: self built business team and sales network If it is a pharmaceutical enterprise with standardized operation, self owned brand and self built team development terminal, no matter it is "two vote system" or "one vote system", it has little impact on such pharmaceutical enterprises For pharmaceutical enterprises without terminal and brand, they need to build their own business team and sales network to handle the issues of delivery, invoice and payment collection The effect of "two ticket system" on reducing drug price is not obvious In the specific implementation process, many insiders found that the "two vote system" did not play a significant role in reducing the drug price In the past, with the help of ticketing companies, reducing the cost of invoicing and avoiding the risk of withdrawal were the two main purposes of bottom price invoicing in pharmaceutical enterprises Before replacing business tax with value-added tax, the invoicing cost of the invoice passing company was far lower than that of the production enterprise Therefore, the enterprise chose the base price for invoicing and asked the dealers to find the invoice company for invoicing, so as to save costs Moreover, the expense of the sales of commission money must be withdrawn through channels Most enterprises are unwilling to bear this risk, and can only be solved by the dealers themselves Therefore, the ticket passing company has assumed the role of withdrawal After replacing business tax with value-added tax, the billing cost of the ticketing company is no longer superior to that of the enterprise, and the enterprise no longer looks for the ticketing company, but directly opens on its own, so the cost increase is inevitable; on the other hand, the demand for cash withdrawal still exists, and most of the enterprises will be handed over to the dealers for handling in consideration of risks, and the dealers will look for the ticketing company or set up their own companies to be responsible for the payment Now, the withdrawal cost and risk will increase, and the increased cost of these two parts is finally reflected in the drug price In addition, economy magazine once reported that after the "two ticket system", some small-scale commercial companies "changed the skin" of the pharmaceutical enterprise departments, carried out ticket scalping to earn distribution fees, and there was a phenomenon of ticket evasion In contrast, the introduction of "one vote system" is obviously more able to protect drug prices and purify the drug circulation environment In the traditional circulation mode, the commercial company undertakes two functions: advance fund and distribution After the "one vote system", it is not feasible for commercial companies to transform into CSOs, because across commercial companies, medical insurance directly settles with enterprises, and commercial companies no longer play the role of capital advance payment, only the function of delivery Generally speaking, under the "one vote system", commercial companies have become the role of couriers, leaving only the distribution function, and the profit space has been compressed Dian Canghe, founder of pharmaceutical cloud, said: "under the" one vote system ", social logistics enterprises may take the opportunity to intervene in the pharmaceutical distribution business For pharmaceutical enterprises, there are more options for pharmaceutical distribution." This is another competitive pressure for commercial companies Commercial companies: actively transform, expand business and find new profit growth points Xiao Lingfei, CEO of Yaofei network, said: "the purpose of the" one vote system "reform is to further optimize medical insurance payment and rational drug use This will further enhance the industry concentration and put forward higher requirements for cost control of commercial companies Commercial companies without service capacity and distribution network will be out of the game, and finally several large-scale commercial companies will stay on the market " Some insiders also believe that the demise is not the only outcome of small business companies They can choose to invest in pharmaceutical enterprises, become regional management, transform and serve hospitals and other institutions, break away from the existing operation mode and become consulting institutions They can also use the precious resources accumulated before to connect with social logistics enterprises to help them develop markets and achieve win-win results One interviewee told arteria.com that after the "one vote system", pharmaceutical companies tend to choose commercial companies with lower distribution prices The competition of commercial companies will focus on distribution costs, and their profits will be thinner In this regard, Xiao Lingfei believes that distribution fees will not be the only source of profit for commercial companies Xiao Lingfei said: "enterprises with large volume, high turnover rate of warehouse, perfect management system and strong distribution ability will indeed occupy a competitive advantage, but commercial companies can also use industry contacts and resources to create new profit growth points through merger and acquisition integration, extension of industry chain, acquisition of pharmaceutical enterprises and other ways." For example, Shanghai Pharmaceutical has acquired the circulation enterprises kantle and Lepu pharmaceutical; Sinopharm holdings is actively expanding the field of equipment and strengthening the construction of its own equipment channels; Jiuzhoutong has focused on the pure sales of primary medical market, and launched fbbc ("F" refers to upstream pharmaceutical production enterprises, the first "B" refers to Jiuzhoutong, the second "B" refers to terminal pharmacies and clinics, "C" refers to terminal pharmacies and clinics Consumer.) Business, layout Internet Medical These measures can deal with the negative impact of "one vote system" to some extent In addition, Jiang Qiang, CEO of mingyizhonghe, believes that the primary medical market in China is scattered, with a large number and a small demand for single type of single institution Therefore, it is difficult to implement "one vote system" in the primary medical market, clinics and small medical institutions in a short time Commercial companies still play an irreplaceable role in these three markets, and can continue to work in these three markets Pharmaceutical companies: build their own team and marketing network, and will be out without innovation ability The implementation of "one vote system" for drugs has obviously affected pharmaceutical companies less than commercial companies After the "one vote system", in the face of a large number of medical institutions, pharmaceutical companies want to achieve docking and information exchange with hospital terminals, they must establish a business team and build a marketing network In addition, a person in charge of an innovative drug R & D enterprise said that products are the core competitiveness of pharmaceutical enterprises No matter "two vote system" or "one vote system", the market demand for innovative drugs will not decrease Xiao Lingfei also said: "now, many pharmaceutical enterprises are selling duplicate varieties Under the" one vote system ", it is more difficult for commercial companies to pass tickets and transfer payments in the past Pharmaceutical enterprises without innovation ability and product advantages will be out in large numbers." Therefore, the majority of pharmaceutical enterprises need to focus on the construction of product quality and innovation capacity Diancanghe said that he wants to implement it nationwide
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