Collection and price limit how can the pharmacy break the game?

In recent years, the intensity of health insurance control fees, in addition to the centralized procurement to significantly reduce the price of drug procurement, but also through the REFORM of the DRG payment system, as well as the standard of medical insurance payment this "command inglis", to reduce the burden of health insurance funds and ordinary people to pay.
against this background, retail pharmacies, especially health insurance-targeted retail pharmacies, certainly cannot stay out of the way.
such as the recent launch of the third batch of national collection and reporting work, Guangdong and other places to encourage the active participation of pharmacies, and hospitals synchronous reporting.
in addition, Zhejiang, Xinjiang and other places also put forward the "maximum price increase of 15%" price limit standard situ at the fixed-point pharmacies.
industry insiders said that under the impact of volume procurement and medical insurance price limit, retail pharmacies should actively change marketing strategies, active transformation and upgrading, adjust management methods, broaden sales channels, in innovation, from humanized services and health management, integration of resources and cost reduction to achieve a breakthrough.
drugstores to participate in the collection of benefits than the disadvantages Of the recent, the third batch of national procurement volume is in full swing.
according to media reports, the Guangdong Provincial Health Insurance Bureau in the third batch of national collection and collection of the work document sferpercent, pointed out that all private medical institutions and retail pharmacies can voluntarily participate in the third batch of centralized procurement of national drugs.
Guangdong Province's "pharmacy and hospital simultaneous reporting" model, can be said to be the third batch of national collection of a bright spot. Liu Mingrui, a senior pharmaceutical industry expert at the
, said that the experience of drug collection in Guangdong Province is a leading country in the country, and there are many places to learn from.
this collection, the pharmacy has the opportunity to directly report the amount of the hospital, the future product winning bid, the pharmacy will be able to get the same collection price as the hospital.
this is very good news for both pharmacies and patients at large.
, however, Zhuhai Pharmaceutical Circulation Industry Association President Su Weixuan on the pharmacy to participate in the collection of different understandings.
in his view, the simultaneous reporting of pharmacies and hospitals is convenient for manufacturers of production plans and distribution, such as the annual plan.
if it were to go back to the planned economy of the past, it would actually be inconvenient for business.
it is understood that in the recent first round of Guangdong retail drug collection and mining pilot, a total of 17 retail pharmacies involved, the amount of more than 110 million yuan, a number of manufacturers to "4 plus 7" winning price, even lower than the winning bid price, to the drugstore supply, the average price of drugs fell by 61.2%.
in addition to Guangdong active pilot pharmacies to participate in the collection, Shandong, Jiangsu, Guizhou, Xinjiang, Zhejiang and other places also sent a letter to encourage retail pharmacies to actively participate in the collection.
this, Su Weiyu think that this is both a home-and-down, but also helpless.
"At the moment, there are more advantages than disadvantages, because collection has a price advantage, but at the same time the problem is: procurement is relatively passive, inflexible, " he said.
" Liu Mingrui also analyzed that under the command inglis of the medical insurance payment standard, the national products of the fixed-point retail pharmacy of medical insurance will fall into the dilemma of price inversion, which will encourage pharmacies to participate in a certain degree of centralized tape procurement, in order to reduce the difference between the purchase and sale of medical insurance varieties, to ensure operation, to attract passenger flow.
, Liu Mingrui also believes that the drugstore to participate in the collection is more beneficial than harmful, not only to obtain the ideal purchase price, but also conducive to prescription outflow, improve patient accessibility.
In addition, pharmacies can also enhance direct contact with pharmaceutical companies through centralized procurement, access to better manufacturer services.
but Liu Mingrui stressed that the current problem is whether the design of the recruitment process is reasonable, whether the amount of retail pharmacies is true, how strong the support of health insurance.
in general, the pharmacy's participation in the collection is still in the stage of trying to explore and constantly improve.
it is understood that the current drugstore participation in the collection of only in the above-mentioned provinces to carry out the pilot, not in a large area of the country spread.
reason, Liu Mingrui explained, on the one hand, the policy is still in the exploration stage, on the other hand, small and medium-sized chain, single drugstores difficult to participate in, they participate in the "quantity" alone is not attractive to pharmaceutical companies.
according to media reports, in 2019 the four major listed drugstore chain market share of only about 10%, based on such market concentration judgment, in the short term, drugstores involved in the collection is also difficult to spread large areas.
"If it is a government request, or in the face of the current price contrast is large, enterprises are still willing to participate."
," Mr. Suweyadded added.
up 15% is unfortunate in encouraging pharmacies to participate in the collection, while the health care sector also through the "health insurance payment standards" to regulate the operation of pharmacies.
recently, the Zhejiang Provincial Health Insurance Bureau issued the "Zhejiang Province to enhance the function of centralized drug procurement platform to promote the payment standards of medical insurance drug full coverage reform program."
program to improve the standard system of medical insurance drug payment system, and pointed out that: "targeted public medical institutions and private medical institutions to implement the same standard of payment for medical insurance drugs."
fixed-point retail pharmacy medical insurance drug payment standards unified according to the medical institutions payment standards up to 15% (excluding state and provincial negotiated drugs) to implement, floating amount in the minimum package not more than 200 yuan.
" it is understood that before Zhejiang Province, Xinjiang, Yunnan, Jiangsu Taicang and other places, also on the medical insurance fixed-point pharmacies put forward a "maximum price increase of 15%" price limit standard. why
why do these places propose a "maximum price increase of 15%" limit for health-care-targeted pharmacies? Not 10% or 20%? Mr Liu said the 15 per cent mark-up rate was based on a fixed hospital drug mark-up rate of 15 per cent.
the National Development and Reform Commission issued in 2006 "on the further rectification of the market price order of drugs and medical services" has proposed that "county and county medical institutions sell drugs, based on the actual purchase price, plus no more than 15% of the mark-up rate, on the basis of the mark-up rate of the increase income for the drug plus", therefore, the pharmacy price increase of up to 15% has a certain policy basis.
for pharmacies, after all, is the nature of the operation, so the price increase is too low will lead to a reduction in profits, the price increase may lead to patients can not accept out-of-hospital prices.
therefore, it is relatively reasonable to set it within 15%.
Su Weiyu pointed out that if it is a collection of varieties to allow pharmacies to increase the price of 15%, pharmacies can still accept, but if all the medical insurance drugs to take a 15% increase in the standard, is very unrealistic, because the current operating costs of pharmacies are very high, generally account for 32%-38% of sales, the price increase of 15% of enterprises also how to survive, so this is unrealistic.
it is worth noting that although the mark-up rate is limited to 15%, the specific implementation is not exactly the same, mainly in the benchmark price of health insurance drugs.
Xinjiang and Yunnan are based on the selected price, the drugstore price increase can not exceed 15%.
and Zhejiang Province is in the "determined medical institutions payment standards on the basis of the up 15%" (excluding the state and provincial negotiated drugs) implementation, floating amount in the minimum package up to a maximum of 200 yuan.
Liu Mingrui believes that for pharmacies, the two different price limit benchmarks are slightly different in nature.
Xinjiang, Yunnan model provisions in the choice price increase of 15%, is actually limited, pharmacies can only earn 15% more money for patients, while the Zhejiang model requires pharmacies to pay 15% of the price of medical insurance, meaning that the health insurance fund to pay 15% more to pharmacies as a guarantee, while pharmacies can still obtain additional profits through market behavior.
contrast, the Zhejiang model is relatively relaxed for pharmacies.
for the impact of the mark-up rate at 15 per cent on pharmacies, Mr. Su said that if the profits were not enough to cover the various costs, many pharmacies would not survive, either opt out of health insurance and lose the big "cake" or accept the loss, which would be difficult for policymakers to get from the ground up.
in fact, as early as the "4 plus 7" urban area procurement expansion, the State Health Insurance Administration mentioned, "health insurance fixed-point retail pharmacies involved in this procurement, may allow them to be on the basis of the price of the right price appropriate increase, the part beyond the payment standard by the patient pay, the following part of the payment standard by the medical insurance reimbursement in accordance with the provisions."
" From this point of view, the drugstore price increase of up to 15% of the price limit standard, or will become a national uniform price limit standard.
Liu Mingrui from the provinces issued a comprehensive analysis of the document, said that all over the country to the fixed-point drugstore mark-up rate of 0%, 15% of the two versions, in terms of the proportion alone, 15% is currently a more uniform standard, but the specific price increase or health insurance price increase, still to be discussed.
in addition, at the beginning of the volume of procurement, the industry is very worried that if the fixed-point pharmacies and medical institutions to implement a unified standard of medical insurance payment, taking into account the cost and cost of the autonomous operation of pharmacies, most of the health insurance drugs will appear inversion prices, resulting in large-scale losses.
therefore, the industry believes that, compared with the "flat in and out", can now give health insurance fixed-point pharmacies 15% mark-up rate, has been unfortunate.
Liu Mingrui agrees.
said that from the data, the four more transparent operating conditions of the four listed drugstore chains, the 2019 annual report shows that gross margin is basically about 38%.
and the price of drugs into the collection of large reduction, leaving the drugstore profit smaller than before, at this time to give the standard of health insurance payment 15% up, is also taking this into account.
, although su Weijuan also agree with this view, but also pointed out that the price of pharmacies than medical institutions, will lead to a reduction in passenger flow, but also not conducive to meeting the needs of ordinary people.
especially chronic disease medication, people would rather go to medical institutions to buy, even if the drugstore price increase 15%, in fact, can not solve the problem of store costs.
in order to improve competitiveness, it will have to do not increase or increase a little less, so that the profits of pharmacies will be less.
concluded: "There is no doubt that pharmacies will be in a much harder position under the pinch of volume purchases and health-care price limits."
to this, Liu Mingrui suggested that pharmacies should comply with policy changes, mainly around operating profits to find countermeasures: 1. Different products to take different marketing models, medical insurance drugs are mainly used for drainage, small profits and sales; 2. Adjust the proportion of different varieties, moderately increase the sales of high gross margin categories, realize the multi-source of pharmacy profits; 3. Pay attention to the collection of non-middle-aged original research drugs, use brand advantages to obtain profits; 4. play synergies, combine sales, use collection varieties to drive the sale of non-collected varieties; 5. active transformation and upgrading, improve industrial concentration, gradually develop into large chain pharmacies to form the advantages of the amount of profit, and thus take advantage of the benefits of the opportunity to develop
, Mr. Su wei-yin, also suggested that pharmacies could work innovation, seeking breakthroughs in humane service and health management, integrating resources and reducing costs.
.