"Dual channel" is good for DTP pharmacy!

Medical Network News, June 4, May 10, the National Medical Insurance Administration and the National Health Commission jointly issued the "Guiding Opinions on Establishing and Improving the "Dual Channel" Management Mechanism for Drugs in National Medical Insurance Negotiations" (hereinafter referred to as the "Guiding Opinions"" ), to include varieties with high clinical value, urgent needs of patients, and low substitutability into the "dual channel" management
.

 

The so-called "dual channel" refers to the two channels of designated medical institutions and designated retail pharmacies that simultaneously satisfy the landing of drugs negotiated by the national medical insurance
.
What does this mean for DTP pharmacies?

 

"Dual channel" landing background and timing?

 

To understand the impact of the "dual channel" policy on the DTP pharmacy market, we must first understand the background of the "Guiding Opinions"
.
Since its establishment in 2018, the National Medical Insurance Administration has greatly accelerated the adjustment cycle of the medical insurance drug catalogue, shortening it from the longest 8 years to once a year, and even some new drugs were included in the medical insurance drug catalogue in the year they were launched
.
However, although the speed of medical insurance access has increased significantly, the hospital's drug access speed has not changed significantly
.

 

Access to medical insurance has accelerated, but access to hospitals is still slow

 

When drugs enter the hospital, clinicians must first evaluate the risks and benefits of the drugs, and then submit a drug application to the department; then the department will initially select and submit it to the hospital pharmacy committee, which will conduct formal review of the drug production license and other documents; Then, the hospital regularly convened the Pharmaceutical Affairs Committee.
Applicants focused on the reasons for drug application, comparison with existing drugs, irreplaceability, etc.
Experts asked questions and discussed and voted independently, and finally approved more than the number of experts participating in the meeting by 2 Passed at /3
.

 

At present, the frequency of meetings of the pharmaceutical committees of most tertiary hospitals across the country is once a year or once a half a year, and the validity period of the National Talks drug entering the medical insurance is only two years.
It is very likely that the negotiated drug will pass the validity period of the medical insurance negotiation catalog before being admitted to the hospital.
Problem
.

 

　　Affected by policies, hospitals have insufficient motivation to introduce drugs

 

　　Under the influence of a series of policies such as the proportion of medicines and zero price difference, hospitals in various places have little motivation to introduce medicines (especially the introduction of medicines with high storage costs such as oncology medicines), which objectively leads to many negotiating medicines that cannot be imported.
You may be admitted to the hospital very late
.

 

　　In response to this problem, as early as July 2019, the Medical Reform Office of the State Council specially organized trips to various provinces to conduct research on the supply of medical insurance drugs
.
In December 2019, the National Medical Insurance Administration and the National Health Commission jointly issued the "Notice on Doing a Good Job in the Implementation of National Medical Insurance Negotiations in 2019", requiring medical insurance, health and other departments to not control the total amount of medical insurance and the drug catalog of medical institutions The quantity restriction, the proportion of medicines, etc.
affect the negotiation of drug allocation and use, and all designated medical institutions are required to transfer drugs in and out according to the catalog, and hold special pharmaceutical management meetings in a timely manner to adjust and adjust the drug catalog of the medical institution.
Optimization
.

 

　　Local pilots have a foundation, and the time for national promotion has come

 

　　Many provinces and cities have already started "dual-channel" pilot projects for special medications.
Jiangsu, Inner Mongolia, Heilongjiang, Hunan Changsha, Yiyang, Xiangtan, Shaanxi Xi’an, Xianyang, Yan’an, and Henan Shangqiu, Hubei Shiyan, Anqing, Anqing and other places have all started.
The "dual channel" management model for the landing of special medicines
.

 

　　In this context, in order to promote the availability of medical insurance negotiation products, and on the basis of the "dual-channel" pilot experience in various regions, the National Medical Insurance Administration and the National Health Commission issued the "Guiding Opinions" to include designated retail pharmacies in the negotiation of drug supply The scope of coverage will form a "dual channel" together with designated medical institutions, and the pilot projects in various places will be officially promoted as national solutions
.

 

　　 "Dual channel" is so good for DTP pharmacies

 

　　The first batch of 19 drugs belong to the main business scope of DTP

 

　　Although the issue of drug availability caused by the "difficulty in hospital admission" of negotiated products is a common problem in all new medical insurance products, from the perspective of the impact on patients, the availability of oncology drugs and drugs for rare diseases is obviously more important.
Is important
.
Therefore, the "Guiding Opinions" specifically mentioned that the "dual channel" focuses on varieties with high clinical value, urgent need for patients, and low substitution
.

 

　　Ten days before the release of the "Guiding Opinions", the National Medical Insurance Administration and the National Health Commission have organized experts to screen 19 drugs that meet this principle from the newly negotiated drugs in 2020 and release them
.
Interpreting these 19 varieties and their indications carefully, we can find that these varieties belong to the main business scope of DTP pharmacy (see Table 1 for details)
.

 

 

　　1907 designated pharmacies, covering major DTP pharmacies

 

　　These 19 negotiated products are currently deployed in 3,324 designated medical institutions across the country, including 1,417 designated medical institutions and 1,907 designated retail pharmacies
.
This list of 1,907 pharmacies actually covers major DTP pharmacies, such as Changchun Dage Pharmacy, Sinopharm Dalian Co.
, Ltd.
New Special Medicine Pharmacy, Liaoning Guorui New Special Medicine Pharmacy Chain Co.
, Ltd.
Guilin Street Branch, Hubei Xinte Pharmacy The Headquarters of the Hangkong Road of the Pharmaceutical University Pharmacy Chain Co.
, Ltd.
are all included in the list of 19 types of medical insurance designated pharmacies
.

 

　　The amount of medical insurance involved exceeds 2 billion yuan, which is very attractive

 

　　For patients in need of new special drugs, these innovative drugs can now be purchased through DTP pharmacies, and they can enjoy the same overall medical insurance reimbursement as hospitals
.
This will undoubtedly bring new traffic and transactions to DTP pharmacies
.
At the same time, for DTP pharmacies, there is a national level of promotion.
The speed of these varieties entering DTP pharmacies and the speed of medical insurance will be greatly accelerated, which will directly promote the speed of variety and the increase in sales of DTP pharmacies
.

 

　　These 19 varieties cover almost all the varieties related to DTP pharmacy among the new medical insurance varieties in 2020
.
Except for 7 injections that are difficult to land in general DTP pharmacies, the remaining 12 can be sold through DTP pharmacies
.
The total amount of medical insurance involved in these varieties exceeds 2 billion yuan, which is very attractive for the DTP pharmacy market with a scale of about 15 billion yuan
.

 

How does 　　DTP pharmacy compete with hospitals?

 

　　A major challenge for DTP pharmacies is competition with hospitals
.
If the varieties are sold in hospitals and DTP pharmacies at the same time, overall patients are more likely to choose hospitals, especially when patients need biochemical and pathological examinations while purchasing drugs, only hospitals can provide one-stop services
.

 

　　The actual operation of many DTP pharmacies has also explained this problem before: some DTP pharmacies have successfully admitted the relevant products to local hospitals, and the number of orders has shown a cliff-like decline
.

 

　　 "Two choose one" support, but there is long-term competition with hospitals

 

　　However, during the formulation of the "Guiding Opinions," the government has clearly noticed such conflicts
.
For the government, in order to solve the problem of the availability of medical insurance negotiations, it is natural to support DTP pharmacies that can solve the problem of accessibility from a policy perspective
.
Therefore, the 19 types of medical insurance designated institutions in the same city have basically adopted the "choose one" strategy: basically in the same city, there are either designated medical institutions or designated pharmacies
.
In this way, for patients who purchase these 19 varieties, there is actually only one choice, and there is no conflict between DTP pharmacies and hospitals
.

 

　　However, with the continuous development of the market, those medical insurance products that are only sold in DTP pharmacies may still be allowed to be sold in hospitals in the region, which will bring competitive shocks to DTP pharmacies
.
Therefore, the hospital competition faced by DTP pharmacies has long existed
.

 

　　Only with four strong abilities can we "smile proud of the market"

 

　　For DTP pharmacies, regardless of whether there is national "dual channel" policy support, it still has to focus on the establishment of four major capabilities to maintain its unique competitiveness:

 

　　①Introduction of varieties, strengthen the introduction of varieties, strengthen the introduction of hepatitis C/hepatitis B, hematological diseases, autoimmune system diseases, rare disease drugs, etc.
, in addition to anti-tumor drugs, and enhance the profitability of DTP pharmacies
.

 

　　②Professional strength improves the level of pharmacy services, strengthens the training and improvement of pharmacists’ professional service capabilities, combines medical big data, artificial intelligence, Internet medical technology and other technologies to connect pharmaceutical companies , hospitals , doctors, etc.
, to provide patients with follow-up, rehabilitation, medication guidance and other services
.

 

　　③Marketing capabilities link industrial enterprises to carry out projects such as patient education, famous doctors live broadcast, and charity medication, to enhance the influence of DTP pharmacies on patients, and to establish the brand power of DTP pharmacies
.

 

　　④ Build an infusion center and carry out the construction of an infusion center, and provide infusion services for drug injection patients through joint hospitals and self-built methods, so as to expand the sales of injection drugs in DTP pharmacies
.

 

　　Self-reliance is strong
.
The DTP market is changing rapidly and new policies are released from time to time.
No matter how the environment changes, DTP pharmacies must strengthen their own capacity building, build differentiated competitiveness, establish brand power, and influence upstream industries
.
In this way, DTP pharmacy will have the strength of "Swordsman Market"
.

　　Medical Network News, June 4, May 10, the National Medical Insurance Administration and the National Health Commission jointly issued the "Guiding Opinions on Establishing and Improving the "Dual Channel" Management Mechanism for Drugs in National Medical Insurance Negotiations" (hereinafter referred to as the "Guiding Opinions"" ), to include varieties with high clinical value, urgent needs of patients, and low substitutability into the "dual channel" management
.

 

　　The so-called "dual channel" refers to the two channels of designated medical institutions and designated retail pharmacies that simultaneously satisfy the landing of drugs negotiated by the national medical insurance
.
What does this mean for DTP pharmacies?

 

　　 "Dual channel" landing background and timing?

 

　　To understand the impact of the "dual channel" policy on the DTP pharmacy market, we must first understand the background of the "Guiding Opinions"
.
Since its establishment in 2018, the National Medical Insurance Administration has greatly accelerated the adjustment cycle of the medical insurance drug catalogue, shortening it from the longest 8 years to once a year, and even some new drugs were included in the medical insurance drug catalogue in the year they were launched
.
However, although the speed of medical insurance access has increased significantly, the hospital's drug access speed has not changed significantly
.

 

　　Access to medical insurance has accelerated, but access to hospitals is still slow

 

　　When drugs enter the hospital, clinicians must first evaluate the risks and benefits of the drugs, and then submit a drug application to the department; then the department will initially select and submit it to the hospital pharmacy committee, which will conduct formal review of the drug production license and other documents; Then, the hospital regularly convened the Pharmaceutical Affairs Committee.
Applicants focused on the reasons for drug application, comparison with existing drugs, irreplaceability, etc.
Experts asked questions and discussed and voted independently, and finally approved more than the number of experts participating in the meeting by 2 Passed at /3
.

 

　　At present, the frequency of meetings of the pharmaceutical committees of most tertiary hospitals across the country is once a year or once a half a year, and the validity period of the National Talks drug entering the medical insurance is only two years.
It is very likely that the negotiated drug will pass the validity period of the medical insurance negotiation catalog before being admitted to the hospital.
Problem
.

 

　　Affected by policies, hospitals have insufficient motivation to introduce drugs

 

　　Under the influence of a series of policies such as the proportion of medicines and zero price difference, hospitals in various places have little motivation to introduce medicines (especially the introduction of medicines with high storage costs such as oncology medicines), which objectively leads to many negotiating medicines that cannot be imported.
You may be admitted to the hospital very late
.

 

　　In response to this problem, as early as July 2019, the Medical Reform Office of the State Council specially organized trips to various provinces to conduct research on the supply of medical insurance drugs
.
In December 2019, the National Medical Insurance Administration and the National Health Commission jointly issued the "Notice on Doing a Good Job in the Implementation of National Medical Insurance Negotiations in 2019", requiring medical insurance, health and other departments to not control the total amount of medical insurance and the drug catalog of medical institutions The quantity restriction, the proportion of medicines, etc.
affect the negotiation of drug allocation and use, and all designated medical institutions are required to transfer drugs in and out according to the catalog, and hold special pharmaceutical management meetings in a timely manner to adjust and adjust the drug catalog of the medical institution.
Optimization
.

 

　　Local pilots have a foundation, and the time for national promotion has come

 

　　Many provinces and cities have already started "dual-channel" pilot projects for special medications.
Jiangsu, Inner Mongolia, Heilongjiang, Hunan Changsha, Yiyang, Xiangtan, Shaanxi Xi’an, Xianyang, Yan’an, and Henan Shangqiu, Hubei Shiyan, Anqing, Anqing and other places have all started.
The "dual channel" management model for the landing of special medicines
.

 

　　In this context, in order to promote the availability of medical insurance negotiation products, and on the basis of the "dual-channel" pilot experience in various regions, the National Medical Insurance Administration and the National Health Commission issued the "Guiding Opinions" to include designated retail pharmacies in the negotiation of drug supply The scope of coverage will form a "dual channel" together with designated medical institutions, and the pilot projects in various places will be officially promoted as national solutions
.

 

　　 "Dual channel" is so good for DTP pharmacies

 

　　The first batch of 19 drugs belong to the main business scope of DTP

 

　　Although the issue of drug availability caused by the "difficulty in hospital admission" of negotiated products is a common problem in all new medical insurance products, from the perspective of the impact on patients, the availability of oncology drugs and drugs for rare diseases is obviously more important.
Is important
.
Therefore, the "Guiding Opinions" specifically mentioned that the "dual channel" focuses on varieties with high clinical value, urgent need for patients, and low substitution
.

 

　　Ten days before the release of the "Guiding Opinions", the National Medical Insurance Administration and the National Health Commission have organized experts to screen 19 drugs that meet this principle from the newly negotiated drugs in 2020 and release them
.
Interpreting these 19 varieties and their indications carefully, we can find that these varieties belong to the main business scope of DTP pharmacy (see Table 1 for details)
.

 

 

　　1907 designated pharmacies, covering major DTP pharmacies

 

　　These 19 negotiated products are currently deployed in 3,324 designated medical institutions across the country, including 1,417 designated medical institutions and 1,907 designated retail pharmacies
.
This list of 1,907 pharmacies actually covers major DTP pharmacies, such as Changchun Dage Pharmacy, Sinopharm Dalian Co.
, Ltd.
New Special Medicine Pharmacy, Liaoning Guorui New Special Medicine Pharmacy Chain Co.
, Ltd.
Guilin Street Branch, Hubei Xinte Pharmacy The Headquarters of the Hangkong Road of the Pharmaceutical University Pharmacy Chain Co.
, Ltd.
are all included in the list of 19 types of medical insurance designated pharmacies
.

 

　　The amount of medical insurance involved exceeds 2 billion yuan, which is very attractive

 

　　For patients in need of new special drugs, these innovative drugs can now be purchased through DTP pharmacies, and they can enjoy the same overall medical insurance reimbursement as hospitals
.
This will undoubtedly bring new traffic and transactions to DTP pharmacies
.
At the same time, for DTP pharmacies, there is a national level of promotion.
The speed of these varieties entering DTP pharmacies and the speed of medical insurance will be greatly accelerated, which will directly promote the speed of variety and the increase in sales of DTP pharmacies
.

 

　　These 19 varieties cover almost all the varieties related to DTP pharmacy among the new medical insurance varieties in 2020
.
Except for 7 injections that are difficult to land in general DTP pharmacies, the remaining 12 can be sold through DTP pharmacies
.
The total amount of medical insurance involved in these varieties exceeds 2 billion yuan, which is very attractive for the DTP pharmacy market with a scale of about 15 billion yuan
.

 

How does 　　DTP pharmacy compete with hospitals?

 

　　A major challenge for DTP pharmacies is competition with hospitals
.
If the varieties are sold in hospitals and DTP pharmacies at the same time, overall patients are more likely to choose hospitals, especially when patients need biochemical and pathological examinations while purchasing drugs, only hospitals can provide one-stop services
.

 

　　The actual operation of many DTP pharmacies has also explained this problem before: some DTP pharmacies have successfully admitted the relevant products to local hospitals, and the number of orders has shown a cliff-like decline
.

 

　　 "Two choose one" support, but there is long-term competition with hospitals

 

　　However, during the formulation of the "Guiding Opinions," the government has clearly noticed such conflicts
.
For the government, in order to solve the problem of the availability of medical insurance negotiations, it is natural to support DTP pharmacies that can solve the problem of accessibility from a policy perspective
.
Therefore, the 19 types of medical insurance designated institutions in the same city have basically adopted the "choose one" strategy: basically in the same city, there are either designated medical institutions or designated pharmacies
.
In this way, for patients who purchase these 19 varieties, there is actually only one choice, and there is no conflict between DTP pharmacies and hospitals
.

 

　　However, with the continuous development of the market, those medical insurance products that are only sold in DTP pharmacies may still be allowed to be sold in hospitals in the region, which will bring competitive shocks to DTP pharmacies
.
Therefore, the hospital competition faced by DTP pharmacies has long existed
.

 

　　Only with four strong abilities can we "smile proud of the market"

 

　　For DTP pharmacies, regardless of whether there is national "dual channel" policy support, it still has to focus on the establishment of four major capabilities to maintain its unique competitiveness:

 

　　①Introduction of varieties, strengthen the introduction of varieties, strengthen the introduction of hepatitis C/hepatitis B, hematological diseases, autoimmune system diseases, rare disease drugs, etc.
, in addition to anti-tumor drugs, and enhance the profitability of DTP pharmacies
.

 

　　②Professional strength improves the level of pharmacy services, strengthens the training and improvement of pharmacists’ professional service capabilities, combines medical big data, artificial intelligence, Internet medical technology and other technologies to connect pharmaceutical companies , hospitals , doctors, etc.
, to provide patients with follow-up, rehabilitation, medication guidance and other services
.

 

　　③Marketing capabilities link industrial enterprises to carry out projects such as patient education, famous doctors live broadcast, and charity medication, to enhance the influence of DTP pharmacies on patients, and to establish the brand power of DTP pharmacies
.

 

　　④ Build an infusion center and carry out the construction of an infusion center, and provide infusion services for drug injection patients through joint hospitals and self-built methods, so as to expand the sales of injection drugs in DTP pharmacies
.

 

　　Self-reliance is strong
.
The DTP market is changing rapidly and new policies are released from time to time.
No matter how the environment changes, DTP pharmacies must strengthen their own capacity building, build differentiated competitiveness, establish brand power, and influence upstream industries
.
In this way, DTP pharmacy will have the strength of "Swordsman Market"
.