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Recently, the State Drug Administration issued the Measures for the Supervision and Administration of Drug Network Sales (hereinafter referred to as the "Opinion Draft"), echoing the Drug Administration Law adopted in 2019, which clearly states that prescription drugs can be sold online, but limits the sales subject, scope and related hardware and software requirements, as well as the rights and obligations of the relevant sales subject.
The core principles of the Opinion Draft are online and offline, and the supervision on and offline is consistent, which is consistent with the national health care regulatory principles for Internet hospitals and the National Health Insurance Administration's principles on medical reimbursement for Internet health care, reflecting the overall thinking of regulation.
prescription drug online sales have been the market's desired policy dividend since 2014, when the market believed that once the policy opened up, drugs in the Internet sector will usher in explosive growth.
but as the market matures, especially as outside participants understand the particularities of China's medical market, the expectations of the good of online sales of prescription drugs are gradually dispelled.
, with the introduction of the Opinion Draft, prescription drug online sales will soon usher in the positive compliance, the long-term development of the market still has a positive role in promoting.
According to the Opinion Draft, the main body of drug network sales is "drug market license holders or pharmaceutical business enterprises", while limiting the scope of online sales of prescription drugs, "drug network sales shall not exceed the mode of business and drug business scope."
who is the holder of a drug network seller, may only sell the drug whose approval number is held.
not obtain the retail qualification of drugs, the drug shall not be sold to individuals.
National drugs under special management, such as vaccines, blood products, narcotic drugs, psychotic drugs, toxic drugs for medical use, radioactive drugs, pharmaceutical-type easily-to-toxic chemicals, etc., shall not be sold through the Internet".
particularly noteworthy is the fact that the Draft Opinion explicitly requires that "prescription drugs and Class A over-the-counter drugs shall not be given to the public by means of drug purchases, commodity gifts, etc.".
Not only is prescription drugs not allowed to be given, but class A OTC is also limited, which means that in the future, various types of websites in the promotion of drugs can not use class A OTC drug-giving methods, which will have a certain impact on the current drug retail platform.
The Opinions highlight the issue of prescription sources, ingesting that "drug retailers who sell prescription drugs online shall ensure that the source of electronic prescriptions is true and reliable, and that prescription transfer reviews are conducted in accordance with the relevant requirements and that used prescriptions are electronically labeled".
with the compliance of Internet hospitals, pharmaceutical e-commerce companies no longer rely on out-of-hospital prescriptions, but rely on Internet hospitals to "create" prescriptions, it is not difficult to achieve compliance.
At the same time, the Opinion Draft also clearly states: "If a drug is sold to an individual, an online pharmacy service system shall also be established, equipped with a practicing pharmacist to guide rational drug use, the number of practicing pharmacists shall be appropriate to the scale of operation, and the sales record of the minimum sales unit of the drug shall be clearly retained and traceable".
it is worth noting here that 2C drug sales need to be staffed with licensed pharmacists and that the number of licensed pharmacists should be appropriate to the scale of operation.
here again embodies the principle of online and offline agreement.
Because retail pharmacies need to be equipped with pharmacists has been more clear, online also requires the size of the operation to equip pharmacists, which led to the existing Internet platform companies have to be equipped with a large number of pharmacists, will also lead to a sharp increase in the cost of pharmaceutical e-commerce companies.
, however, overall, while the Opinion Draft is good for prescription drug online sales, the main sales scenario for prescription drugs is concentrated in hospitals rather than out-of-hospital, and the increase in pharmaceutical e-commerce is actually limited.
this is constrained by three main factors: hospitals, health insurance and pharmacies.
First of all, from the point of view of hospitals and even primary medical institutions, the power of prescription outflow is very weak, not only because hospitals still have interests in drug sales, hospitals also use drugs as an important source of income, large-scale prescription outflow equal to their own income scale has been significantly reduced.
, although, after collection, the hospital in some drugs have no interest, but the collection is based on the hospital's dosing, the hospital must also complete the relevant use.
On the other hand, with Medicare including Internet hospitals in reimbursement, hospitals and primary medical institutions also hope to obtain and retain customers through Internet hospitals, prescription drugs are an important means for medical institutions to maintain connectivity with patients, if prescription outflow is allowed, the closed loop of medical institutions themselves will be broken, patient retention rate will be significantly reduced.
second, from the point of view of health insurance, because of the localization of health insurance management and for each pharmacy has total control, the current prescription drug online sales if you want to use health insurance, can only cooperate with pharmacies.
, however, under total health care, pharmacies are unlikely to be able to handle out-of-the-way prescriptions without restrictions, meaning that online sales of prescription drugs cannot rise rapidly in any one region.
combined with outpatient co-ordination, the future reduction of health insurance accounts will be inevitable, which will lead to a substantial reduction in the available medical insurance funds outside the hospital.
even if pharmacies can get a portion of the funding for outpatient co-ordination, the total amount of money available for online out-of-hospital health care payments will continue to shrink in the future because of the small outflow of hospital prescriptions.
And, as Medicare pays prices push away in the future, prescription drug profits will face a big drop in profits, and as long as the collection continues to drive, hospitals and pharmacies will continue to reverse the price of drugs, users will further return to the hospital, out-of-hospital prescription drug access will also face challenges in the short to medium term.
In the end, from the pharmacy itself, its cooperation with the platform is mainly due to the need for customers and compliance, once prescription drugs are opened online, health insurance is its own competitive advantage, in the future cooperation will be more advantageous than now.
, especially large and medium-sized drugstore chains, can obtain medicare reimbursements by prescribing them through their own Internet hospitals, and these offline customers no longer need to be directed online.
Therefore, the prescription drug online sales ban is only a limited benefit to pharmaceutical e-commerce, in the long run, after outpatient co-ordination, medical institutions rather than outside the hospital will continue to be the main scenario of prescription sales, out-of-hospital can only be a narrow market under the limited supplement.