It's hard for hospitals to pay back, and 4000 pharmaceutical companies are suffering

In the face of 960 days of non payment of public hospitals in Hubei Province last year, the debt of tertiary hospitals was 140 million yuan In the face of the implementation of the "two vote system" and other policies, what should be done as a drug manufacturer? Is it to completely tear up the face with the hospital and fight in court? Or to swallow your breath and continue to rely on borrowed funds to survive? Obviously, both of them are too extreme, which is not in line with the actual situation of China's pharmaceutical market at present The key is to find out the factors that affect the price of drugs in the face of the general demand of the society, and find out the reasons in the difficulty of drug payment collection In collaboration with hospitals, governments and enterprises, on the one hand, the government tries to promote the period of hospital payment collection, on the other hand, it actively solves the problem On the one hand, to promote the effective implementation of the reform measures of "medical separation" may be the real way out for the pharmaceutical industry When it comes to the factors that affect the drug price, we have to mention the problem of hospital payment From last year's annual reports of major listed enterprises, we can clearly see that the large amount of receivables is jaw dropping It is just because the amount of receivables is too large, which affects the normal operation of enterprises, and has to borrow capital turnover, that the profits of enterprises decline (such a large base of loans, profits Interest is also very expensive), so some netizens infer that "the drug price is inflated", at the same time, there may be the shadow of "bad payment collection" Again, when it comes to the issue of hospital payment collection, we have to mention the "two ticket system" Before the introduction of the "two ticket system", pharmaceutical companies did not directly face the hospital They all sold drugs to the hospital through a series of distributors The issue of natural payment collection is the problem of distributors But in April 2017, after the full implementation of the two ticket system, Enterprises need to face the hospital directly, which is equivalent to transferring the pressure of the previous dealers to the pharmaceutical enterprises directly However, in the face of so many hospitals across the country, the pressure will naturally multiply Trade receivables and annual growth rate of Hengrui from 2013 to 2019 note: in April 2017, the two vote system was implemented In the first half of this year's published semi annual report, yaozhi.com combed the data related to the receivables of the top five pharmaceutical enterprises in terms of business income and summarized them into the following table Up to now, the receivables of pharmaceutical enterprises account for more than 10% of the total assets, and some enterprises account for more than 20% What's more shocking is that the receivables of almost all enterprises far exceed the net profit of the first half of this year Dongcheng In the pharmaceutical industry, for example, the proportion has even reached 500% It's a terrible fact that the amount of nearly 1 billion arrears, if the loan, at least 100-200 million yuan of interest per year, corporate profits will be reduced by at least 20% Proportion of receivables in the first half of 2019 Annual Report Nowadays, it's hard to collect money It's not a day or two It's not a day It's not a day It's a day or a month It's also doomed to create a gloomy situation According to the analysis of Li Tianquan, the co-founder of yaozhi.com, it's not hard to find several important reasons for the situation 1 The hospital really has no money Since the implementation of medical insurance, the post settlement of expenses is such a rule, "first see a doctor and then pay", the hospital pays the medical expenses in advance, the patient only needs to pay part of his own expenses after seeing a doctor, and the rest of the expenses are directly paid to the hospital by the medical insurance department Under normal circumstances, it may take a year or more for the hospital to receive the advance payment from the medical insurance, and the medical insurance bureau will review whether the hospital violates the rules within one and a half to two years If it violates the rules, it can reduce the number of payments or refuse to pay In order to operate the hospital, it is reasonable for the hospital to pay back to the enterprise after the medical insurance settlement 2 Although many documents have been published in recent years, which emphasize the problem of payment collection and shorten the period of payment collection of medical insurance center, similar to the opinions on the supporting measures of national organization for centralized drug purchase and use pilot medical insurance, prior to the official launch of the pilot work, medical institutions shall be paid in advance according to not less than 30% of the special procurement budget, and medical institutions shall be required to The contract stipulates timely settlement with the enterprise, reduces the financial cost of the enterprise, and encourages the medical insurance agency or purchasing agency to directly settle or prepay the drug payment with the enterprise But some hospitals are still reluctant to give money to pharmaceutical companies even if they receive the settlement funds from the medical insurance center They believe that the profits of pharmaceutical companies in medicine, even under the control of the state, are far from unsustainable Deliberately delaying the time of payment collection means that the funds in hand will be more surplus in the short term, and the priority of payment collection will drop again and again 3 Last but not least, the inequality between hospitals and pharmaceutical enterprises is the root cause of the current situation When does the hospital pay back become a strategy at a certain level Xu Mingliang, the former president of Guangde County People's Hospital in Anhui Province, was accused of taking bribes Most of the bribers are salesmen or managers of pharmaceutical equipment companies Nearly 10 witnesses said that they should give Saihong, the president of the hospital Package is to be able to pay more attention to the company's capital pressure In terms of this incident, the hospital has the absolute initiative on the issue of payment collection The hospital regards the drug payment collection as a bargaining chip or advantage with the pharmaceutical enterprises As long as the collection cycle is in hand, the initiative of negotiation is in hand, and the inequity of transaction is fully reflected Of course, the above description is actually part of the reason for the huge receivables of pharmaceutical enterprises, but it is also one of the most important reasons Next, since the reasons for the unfavorable payment collection have been found, how to solve the problem naturally becomes the top priority Li Tianquan, the co-founder of yaozhi.com, believes that the government, as the superior of both the hospital and the enterprise, takes the initiative to bear the burden of solving the problem 1 4 + 7 does alleviate the problem of arrears at present, but because it is in the trial stage, the number of drug varieties is insufficient, only 25 For drugs with such a large base in China, it is a drop in the bucket If it can be promoted in an all-round way nationwide in the future, it may be possible to solve the problem of repayment by existing drug companies; 2 "Separation of medicine" is the trend and the future direction of China's pharmaceutical industry The core of the reform is to follow the example of the United States and Japan Taking medical treatment as a separate service, the outpatient department of the hospital only provides diagnosis service, and the patient can take the medicine outside the hospital, so that the problem can be solved naturally; 3 Accelerate the audit speed of medical insurance settlement center on medical insurance expenses as much as possible, shorten the settlement cycle, reduce the waiting process, so that the payment can reach the drug manufacturing enterprises quickly (in the middle of July, the state announced to prepay 40% of the last month's medical insurance expenses to the hospital in advance, so that the hospital can collect funds faster); 4 On the other hand, the United Commercial Bank established a "low interest special" loan project for pharmaceutical enterprises to reduce the capital turnover cost of enterprises, and reduce the cost pressure of enterprises as much as possible within the fixed collection cycle In fact, in order to reduce the price of drugs, it is too one-sided to simply oppress the profits of drug companies It is the nature of businessmen to pursue profits To solve the unequal trading position between hospitals and enterprises, at the same time, it is also necessary to strictly implement the policy of "separation of medicine", which is the real solution It is the practice of smart people to take into account the interests of the government, hospitals and enterprises, and not to do the thing of fishing with all the efforts 。 Statement: this opinion only represents the author, not the position of yaozhi.com, welcome to exchange and supplement in the message area; if you need to reprint, please be sure to indicate the author and source of the article.