Lilly is exposed to routine return card rebate doctor insulin 30 million a year

2013-08-22 source: what's the secret hidden under dozens of electronic vouchers for sales and millions of conventional documents for budget allocation in 21st century economic report? This part of information from the internal outflow of Lilly China, the US pharmaceutical giant, has led to a long-term and huge medical bribery chain According to a 2012 budget resource allocation document, the company spent nearly 9.5 million yuan on the "international conference, national conference, regional conference, TP activity, picture reading dialogue, basic drug TP and other six categories" conference for ubilin, a diabetes product Not only that, there was a special fund of 2.5 million yuan called "TP fee for community promotion of base drugs specially approved by marketing department" in that year, which was specially responsible for attacking the base drug market in Shanghai Wang Wei, a former senior manager of Lilly, disclosed to our reporter that Lilly company only has two main insulin products in Shanghai and Anhui region, namely "Youbi Lele pen classic and Youbi Linbi youban II", and the illegal cost of which is at least 30 million through direct kickbacks of doctors in a year, which does not include the kickbacks of donations and other products in the form of excessive speaker remuneration and inflated conference expenses "In order to block competitors' competing products and install our products, all kinds of regular bribes and special funds are very common in the company, which is no less serious than GSK case." Wang Wei said The supervision and inspection concerning the operation of foreign pharmaceutical enterprises in China is being carried out in an all-round way It is also the fourth large multinational pharmaceutical enterprise in China to be accused of bribery scandal in two months after GSK in the UK, Sanofi in France and Novartis in Switzerland In response to the above situations, Lilly China said in a statement to reporters on the 21st: "Lilly pharmaceutical attaches great importance to the situations mentioned These situations, if true, are totally inconsistent with Lilly's values, relevant policies and the compliance requirements repeatedly stressed by all employees " The products of Lilly that are exposed this time cover almost all the drugs used in the endocrine field At present, three foreign enterprises, namely Denmark novo, the United States Lilly and France Sanofi, stand in full swing, with their market share varying with each other In the scuffle of the foreign legion, Tonghua Dongbao, a domestic enterprise, is catching up with the price advantage, and the competition is extremely fierce Such as diabetes, high blood pressure, such a huge audience of chronic diseases, drug demand continued and stable The field of related medicine has always been the battleground of large pharmaceutical enterprises The annual growth of diabetes products in the emerging pharmaceutical market led by China is 26% from 2007 to 2011, and the share of global diabetes drug market is expected to reach 30 billion US dollars in 2017 The influence of sales in China on Lilly is becoming more and more obvious Founded in 1876, Lilly is one of the top ten pharmaceutical companies in the world Since the late 1990s, Lilly has invested more than 2 billion yuan (about 300 million US dollars) in China, and Lilly China has become the second largest branch of Lilly group in the world The exposed Lilly products almost cover all the drugs used in the field of Endocrinology The product series such as youbile, youbilin, youban II and Byetta are the insulin drugs strongly promoted by the company in recent years Ubilin (recombinant human insulin injection) is designed for those diabetic patients who need to use insulin to maintain blood glucose level It is suitable for the early treatment of early diabetic patients and the treatment of diabetic patients during pregnancy Ubilin (liproline insulin injection) is used for the treatment of adult diabetic patients who need insulin to maintain normal blood glucose homeostasis The two products also include youbilin 70 / 30, youbilin medium efficiency, youbile 25 and youbile 50 This field also includes two other products of Uber II and Uber classic Wang Wei, who has a good understanding of the sales of the aforementioned products in Shanghai and Anhui, told reporters that Lilly mainly competes with Nuohe for the market, but the actual situation is not dominant, and Lilly can only break through the market share quickly by this means of bribery "Such means are usually done in a very hidden way, seemingly in compliance But the insiders know it's a fake move " "Even the top management will explicitly imply that the medical representatives will do so Because slow drugs such as insulin need to be used for a long time, unlike ordinary drugs that pay bribes according to the prescription amount, Lilly's rebate for insulin products is to compensate doctors according to the number of newly developed patients " The specific method of "pay kickback by head" is that Lilly regularly visits the medical representatives of all levels of hospital departments to inform doctors that after each new patient uses ubilin product, the doctor will fill in a card that records the personal information and medication details of the patient after issuing a prescription, which is called "return card" in the industry The task of the medical representative is to collect the card regularly and pay the doctor the corresponding remuneration according to the number of returned cards, which is only for new patients According to people familiar with the matter, there are many products sold at a marked price, such as youbilin, youbile classic and youban II The return points of drug agents nationwide range from 100 to 300 yuan for each new patient Among them, Anhui region is generally between 100 and 150 yuan, and Shanghai is 200 yuan For those regions that are locked in the competition with Nuohe, the retail price of youbilin market is only 60-70 yuan per person The company's early heavy investment in order to continue to bind patients later is obvious Wang Wei said straightly that the company's strategy is very clear After patients are used to using one kind of insulin, they will not change other brands easily Moreover, this product is relatively professional, and patients usually follow the instructions of doctors strictly, so it is more controllable Therefore, it is necessary to repeatedly advocate with doctors that we should make more early and persistent efforts to make Lilly brand insulin products, and consolidate this relationship with practical interests According to the 2012 card return plan of Eli Lilly in Anhui and Shanghai, youban II plans to return 34000 cards, with an average of 2196 cards per month There are 8737 classic return cards of ubile, with an average of 757 cards per month "Between January and August 2011, ubile received 78000 return cards nationwide." According to Wang Wei, the annual bribe amount of these two products in a large region is more than 6.4 million yuan if calculated by 150 yuan per card returned, and the bribe amount of only one product of youbile classic in the first eight months of 2011 is more than 11.7 million yuan nationwide "The monthly card return level of two major products, youbile pen classic and youban II, is at least 25000 nationwide According to the minimum standard of 100 yuan per card, the amount of bribes paid in one year is at least 30 million." Wang Wei said straight In the promotion of Byetta, another product, Wang Wei said that in Shanghai, the Commission for the more expensive product is 500 to 800 yuan per card In the last year, the card return plan of baipida was 1050 Calculated by 650 yuan / card return, the amount of bribes paid by a large region in a year was nearly 700000 yuan A data shows that the corresponding reward and punishment mechanism for the number of returned cards is very strict: Lilly will reward the company's medical representatives according to the representatives with the highest amount of insulin returned cards in each region, including some representatives with an average monthly number of 130 in 2011 According to its statistics, 34 cards are returned per capita in the region, while 45 cards are returned per capita in the country, which is also one of the important basis for the assessment and promotion of supervisors in various regions "A medical representative focuses on 10-15 hospitals In Anhui, each medical representative is required to complete the task of developing 300-400 new patients every month If not, he will be eliminated from the team." Wang Wei revealed Not only that, the company will count and publish the ranking of the number of returned cards per capita of the medical representatives every month, and the medical representatives with high loss rate will also be publicized and reminded The systematic internal "return card" assessment mechanism reflects the great influence of the bribery chain on the company's sales The reporter found that in the statistics of the number of cards returned and the actual feedback sales volume in 2011, the card return cost of several regional managers was RMB 4500 At the same time, the company will count the hospitals with the highest insulin return card, among which there are not a few hospitals with more than 100 insulin return cards per month The First Affiliated Hospital of Harbin Medical University ranks first with 117 insulin return cards per month Special attack secret technology enterprises will also divide doctors into "high prescription doctors and even prescription doctors", so as to carry out targeted public relations After the GSK case broke out, the personnel involved in the case had opened a dual channel for multinational pharmaceutical companies to bribe medical personnel and take bribes themselves, and then passed this part of the cost to consumers after the drug price was raised "Take a medicine for treating hepatitis B as an example The ex factory price is about 140 yuan After dealers, hospitals and other layers of price increases, the price finally reaches 210 yuan in the hands of patients." Liang Hong, the former general manager of GSK's business operations, said he was arrested With the details of Lilly's bribery revealed, the two methods of operation are highly similar "These are the" hidden rules "of the process industry Compliance training has been carried out since the pharmaceutical representative took the post However, the training content often teaches the pharmaceutical agent how to go around the rules Some trainers will even tell drug agents how to bribe within the scope of compliance The company is only responsible for the reimbursement of compliance Chinese food expenses and membership fees, but whether the specific meal expenses are fake meal expenses will not be asked more " Wang Wei said "From how to evade industrial and commercial inspection to how to deal with the media, there will be training, from Lilly company's superior level to the medical representatives." "In the first two years, novo and insulin products dropped their standards in Shanghai, and Lilly's market war also entered a short-term frenzy The company has allocated 2.5 million yuan to find a group of hospitals that represent Shanghai, hoping to seize the market share of the competitors The proportion of bribery funds in the special fund should not be small Inside the company, there are leaders who are outspoken to ask the drug agency to pay 200 yuan a piece to replace the products of rival Nuohe, no matter what extraordinary measures the other party takes " In the 2012 budget resource allocation document of Lilly, the reporter found that there was a special fund of 2.5 million yuan in that year, named "TP cost for community promotion of base drugs specially approved by marketing department", which was specially responsible for the base drug market in Shanghai According to the training data, the medical representatives who failed to reach the goal in the current month must take targeted actions in the next stage The company for example said "invite the supervisor to follow up, visit the director of the Department of endocrinology to discuss the cooperation plan for the whole year" and so on Not only that, the reporter found in the product data of baipida that: the company will divide and publicize the sales level and contribution proportion of new patients in different regions every month, and make a comparison according to the indicators such as "planned number of patients, number of new patients and achievement rate", so as to supervise and urge the medical representatives in each region Its internal documents show that the company will collect the basic information (number of new patients, sales share, projects in the hospital, clinic) of competitors such as novo, Bayer, Tonghua Dongbao and Sanofi in the hospital, and collect the information of doctors in the Department, which will specifically list the "main needs of the director department" for cooperation.