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    Home > Active Ingredient News > Drugs Articles > National centralized procurement shocked 10 billion pharmaceutical market, tens of thousands of pharmaceutical representatives or unemployed

    National centralized procurement shocked 10 billion pharmaceutical market, tens of thousands of pharmaceutical representatives or unemployed

    • Last Update: 2018-09-06
    • Source: Internet
    • Author: User
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    The 11 cities (4 + 7, Beijing, Tianjin, Shanghai, Chongqing, Guangzhou, Shenzhen, Shenyang, Dalian, Xi'an, Chengdu, Xiamen) led by the medical insurance bureau will soon launch a joint centralized procurement plan This national centralized belt purchase plan is mainly originated from the third batch of belt purchase plan in Shanghai, which is mainly aimed at the current products passing the consistency evaluation The scheme puts forward the idea of "no quality level, only winning the bid, 60-70% market share", which will make the products passing the consistency evaluation have a great leap in market share and sales volume Because the specific scheme has not yet been determined and the space is limited, I will not analyze it in detail here Let me directly say my conclusion: the medical insurance foundation will save tens of billions, the expired patent products of foreign enterprises will lose tens of billions of market, and the sales volume of individual products through consistent products in China will increase greatly In terms of the current consistent products, the most impacted products of foreign enterprises may be as follows (incomplete statistics taking cardiovascular products as an example): the most direct starting point for the medical insurance bureau to design this procurement policy is to save medical insurance funds At present, there is no room for expansion in terms of the number of insured people in the medical insurance fund (although the new rural cooperative medical system has been merged, it can be regarded as the insured people) The growth of income has slowed down obviously, while the pressure of expenditure has been increasing with the access of new products, the aging of population and other factors According to the current trend, it is expected that by the middle of this century, the health insurance fund will face the pressure of wearing the bottom In this severe situation, medical insurance fund must spend more efficiently There are three most effective ways to improve the expenditure: the reform of medical insurance payment mode (total budget control, diversified payment mode), the adjustment of expenditure structure (such as reducing the expenditure of auxiliary drugs and expired patent drugs), and the direct reduction of purchase price (bidding to reduce the price or payment standard) It is reasonable to reduce the price of the original research drugs The international common situation is that the original research drugs withdraw from the market directly after the expiration of the patent due to the listing of low-cost generic drugs, which is the so-called "patent cliff" Before, in the era of national development and Reform Commission drug government pricing, the government pricing was also proposed to solve the problem, but because of the huge quality difference between the original research drug and the domestic generic drug, it gave up Now, the consistency evaluation of generic drugs has been gradually promoted It can be considered that the previous quality differences have been greatly reduced, and the preferential treatment given to products through consistency evaluation in terms of access is clearly mentioned in the previous documents of the State Council The traditional marketing mode of foreign enterprises is challenged At present, the marketing mode of foreign pharmaceutical enterprises in China is the same as that of the vast majority of countries in the world, that is to say, the prescription and sales volume are brought by the information of medical representatives to doctors It should be said that the reason why this marketing model can be put all over the world is reasonable, because unlike many other disciplines, medicine is evolving at a high speed in terms of knowledge Without clinical promotion of medical representatives, it is difficult for doctors to have a comprehensive understanding of emerging new drugs and master their clinical application According to some data, more than 60% of new drug information obtained by doctors comes from medical representatives Moreover, the clinical research of new drugs is also inseparable from the support of doctors The new indications of many products are further studied and deepened according to the clinical practice of doctors In this mode, drug marketing can be simplified as the formula: sales volume = drug representative efficiency × number of drug representatives After the cost of R & D is eliminated, the biggest cost is the cost of human resources, while the cost of production is almost negligible According to the above derivation, it is easy to draw a conclusion that under the premise of relatively fixed efficiency, as long as the number of medical representatives continues to expand, the sales volume will continue to increase This conclusion has also created a lot of sales myths around the world, such as Lipitor, Sumeria and so on These products are not only excellent in themselves, but also because of the excellent work efficiency and large number of medical representatives, which make these products become world champions before and after But there is also a problem with this conclusion, that is, the maximum efficiency and the number of medical representatives are related to the market size and competitive situation It is also well understood that in terms of market size, according to the epidemiology theory, the incidence rate of each disease is relatively fixed Indeed, with the improvement of the level of doctors' diagnosis and treatment, the market size can be enlarged in the recognition rate and intensive treatment of disease, but there will be an upper limit in the end And the competitive situation on the one hand determines that mee-best will have the biggest market advantage On the one hand, it also determines that the price difference between them will not be too large Especially in the foreign patent cliff, once mee best passes the patent, the payer will immediately tend to pay for the imitations of the product, which also leads to that if mee too and mee better are listed later, it is difficult to occupy a place in the market The past actual market situation in China is very different from that in foreign countries The main reasons are as follows: first, the medical insurance party adopts the passive payment method according to the project in terms of payment, that is, how many prescriptions the doctor prescribes, the medical insurance can only pay the bill passively Moreover, after the government cancels the pricing of drugs, the medical insurance party loses a good hand to directly reduce the drug price through the third party Second, there is a big difference in the level of generic drugs in China According to the survey of Ding Xiangyuan, more than 80% of doctors prefer to use the original research drugs In this regard, the medical insurance really can not blame doctors for lack of cost control awareness, especially in the environment where patients tend to simply think that imported drugs are good and the Doctor-patient Conflict is so great Third, the market of China The potential is really huge The world's first population base and towards an aging society, the economy has reached a certain level, although the growth slows down, it still maintains a high speed, and the exploitable market potential is very huge Based on the above market conditions, even if the product patent has expired and there are many imitations, foreign enterprises still have a very large sales team in China For foreign enterprises with chronic disease product market, the employees of Chinese branch companies will grow to the largest in the world, because the increase of the number of employees can bring the growth of sales volume through pipeline training to achieve a certain efficiency It should be said that the above model has achieved great success in China While reaping a large number of prescriptions, foreign enterprises also have obvious advantages in access through maintenance experts, such as independent pricing policy, bidding independent quality level, directory access, one product, two regulations, etc., which all have expert support foundation Therefore, many domestic companies have begun to learn this set of "academic promotion" strategy and apply it to their own generic drugs, especially those companies with exclusive popular generic varieties, will directly dig people from foreign enterprises to establish a similar self-employed team The promotion materials often copy the tests of the original products in the first few pages, and emphasize the consistency with the original research in the last page This kind of all-round strategy of taking the original product car can often achieve better results Let's go back to the conclusion at the beginning of this article: this 11 city belt purchase mode will be a very terrible ice storm, which will destroy this kind of marketing mode of crowd directly Due to the large number of medical representatives of foreign enterprises and some generic pharmaceutical enterprises in these 11 cities, tens of thousands of people may even lose their jobs overnight under the worst estimate Of course, the situation may not worsen so fast in a short period of time After all, the volume purchase only counts the consumption of the previous year, without considering the possible growth of the market in the next year Moreover, when the market share of the product itself is less than 30%, the impact may be smaller In order to maintain a certain continuity of drug use, medical insurance will certainly not kill all the original research products in one stroke, but on the one hand, the same medical insurance payment standard will be established, and the self payment amount of the original research products will be much higher, on the other hand, the purchase price may be directly reduced to reduce the price difference between the original research products and generic drugs The best way for foreign enterprises and some self-employed generic pharmaceutical enterprises to respond to the market of centralized procurement is to transfer the representatives of existing old products to the new product group But the bad news is that there are too many representatives of old products, often several times as many as new ones The good news is that no matter the approval or medical insurance, the access speed of new products will definitely be further accelerated in the future; the central strategy is to expand the market in the second and third tier cities or even lower tier cities, which many large foreign enterprises have begun to lay out Although they also adopt the strategy of representing the number of people, and the efficiency is far lower than that of large cities, the Chinese market is really broad, and the growth space is still not small This kind of strategy is afraid of the further expansion of pilot products and cities in centralized procurement, and even the national level with volume procurement in the future The next strategy is that in extreme cases, foreign enterprises can also use the strategy of price war In fact, from the perspective of pure production and manufacturing costs, foreign enterprises will not necessarily be much higher It is not known what the final result of the 11 cities' volume purchase will be, but it is not difficult to see the policy design idea of the medical insurance bureau: saving medical insurance fund is certainly the initial starting point, while not reducing the quality of the purchase, the purchase price will be greatly reduced, the sales cost will be greatly reduced by reducing the purchase price and guarantee consumption, and the number of medical representatives will be reduced There is a saying on the Internet that is said to be director Zhan, "I want to lay off 3 million medical representatives across the country" Although it seems very absurd, it does make sense For expired patent products and generic drugs, do you really want to maintain high prices for medical representatives? Is health insurance going to pay for it? If the health insurance saves a lot of expenditure, it can further accelerate the access of new products, such as timely negotiation or dynamic adjustment Perhaps foreign companies will make up for the loss of expired patented products in new products It should be said that this is a common international thinking and also a way to encourage continuous innovation On the other hand, through policy design, the health insurance bureau greatly encouraged the further progress of generic drug consistency evaluation We should know that many industries in our country are moving from "high-quality imitation" to "micro innovation in imitation", and then to "comprehensive innovation or even the first in the world" Although the R & D investment in the pharmaceutical industry is still far behind the developed countries, we are currently the largest country of APIs In the future, through consistency evaluation, we can completely surpass India to become the largest country of preparations, and then move to innovation first in the future is also a dream that can be realized In the end, although the pilot reform is likely to have a great impact on some peers, especially foreign counterparts, we should believe that the government will make a smooth transition as much as possible We should know that the promotion of innovative products is the right way for pharmaceutical representatives Medical representatives will always be a promising career.
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