State Council News: One vote dictates the approaching winter of dealers

▍ finishing: Mick There is no middle toss invoice, one vote directly On November 15, the leading group of the State Council for deepening the reform of the medical and health system issued the notice on further promoting the experience of deepening the reform of the medical and health system in Fujian Province and Sanming City (hereinafter referred to as the "notice") to release major signals The circular pointed out that by the end of December 2019, all provinces should fully implement the purchase and use policies of 25 drugs under the pilot reform of centralized purchase and use of drugs organized by the state In 2020, according to the national unified deployment, expand the scope of centralized procurement and use of drugs by national organizations Comprehensive medical reform pilot provinces should take the lead in promoting medical insurance agencies to directly settle payments with drug production or circulation enterprises, and other provinces should also actively explore (screenshot source: Official Website of national health and Health Commission) From the content of the document, we can see that the medical insurance department directly settles accounts with enterprises, which means that the one vote system has come, and it should be gradually promoted not only in the comprehensive medical reform provinces, but also in other provinces On September 30, nine departments, including the State Medical Insurance Bureau, jointly issued the implementation opinions on the pilot project of centralized drug purchase and use organized by the state to expand the regional scope, explicitly encouraging the regions with conditions to directly settle drug payments between the medical insurance fund and enterprises In addition, the document also requires all regions to actively adopt independent or cross regional alliance and other ways to carry out volume and budget procurement for drugs not included in the centralized procurement and use of national organizations in accordance with the requirements of volume procurement, integration of bidding and procurement, quality priority, quantity assurance and payment collection At the same time, all localities should explore centralized procurement by category for high-value medical consumables produced by many enterprises with large clinical dosage, high purchase amount, mature clinical use Before the end of September 2020, comprehensive medical reform pilot provinces should take the lead in exploring Before we understand the one vote system, we should make clear the relationship between the two vote system and it At the end of 2016, the medical reform office of the State Council and other ministries and commissions jointly issued the implementation opinions on the implementation of "two ticket system" in the drug procurement of public medical institutions, "two ticket system" refers to that the drug manufacturing enterprises issue one invoice to the circulation enterprises, and the circulation enterprises issue one invoice to the medical institutions This requires medical institutions, when the drugs are accepted and put into storage, they must verify that the tickets, goods and accounts are the same before they can be put into storage and used It is not only necessary to ask for and verify the invoice from the distribution enterprise, but also to ask the distribution enterprise to issue a copy of the purchase invoice with seal provided by the production enterprise The name of the drug distribution enterprise, the drug batch number and other relevant contents of the two invoices are mutually verified, and they are included in the financial file management as the payment voucher of the drug by the public medical institution This means that the "two ticket system" requires that invoices can only be issued twice at most from production to use, that is, there can only be one level of distributors at most One vote system can be simply understood as the direct selling mode of enterprises What is the impact on dealers and agents in this mode? In this mode, manufacturers can establish their own business teams, build sales networks, integrate manufacturers, that is, "overall solution providers", enhance the controllability of each link, and timely obtain the feedback from terminals and consumers There are two ways for manufacturers to achieve this: one is to acquire and integrate existing distributors; the other is to establish their own business team, including personnel from zero to establish and recruit existing distributors At the same time, when the price of consumables and drugs has been reduced to the floor price, "one vote system" has become an inevitable choice Because the price drop after negotiation is too large, some products have no margin space, so most circulation enterprises choose not to distribute considering the profit; on the other hand, many machinery enterprises and pharmaceutical enterprises will choose to distribute by themselves It can be seen that one vote in the circulation of products is a kind of stress response under the condition Recently, the general office of the CPC Jiangsu Provincial Commission for Discipline Inspection, the general office of the Jiangsu Provincial Commission of supervision, the Jiangsu Medical Security Bureau and the Jiangsu Provincial Health and Health Commission issued the notice on promoting the sunshine procurement of high-value medical consumables in the province, saying that from October this year, the public medical institutions in the province will be promoted to carry out sunshine procurement on the provincial platform All the procurement costs of public medical institutions in the province are settled through the provincial platform to guide and promote online procurement through unified settlement, so as to realize the integration of business flow, information flow and capital flow of the provincial platform, which is referred to as "integration of three flows" The main purpose of integration of three flows is to implement "one vote system" That is, the production enterprise directly issues invoices to medical institutions That is to say, through the establishment of a unified provincial pharmaceutical purchase settlement account, the medical and health institutions will pay the drug payment to the settlement account, and the settlement account will pay the drug payment to the production enterprises.