Nine logics that need to be clarified for generic pharmaceutical enterprises in the post-4 + 7 Era

After 4 + 7, not only all medical people have become "frightened birds", but also deeply trapped In the post-4 + 7 era, where is the future of China's generic drugs? What kind of impact will India's low-cost generic drugs have on the industry? Almost every field is full of people How to take the road of transformation? If the sales team is going or staying, should innovative preparations be made In view of this series of current affairs and problems, the author got up early in the morning to code words and worked out the following nine logics However, these nine logics only represent the author's personal views, insights and inferences, which are not necessarily correct and insufficient Welcome to supplement and correct them We can't look at 4 + 7 without medical reform The latter is just a move of the former In recent years, one of the major purposes of medical reform is to leverage the interest chain of "medical support" and "excessive medical treatment" for many years Not long ago, an article exposed that doctors in a hospital in Qingdao were killing patients, which caused a storm This is the so-called "over medical treatment" Although the article said that doctors over prescribed tests, in fact, the phenomenon of over prescribing drugs is also common Because of the over prescribing of medicine by doctors, the so-called "magic medicine" came into being in the industry Some salesmen even claimed that the drug market was not innate, but made by people After the implementation of universal health insurance, there is no doubt that health insurance is the biggest payer of over medical treatment and drug-based care In addition, the aging is becoming increasingly severe If there is no way to do something, it will be in deficit in a short time Therefore, in recent years, a series of big moves issued by the state seem to fundamentally cure this malady which has lasted for many years 4 + 7 drug price reduction, on the surface, is to save medical expenses, but on the deep level, it is a good move to solve the problem of medicine Although the country has played many good chess in a row, many people still think that the power is limited, so the news at the beginning of the article came one after another In fact, the current situation is very clear, but there are still medical people who are lucky First of all, in order to solve the problem of supporting doctors with drugs, the state has recently announced a plan for the reform of the salary system of medical institutions Although the plan is not directly related to the pharmaceutical industry, it is clear that through the reform of the salary system, doctors' income has increased, the temptation of "kickback" has naturally decreased, and the phenomenon of over prescribing drugs will be curbed to a certain extent; second, The State adopts both hard and soft measures, such as adjusting the prescription system, strictly monitoring the prescription of some products, forbidding western medicine to prescribe Chinese patent medicine, medical insurance staff to enter the hospital for supervision, etc., to restrict the behavior of doctors administratively; thirdly, external intervention, checking the accounts of drug enterprises with high marketing cost, so as to prevent the second occurrence of kickback behavior; finally, medical insurance limits the indications and clinical evidence, D RGS and volume purchasing work together It's not hard to imagine that 90% of gross margin generic drugs will soon disappear Even if some pharmaceutical companies have such varieties, they have to hide them well Otherwise, they will be too "eye-catching" in the annual report and will be audited if they can't get it right With the step-by-step implementation of the medical reform, many people in the industry have also seen the situation clearly, but some people have proposed that doctors can't do articles on drugs, but they can continue to do articles on inspection, so they need to transform to do diagnosis and equipment Here, the author reminds the majority of medical people that although the market for diagnosis and devices is also very large, the playing methods of devices, diagnostic reagents and drugs are totally different Moreover, medical reform can do so many articles on drugs, and diagnosis and devices will not be better in the future In that sentence, if you don't understand the situation, you will be in a hurry to go to the hospital, and pay your wife carefully before you turn into a soldier In the post-4 + 7 era, the country still needs to encourage the development of generic drugs From the data released by the country, it is not difficult to see that the growth rate of health care expenditure has exceeded the growth rate of income With the increasing aging situation, this problem will become more prominent However, from the perspective of "taking from the people, using for the people", the money of medical insurance will eventually be paid out, and the scale is growing In order to save medical insurance expenses and protect more people, the country will vigorously develop generic drugs At present, a series of medical reform may only be the adjustment of payment structure to use good steel on the blade Therefore, as long as pharmaceutical enterprises follow the adjustment direction of medical insurance payment structure to build their own product line, there are still many opportunities to make money, and the plate may be bigger and bigger It is the general trend that the profitability of generic drugs gradually declines What pharmaceutical enterprises have to do is to stabilize themselves in the general trend of decline, make their decline speed smaller than the overall market, and strive for more time for transformation 4 + 7 mainly affects the market of grade hospitals India's generic drugs come in, and can only take root in the market of grade hospitals at first However, there are still a large number of clinics, private hospitals and pharmacies in China, and the purchase channels of these institutions are different from those of 4 + 7 with volume purchase, and there is still a large active space IMS data shows that grassroots prescription drugs and pharmacies account for 24% of the total prescription drug market With private hospitals, the proportion may be as high as 30% Moreover, the outflow of prescriptions is continuously accelerating, so we must accelerate the layout of this "invisible" market In addition, with the continuous popularization of primary medical treatment, there is a great opportunity for the development of slow disease medicine and general medicine Before, it was hard for the author to believe that the out of hospital market of products such as Plavix, Lipitor and luohuoxi accounted for 30% of the total sales Since foreign enterprises have done it, local enterprises should be able to do it The pattern of 4 + 7 is still a mystery Although the pushing speed of 4 + 7 exceeds the expectation of many industry experts, what the pattern of 4 + 7 will be in the future is still a mystery Fortunately, this time, Hebei Province followed up with 4 + 7, and we saw some clues First, Shiguibao, the manufacturer of fosinopril, the 4 + 7 winning product, cannot supply because of insufficient capacity, so it can only be supplemented by other enterprises; second, non 4 + 7 winning enterprises are allowed to quote; third, the quotation of some products is even lower than that of 4 + 7 Based on these three aspects of enlightenment, can we speculate that although Hebei follows up 4 + 7, it is not exactly equivalent to 4 + 7 of 11 cities; will there be more differences in the future when 4 + 7 is pushed across the country? It is not hard to imagine that if the national unified lowest price single bid winning system is used, it may lead to insufficient supply or monopoly of products, and if the multi-standard system is used for procurement, it may return to the previous problems: the sales volume of those with high bid winning price is large, in addition, China has a vast territory, a highly diversified pharmaceutical market, different regions and provinces have different drug demand and drug structure The unified adoption of the 4 + 7 model for centralized mining throughout the country may face the problem of considering one thing and losing the other In view of this series of problems, the author thinks that the most reasonable way is that in the future, there may be many state-level purchasing groups with volume similar to 4 + 7 Some products or some regions will be pushed aside by provincial purchasing groups with volume Each group will report the volume of each group, and each province will report the volume of each province, which can not only solve the monopoly problem, but also solve the supply problem, and maintain the lowest price The principle of winning the bid is to invite bids once a year Every enterprise has the chance to win the bid 4 + 7 won the bid at such a low price Some insiders doubted whether the production enterprise had the possibility of profit hanging upside down or vicious low price bidding at the beginning, and whether it would continue to supply goods or cut production cost in the future (the preparation standard is 90% - 110%, and some enterprises can supply materials at 90% or 95% in order to save costs, and the quality inspection is qualified, but the curative effect may be affected) In front of the crowd Faced with such a series of problems, the bidding unit may not only be responsible for price negotiation, but also calculate the production cost and capacity of the enterprise, otherwise the consistency evaluation will become a one-time evaluation And how to avoid this problem, perhaps many people have already had the answer, one is to strengthen the supervision of the whole life cycle, the other is to encourage the internationalization of pharmaceutical enterprises, with the help of the international advanced review institutions, to restrict the production quality of enterprises In fact, this point has been reflected in the bidding process of many provinces - European and American products approved or with European and American cGMP certification can win the bid at a relatively high price, perhaps this is the so-called quality embodiment, which is the confidence of government departments in the product quality of pharmaceutical enterprises Therefore, internationalization and cGMP certification are imperative for each large and medium-sized pharmaceutical enterprise There are thousands of drugs in China with terrible butterfly effect If all drugs are purchased in quantity, the workload is huge, and the cost of time and manpower is too high, so the author thinks that the butterfly effect is the most important factor in 4 + 7 For drugs with low price, small dosage and mainly circulating in the market outside the hospital, the significance of carrying quantity purchase is limited, or the possibility of being carried quantity purchase for a long time is very small Although it's just butterflies that stir their wings, it will have a huge impact on the pharmaceutical industry Through 4 + 7 to grasp the typical, through several products with the best effect and the largest market, the drug price in the whole treatment field has been greatly reduced In such a background, the original research is not listed in China, the academic is not sufficient, and the market recognition of low varieties will be very awkward, because the price is reduced, the profits will not cover the cost of academic, and the market cultivation will be very difficult, even be strangled in the cradle Therefore, in the future, the pattern of generic pharmaceutical products in China may be more centralized For some products with small market and low price, pharmaceutical enterprises are not profitable and may face the risk of drug shortage In addition to the 4 + 7 butterfly effect, pharmaceutical companies also need to pay attention to the butterfly effect that Indian generic drugs may bring People familiar with current affairs may know that China and India held two rounds of negotiations at the national level in May and June respectively Although the author believes that in the face of the fatal impact of low-cost generic drugs on the industry in India, local governments, associations and some relevant government departments may come out to serve as the industry platform, or even two representatives will come out to speak for the industry Therefore, it is unlikely that large-scale Indian products will come in at one time, but even if a small number of products are put in, these products also have It may become "deep-water bombs" one by one, causing a secondary impact on the existing drug price, which is no less powerful than another 4 + 7, which is very desirable for the medical insurance with the demand of fee control and fee reduction Therefore, we should be fully prepared to reduce production costs As early as the announcement of 4 + 7, some people in the industry put forward the idea of "avoiding 4 + 7 product project" Perhaps they have come up with the idea that 4 + 7 focuses on the butterfly effect - it's impossible or impossible to purchase thousands of generic drugs in a certain period of time Their point of view is to avoid the 4 + 7 selected atorvasts and rosuvas, and to seek the second place, to do symplectic and matched cutting In fact, this view can't stand at the very beginning, because they ignored the role of 4 + 7 "four and two thousand catties" Atorval and rosuva are the best products in the same field with the highest market recognition Since these two best in class are both pressed to the floor price, simvastatin and pirvastatin, which have no advantage in safety and effectiveness, can't enjoy the high price On the one hand, if the medical insurance is based on 4 + 7 For the reimbursement of price benchmark, the price difference must be paid by the patient, and the patient may question it; on the other hand, the so-called "long illness makes a doctor", even if the patient no longer knows the medicine, for a long time, the so-called "high price mechanism" will not break itself Therefore, in the field of general medicine, the theory that we want to avoid 4 + 7 varieties and enjoy high prices alone is not only