The 6000-word long text analyzes the portfolio strategy that has to be studied under DRG.

The purchase of 4 plus 7 band volume greatly affected the pessimistic expectations of pharmaceutical companies for the future, a considerable number of enterprises began to plan ahead to seal the post, the abolition of the product line, once came out of the head of foreign enterprises will be generic drugs, over the patent drug product line overall packaging and sale of events.
this year's accident deepened this trend - since the outbreak of new coronary pneumonia, the author learned that some hospitals in the first quarter of outpatient visits even fell by 90%.
in such a situation, some enterprises out of layoffs, pay cuts and other rumors, it is not surprising.
that winter is coming, it may be too early to say it's cold.
2019, the National Health Insurance Agency officially issued a document establishing 30 DRG-paid pilot cities, and requested that from January 2021, 30 pilot cities will formally implement DRG actual payments.
in accordance with China's policy reform has always been "pilot full, comprehensive spread" model, it can be said that the disease diagnosis related group payment this novel medical insurance payment model has entered the countdown to the official debut.
according to various media on the market, from the media's endless analysis reports, it is generally believed that the implementation of DRG can control medical expenses, reduce the pressure on health care payments.
, of course, this means a harsher "39 winter" for drug manufacturers.
One, Recognize the Nature of DRG Tools" DRGs Disease Diagnosis Group is a system that manages patients into several diagnostic groups (DRG groups) based on factors such as age, diagnosis of the disease, complications, treatment methods, severity of the condition, and transfer.
health insurance payer will establish payment criteria in accordance with the diagnostic team and directly settle with the hospital.
and the patient's own payment method, reimbursement rate will not change.
" from the above discussion, we can see that DRG is a clinical performance of a variety of complex diseases, first in accordance with the "clinical characteristics are similar, similar resource consumption" principle of grouping, and then the development of each group of corresponding payment standards.
, for example, this process is like our pharmaceutical companies to different speaker, according to the different classification of academic/ administrative job levels, respectively, to develop different standards of lecture remuneration.
the purpose of establishing standards for the payment of lecture fees, or to facilitate financial supervision and reimbursement of corresponding expenses.
So you could say that DRG is both a medicare payment tool and a hospital performance management tool, but essentially DRG is a financial management tool that applies to the medical field and studies how to keep accounting in charge of medical expenses.
so it's no surprise that many of the DRG literature is published in accounting journals when we look online for relevant literature.
2. The layer transfer DRG data under the pressure of medical insurance fee control under DRG, as the most effective data to reflect the consumption of disease resources, is the most direct and most realistic cost data, and its effectiveness will be significantly better than the drug data added up solely by sales data.
The future with the tightening of drug procurement power to a higher procurement body, which means that hospitals under the pressure of cost accounting, will consider the selection of drugs from the entire business side, such as the inevitable more attention: the cost-effective selection of drug-consuming products, can use generic drugs without original research, consistent quality of the case with cheap;
Thus, most of the pressure on hospital cost accounting has shifted to the two main bodies in the current drug sales chain - pharmaceutical companies and clinicians, which will face: 1, the weakening of the drug companies' voice in drug pricing;
has thus completed the layer shift of pressure on health care fees.
Three, DRG era pharmaceutical sales strategy transformation outlook DRG under the health insurance control fee pressure layer transfer, will lead to the overall decline in drug use, a sharp reduction in profits of single varieties and generic replacement, will lead to the original one product can feed a sales team of the so-called "hard work" model is difficult to maintain.
therefore, the transformation of the marketing model of pharmaceutical companies has become inevitable.
the current widely recognized transformation approach is probably the following aspects: academic marketing to further strengthen the DRG era of standardized, standardized medical needs are extremely urgent, the implementation of clinical path will be truly grounded.
, by strengthening the academic status of the product, so that the product can be integrated into the clinical path at all levels, will become the focus of marketing work.
development of emerging channels such as retail and Internet hospitals has shown that in order to reduce hospital cost pressures, the implementation of DRGs can lead to the flow of prescriptions.
pharmacy, network medical team, advance layout of new channels to become one of the direction of marketing transformation.
To increase investment in scientific research and promote the real progress of disease treatment DRG's macro logic is to consider the best cost-effective health economics, economic leverage-driven standardization of clinical practice behavior, with the most reasonable cost so that more people can see the disease, will prompt medical institutions and doctors to use a wide range of mature cost-effective products, so that for the general innovative drugs is a negative.
But for some drugs that can really drive innovation in the concept of clinical treatment, even if they don't get into health insurance, they can still be sold by directing patients to out-of-the-way pharmacies or DTP pharmacies, thereby maintaining their high profits, so for this kind of innovative drugs, health insurance is a double-edged sword, to make a comprehensive decision.
is more cost-effective, from a single product sales, to a group of product sales to change the market competition is a highly complex behavior, there are many factors affecting the outcome of the competition, but costs and inputs are undoubtedly very important factors.
policies such as DRG and volume procurement have reduced the profit margins of pharmaceuticals, but both academic and cooperative investment may not be reduced.
when the meager profits of a single product's output are not sufficient to support large input expenditures, more products are needed to contribute profits and share input costs.
, is any combination of products able to achieve this (co-contribution of profits, sharing of input costs)? Is there a strategy to save money and make more money by cleverly building your portfolio? This is the core of this article to explore the content.
, the construction of the product portfolio model under DRG At present, the marketing expenditure of a drug can be divided into two categories from the main categories: 1, the input cost of academic activities;
When we combine some drugs, we will find that there are some combinations of academic activities of the input cost or the cost of the customer input is not a simple 1 plus 1 x 2, but the emergence of a 1 plus 1 x lt;2 situation.
is the basis for building our portfolio strategy model under DRG.
First of all, let's assume that there are only A, B products combined, according to A and B products involved in the ADRG group and target customers, there are obviously the following four combinations: at the same time set: a product in a hospital unit gross margin is M (gross margin - end price - base price - hospital / distributor rebate), annual academic input for X, customer input for K, product net profit is Y.
general: a is a constant.
So obviously there is a net profit of the product Y-M-X-K then, the net profit of combination one is: Ya-Yb-Ma-Mb-(Xa-Xb)-Ka-Kb, that is, when Product A, Product B The total net profit is the net profit when the A and B products are sold separately when the same ARG group is not covered (i.e., the products of A and B cover different subdivisions with different clinical characteristics, and when the subdivisions are different and the academic inputs are certainly different), and when the same target customers are not covered, the net profit is the net profit when the A and B products are sold separately.
the combination of A product and B product, the effect is 1 plus 1 x 2, and no combined force is formed.
To give a simple example of the treatment of EGFR mutant non-small cell lung cancer Gifitini, ADRG group for ER1 respiratory tumors, the main application department for oncology, treatment of mild and moderate primary hypertension of Pythatan, ADRG group for FV2 hypertension, the main application of the department is: cardiology.
it is clear that Givitini and Pythatan cover different ADRG groups and different target customers (only most cases are considered here and not discussed in a few special cases), and that they do not work together in sales.
But when we look at the case of combination two, we find that combining two products saves some customer input by covering the same target customers, so the net profit of combination two is: Ya-Yb-Ma-Mb-(Xa-Xb) -Ka (or Kb) also means that when Product A, Product B does not cover the same ADRG group, but covers the same target customers, the net profit compared to the situation in the combination of one significantly improved, playing a 1 sl;2 effect, forming a joint force.
As a result of cost savings and increased net profits, it is clear that the company is able to feed back more marketing investment in this market than in combination in the face of competition, or in the face of generally low drug margins, resulting in increased competitiveness and increased risk resistance."
For example, Gifitini for the treatment of EGFR mutant non-small cell lung cancer, ADRG group is ER1 respiratory tumor, the main application department is oncology, treatment of advanced gastric adenocarcinoma or gastric-esophageal combination of adenocarcinoma adenocarcinoma apatine tablets, ADRG group is GR1 Digestive malignancies, the main application department is also oncology, it is clear that Gifitini and Apatini cover different ADRG groups, but applied to the same department, thus saving some customer input, and because the same customer sales of two products, no doubt increased customer viscosity, the two can form a certain combination in sales.
When we consider the case of combination three, since product a, B belongs to the same ADRG group, i.e. A, B product covers the same clinical characteristics of the sub-disease, then obviously can save some academic input, so the net profit of combination three is: Ya-Yb-Ma-Mb-Xa (or Xb) - (Ka-Kb) also means that when Product A, Product B covers the same ADRG group, but covers different target customers, the net profit compared to the situation in the portfolio is also improved, but also played the effect of 1 and 1 ,lt;2, forming a joint force.
Also an example of the treatment of EGFR mutant non-small cell lung cancer Gifitini, ADRG group is ER1 respiratory tumor, the main application department is oncology, human EGFR mutation gene testing reagent (multifluorescent PCR method), ADRG group is also ER1 respiratory tumor, the main application department for the examination department.
It is clear that gificini and human EGFR mutation genetic testing reagents belong to the same ADRG group, but cover different target customers, thus saving some academic input, and because they are both in the field of respiratory tumors, the two will also have a mutually promoting role in academic promotion, forming a certain synergy.
When entering the case of combination four, since products A and B belong to the same ADRG group and cover the same target customers, it is clear that academic input and customer input can be partially saved, so the net profit of the combination four is: Ya-Yb-Ma-Mb-Xa-Ka (or- Xb-Kb) obviously, the net profit of the combined number of four is higher than in the other three cases, thus forming a stronger combined force.
also used Gifitini as an example for the treatment of EGFR mutant non-small cell lung cancer, ADRG group for ER1 respiratory tumors, the main application department for oncology, the treatment of ALK mutant non-small cell lung cancer, ADRG group is also ER1 respiratory tumor, the main application chamber is also oncology.
it is clear that Giffetini and Aletini belong to the same ADRG group and cover the same target customers, which is the ideal combination to form a greater synergy during the sales process.
after discussing the four product combinations above, we can extend the model to several product portfolios, with n product categories sold in a particular market and a net profit of Yn.
are also discussed in four ideal situations: ideally one n products do not belong to the same ADRG group, nor do they cover the same target customers, and there are ∑Yn-∑Mn-∑Xn-∑Kn Ideal II n products do not belong to the same ADRG group, but cover the same target customers, there are ∑Yn-∑Mn-∑Xn-K ideal three n products belong to the same ADRG group, but cover different target customers, there are ∑ ∑Yn-∑Mn-X-∑Kn ideally four n products belong to the same ADRG group, and cover the same target customers, there are ∑Yn-∑Mn-X-K obviously, according to the simple Mathematical knowledge, four ideal product net profit size in turn: ideal situation four , ideal situation two , ideal situation three , ideal situation one of course, the reality of a company's product line is complex, it is impossible to an online all products are in line with the ideal situation four, A product often also covers multiple ADRG groups or multiple target customer groups.
therefore, we should choose the main push direction as far as possible to form a product portfolio that belongs to the same ADRG group as our main product, or that covers the same customer.
the above reasonable product portfolio can not only reduce the cost input, but also save the sales staff working time, thereby saving labor investment.
Especially with a portfolio that covers the same target customer, we can also model analysis: the frequency at which a representative is able to visit the same customer each week as a valid indicator, assuming that the number of customers a representative can visit a day is n (n generally constant), the frequency of visits to the same customer per week is h, and the number of customers managed by the representative is N ?5n/h (n is constant).
if the representative manages multiple products, there are three situations: 1, multiple products cover different target customers, then N, according to the formula N , 5n/h.
the number of customers a representative needs to manage increases, the frequency of weekly visits decreases.
2, multiple products cover part of the same target customers, the same N , h .
the frequency of weekly visits will decrease, but since the number of customers to manage has only partially increased,