The great test of drug bidding comes to drug companies, whose profits are diluted, and they are eager to find new ways to help themselves

Source: Economic Observer 2015-08-24 according to the national regulations, by November this year, the new medical reform will carry out the drug bidding in Quzhong, and all provinces in the country must enter the bidding process In this countdown phase, bidding, price reduction and redemption are three sensitive words that are currently put in front of pharmaceutical companies 2015 is the year of drug bidding and price reduction At present, drug bidding in various provinces is in full swing Pharmaceutical enterprises strive to enter the bidding catalogue, but after entering, they find that the life is still not easy They are facing the dilemma of sharp price decline, the re negotiation of hospitals and further reduction of profits In fact, the downward pressure of drug price in turn is to achieve the overall goal of rational drug use and cost control in the medical reform That is to say, reform party, hospital, pharmaceutical factory, these three interest bodies will carry on the territory reconstruction in this round of medical reform Now mobile medical is in full swing, pharmaceutical companies hope to create their own closed-loop, direct to consumer sales Under the pressure of price falling again, some pharmaceutical companies began to find new sales channels; however, this market is still in the cultivation period, at this time, the prospect of self redemption of pharmaceutical companies is unclear Renhe pharmaceutical recently decided to invest nearly 200 million yuan to build an Internet medicine platform, to temporarily slow down its continued investment in cloud health Most pharmaceutical e-businesses, such as Yiling Pharmaceutical Co., Ltd., live in the expectation of the future So in this situation where all parties have appeals, how to solve the current dilemma of pharmaceutical enterprises? A late "strength" competition in the 2015 drug bidding year, winning the bid clearly ranked first in the eyes of pharmaceutical companies, because to ensure that the main market is the core for pharmaceutical companies to survive, and then qualified to talk about redemption In the pattern of Chinese pharmaceutical market, about 80% of drug sales come from medical institutions According to the economic observer, in the past, when it comes to bidding, some pharmaceutical companies began to rush to find leaders According to medical salesmen, some drugs spent more than 500000 yuan or even a million yuan in order to be shortlisted and win the bid However, when the wool comes out of the sheep, the final cost is shared in the price of medicine, which makes the price of some medicine higher This year is different, which is why the industry calls this year the year of bidding With the fall of the national development and reform price department and the people in charge of drug prices, the clean bidding officially started The winning of the bid mainly depends on the comprehensive strength factors such as enterprise scale, product quality and sales volume Therefore, in this round of bidding, the main problem is that the enterprise personnel in charge of the bidding have a thorough understanding of the materials and have a good calculation of the bidding price In the words of elim people, pharmaceutical companies are like monkeys now In order to survive, they are more worried "When I go to work every day, the first time is to quickly open the web page to see whether the draft for Soliciting Opinions on drug bidding in various provinces has changed a lot If the benchmark hasn't come out yet, the stone in my heart will fall to the ground and secretly rejoice; because without the benchmark, I can't calculate the price of the product, which means that I don't have to work hard to determine the price " Said Li Jun, a person from Yiling pharmaceutical industry Now the second stage of "bidding" is actually a short rest after a round of suffering Compared with the first stage of "Catalogue", bidding makes the heart of pharmaceutical companies more painful 2015 is the year of bidding, and it is also the year of managing bidding chaos and standardizing management For example, in addition to the traditional bidding catalogue, basic medicine catalogue and low-cost medicine catalogue, the catalogue of first-aid medicine and the catalogue of gynecology and pediatrics products have also been added Another difference between this bidding and the past is that it breaks the previous situation of unlimited dosage forms and specifications, and further improves the quality and orderly management of drugs Obviously different bidding policies also force the bidding directors of pharmaceutical enterprises to adapt to the new changes According to a person from a pharmaceutical enterprise, in the past, only the applicability of drugs was standardized in the bidding, while the dosage forms and product specifications were purchased by hospitals themselves, without any regulations Specifically, after winning the bid for a drug, five or six pharmaceutical companies rushed to introduce their products into the purchasing scope of the hospital due to the lack of restrictions on the dosage forms and specifications Due to the staggered peak operation, each enterprise adopted different management and sales strategies for dosage forms This also led to multiple dosage forms of a drug in the hospital, which buried the potential of chaotic competition among pharmaceutical enterprises In this year's drug bidding, in order to straighten out the chaotic situation of competition among enterprises under the competition of multiple dosage forms, improve the quality of pharmaceutical enterprises and support the concentration of pharmaceutical enterprises, and abandon small and medium-sized enterprises, document 70 puts forward new requirements for three common specifications of one product, two dosage forms "Now there are restrictions on dosage forms and specifications, and the sudden reduction of the scope indicates that some specifications will be withdrawn from the market." Li Jun, an insider of Yiling pharmaceutical, said that the decision on which specification to withdraw depends on the requirements of the catalogue In fact, at present, clinical medical institutions implement platform procurement for drugs, strictly prohibit any form of procurement outside the bidding catalogue and offline procurement From this point of view, entering the bidding catalogue is the only way to clinical sales of drugs According to national No.7 document (guidance on regulating centralized drug purchase in public hospitals published on February 28, 2015) and No.70 document (7) The guiding ideology of classified procurement and step-by-step implementation is stipulated in the bidding document If the products of an enterprise do not enter the category catalog, it means that the opportunity of bidding is lost and the threshold of clinical sales cannot be obtained In the process of making the bidding catalogue, the state has added many new restrictions on the catalogue, and made further subdivision and requirements in the sales scope, alternative methods, price reduction standards and drug use rules of drugs "The preparation period of these materials alone is very painful You should not only look at your own bowl, but also look at the situation of other people's homes You can't dare to fight until you figure out the approximate rate of gain and loss." Li Jun said that after meeting these questions, we should list the common specifications according to the sales situation, which also makes the competition of enterprises white hot "If the first three specifications are shortlisted, the other one will be withdrawn from the market." Li Jun said that in the process of being shortlisted, many enterprises' products will face the crisis of death For example, if an enterprise in Henan Province has six products that do not cross the threshold in one province, it means that its sales will decline seriously If this calculation, a cardio cerebrovascular drug, if the enterprise is not shortlisted in Henan Province, its loss will be in tens of millions Behind the dilution of profits of pharmaceutical companies, however, being shortlisted does not mean winning the bid After entering the catalogue, we can only say that we have crossed a threshold The next step is to bid and win the bid What disappointed Li Juns was that life was more difficult after the first threshold In addition to standardizing the bidding market rules, the most important goal of bidding is to "reduce the drug price" According to relevant data, in the bidding of Hunan Province, the largest decline of 34 bargaining varieties of Merck pharmaceutical giant is 39.8%; the largest decline of Pfizer 34 bargaining varieties has reached 55% In the first round of bidding, experts suggested that the price should be cut down by 50% on the basis of the bidding guide price; some experts did not consider the reason for the enterprise to give a counter-offer, and the second round of suggested price only increased by a few cents or cents on the basis of the first suggested price And Li Jun's products in this round of bidding decreased by about 15%, "have been fully competitive products, the profit is not so much." He exclaimed With the downward pressure of Hunan's bidding price and the linkage between the cities according to the bidding document No 70, Li Jun said that he was very distressed, because the prices of other cities will fall again under competition Although other provinces and cities have not opened bids at present, in the evolution of this procedure, Li Jun has felt that some regions can only abandon the bids because the prices are too low If the bid is abandoned, the shortlist at this time is meaningless But if you directly give up the opportunity to be shortlisted, the enterprise will not be willing And in the chat of many pharmaceutical enterprises, what they are unwilling to do is to take turns in the reform of drug prices in the medical reform They believe that the medical reform falls on the drug reform, not on the service providers' hospital "Since the beginning of the new health care reform in 2009, the first cut has been the price of drugs, which has been reduced by almost 40% across the country." Next, regions will supplement drugs, reform pilot cities to sell drugs at zero margin, and once again squeeze drug companies, making their lives more and more difficult, said a senior drug company official Perhaps, in the process of reform, the interests of the reformers, hospitals and pharmaceutical enterprises have to be re approved because of the reduction of drug prices According to people close to the health and Family Planning Commission, during the implementation of the national basic drug system in 2009, some of the drug price water was squeezed out during the bidding, and now it continues to squeeze, which can make the patients' drug consumption fall back rationally; at the same time, it can alleviate the disadvantages of hospitals supporting their medicine with drugs Prescription drugs are listed in the medical insurance catalog Although the reimbursement proportion is different, if patients use them, they will bear part of the financial burden on the basis of their own payment High drug prices are obviously a burden for patients and finance According to China's medical and health development report 2014 released in February this year, the average growth rate of China's total health expenditure in the past three years has reached 13.20%, which is 1.62 times of GDP growth rate in the same period This also means that if we can't control the current rapid growth of medical expenses, it will inevitably make the government finance and the real economy bear a heavy burden From the perspective of the reform party, it is imperative to improve the efficiency of medical insurance funds, so the drug price is an important breakthrough At the same time, the medical insurance quota also controls the use of drugs in hospitals According to some hospital personnel, the medical insurance quota allocated to departments has decreased by about 20% since this year On the other hand, for hospitals, when financial subsidies are insufficient, we can only hope that pharmaceutical companies can increase the rebate point again As the upper reaches of profit losers and pharmaceutical companies, hospitals naturally have to "hide their money" In the past drug price chain, taking general medicine as an example, the profits of pharmaceutical enterprises accounted for about 20%, hospitals accounted for about 25%, and the intermediate agents, distribution and other links accounted for more than 40% With the bidding price reduction in 2009 and the implementation of unified distribution, more than half of the water in the middle link has been squeezed out In fact, in this round, most of the hardest hit are intermediary agents In the pilot city of medical reform, where the drug mark up was cancelled, the enterprises were asked by the hospital to increase the subsidy, so the profits of the enterprises were diluted If we analyze the income structure of a hospital, 10% of its income depends on financial subsidies, and nearly 90% of its income comes from drug income and medical income That is to say, half of the hospital's income comes from prescription drugs in pharmacies In this round of reform, due to the cancellation of the bonus part of the loss of the hospital, and the local government's compensation is not in place, it will