The pharmaceutical retail industry on the eve of the big change

Judging the trend of the pharmaceutical retail market cannot only be seen from the inside of the market, and future market changes will not only be as simple as online and offline games, but will be affected by the overall health care reform environment in China, especially those focusing on medical insurance.

First of all, from the perspective of the medical reform trend of overseas developed countries and the reform of the pharmaceutical retail market promoted by it, the key to the large-scale pharmaceutical retail market is not the policy itself, but the medical system

Reimbursement of prescription drugs in the US market is highly dependent on PBM (Pharmaceutical Benefit Management).

In Japan, which is located in East Asia with China, social security covers all people and there is no third-party prescription management agency, and the drug retail market is highly fragmented

Therefore, from the experience of Japan, even if most of the prescriptions are outflow, as long as the system is fully covered by medical insurance, it is impossible to produce a highly concentrated pharmaceutical retail market, which has a clear reference significance for the Chinese market

Secondly, with the reform of medical insurance and hospitals, without large-scale subsidies to medical institutions, it is impossible for the pharmaceutical retail market to rely on prescription drugs to scale up

First, the direction of China's medical insurance reform is not to promote the outflow of prescriptions, but to reduce drug expenditures in general

Second, with the deepening of medical insurance reform, the return of drug sales to hospitals will be the norm

Third, the withdrawal of OTC from medical insurance is a very clear trend, which is a real drawdown for Chinese retail pharmacies

In 2020, personal accounts will spend 207.

Fourth, in the general environment of centralized procurement and drug price negotiation, since drug prices are getting lower and lower, and even the ex-factory price is the payment price for medical insurance, pharmacies have no profit on this type of product

As the Japanese prescription drug market has become saturated, pharmacies specializing in the retail of prescription drugs have transformed.

However, drugstores with fast-moving sales capabilities have entered prescription retail

Finally, hospitals can still cut a piece of cake from the prescription drug market, but the market size is relatively limited, and hospitals will still be the main battlefield for drug sales

The Chinese market always compares with the United States when making market predictions, which is a bad assumption in the medical field

In a market situation like the United States, most retail pharmacies have gained a huge volume because of alliances with large-scale commercial insurance, and thus gained a high share of the market

But if, like in Taiwan, hospitals still rely on medicines for income, the rate of prescription outflows is firstly very low, and they can only rely on primary clinics to obtain outflowed prescriptions
.
The prescription outflow rate in Taiwanese hospitals is less than 1%.
If the basic level is included, the prescription outflow rate in Taiwan is 34%.
Even so, most prescriptions still flow to hospital stores or pharmacies next to clinics
.

Retail pharmacies in Taiwan are bleak in obtaining prescriptions.
Only 55% of pharmacies operate prescription drug business.
On average, each pharmacy obtains only about 10 prescriptions per day, and 45% of pharmacies do not operate prescription drug business but only operate OTC.
And health products and other non-medical insurance reimbursement products
.
Taiwan’s hospital pharmacies are thriving.
According to statistics from Taiwan’s National Health Insurance, Taiwan’s hospital pharmacists have an average dose of 150 prescriptions per day, which is much higher than the prescribed number.
Some private consortium medical centers pharmacists can dose as much as 360 prescriptions per day.
More than Zhang
.

The current situation in Mainland China is similar to that in Taiwan.
Due to the lack of prescription outflow conditions, there is no PBM as a tool that can help increase market share.
It can only rely on hospital-side stores that are closely related to hospitals for development
.
The development of hospital-side stores has three characteristics: First, the gray income of doctors comes from medicines, which must have a fixed interest chain and be convenient for patients to get medicines nearby.
Only hospital-side stores can meet this point
.
Due to the relatively long process for the assessment of the proportion of hospital medicines and the admission of medicines to the hospital, some medicines have to be flown out of the hospital, and the hospital side stores can still clearly meet the needs of patients with these medicines
.
Second, since China does not have pharmacist dispensing fees, the gross profit of prescription drugs continues to fall, and hospital-side stores can only rely on prescription drugs to generate revenue rather than profit
.
It is difficult for courtyard shops to obtain sustained growth momentum under low gross profit, which further exacerbates the fragmentation of the market
.
Third, the courtyard-side store market is highly fragmented, and it is difficult for leading companies to segment high market shares.
It is difficult to generate large companies.
Only small and medium-sized companies can be used.
It is not as good as traditional retail pharmacies that can make a larger scale
.

Therefore, from the perspective of overseas experience and China's domestic market, under the promotion of policies, retail pharmacies are about to usher in a fundamental change.
The trigger point of the change will depend on the time when OTC withdraws from medical insurance, or the time when an account is cancelled
.
Once the personal account is cancelled, OTC completely withdraws from medical insurance, and retail pharmacies will have to switch to a self-paid drug, medical equipment and other non-pharmaceutical model.
The sales capacity of healthy fast-moving consumer goods will determine the market share of retail pharmacies
.
Hospital-side stores will also continue to develop, but they will not be the main market for retail pharmacies.
The hospital-side stores will focus on self-paid high-priced drugs and some other varieties that are difficult to enter the hospital.
The scene of chronic disease medication is still concentrated in hospitals and grassroots, especially It is in the medical union, which will further squeeze the retail pharmacies outside the hospital
.