The two MNCs are also scaling back county-level teams as new drugs begin to sink

June 2, according to self-media "Drug Sla" reported that division S and Division A in the near future to the grass-roots market personnel adjustment and optimization. Some provinces in division S have to optimize more than 10 jobs, while others have some jobs to optimize.Division A is also in the county team internal staff optimization, the last phase-out system, selected employees will be transferred to a third party to sign the contract.According to E Drug Manager, Division S refers to Sanofi, while Division A is AstraZenecom. County-level market is a vast blue sea, two foreign enterprises at the same time to streamline and optimize the county-level team, as if the county-level market in the past two years of high-speed growth figures do not match.In the past few years, a number of multinational pharmaceutical companies in the county market competition layout, but the results are good or bad. In the past two years, encouraged by the hierarchical diagnosis and treatment policy, it is clear that the county is beginning to become MNC's top priority again. From the IQVIA sample hospital data, MNC in 2018 in the second-, third- and fourth-tier cities growth rate of 10.9%, 11.9%, 8.8%, 2019 figures further improved, in the second-tier, third-tier, fourth-tier cities growth rate of 13.8%, 15.5%, 22.3%, respectively.On the one hand, the county-level drug team is shrinking, on the other hand, the county-level team is expanding. In April 2020, AstraZenecom announced the formation of a county-level oncology team, to achieve an average of one full-time tumor representative per county coverage, the county oncology team to recruit a total of hundreds of people, both external recruitment, but also to encourage internal transfer.Drug managers have learned from people close to the company that AstraZeneta's county team and county oncology team are separate and separate teams. While county teams are shrinking and optimizing, county cancer teams are expanding. This internal optimization of AstraZeneta has freed AstraZeneta of increased attention and investment in the county cancer market.Under the influence of high blood pressure, chronic diseases and other popular medicines have been included in the collection, as well as overlaying the epidemic, it has become a common choice for MNC to reduce the county-level general medicine team, reduce costs and improve efficiency. At the same time, new drugs such as cancer drugs are starting to look at this vast market, and both local biotech and MNC are starting to find ways to sink innovative drugs. What are they going to do? Will the county market usher in a new stage of development as a result?

pressure fermentation, Sanofi scaled back the county-level general medicine teamThe vast primary health care market has always been Waterloo for multinational pharmaceutical companies in China. The vastness of the region, high labor costs and other reasons, so that multinational pharmaceutical companies in the past few years have been laid out, and then have retreated.Sanofi was the first multinational pharmaceutical company in China to try to lay out the primary health care market, and in 2012 when MNC disbanded the grass-roots marketing team, it set up an independent primary health care division, the sinking force is not small.Sanofi's Primary Care Division focuses on cardiovascular and diabetes, and its core product, Porvi, is the primary product. Sanofi's main method of sinking is to quickly deliver advanced disease management concepts to the grassroots level by influenceing key opinion leaders and the application of digital platforms. As of October 2018, Sanofi's grassroots team is approximately 1,200.However, with the consistent evaluation and collection policy continued to advance, the phenomenon of maintaining high prices for patent-expired original research drugs represented by Polive and so on will no longer exist, and in the face of lower-priced generic drugs, it will be difficult to further expand the scale of product revenue by expanding brand coverage. In the 4-plus-7 expansion, Sanofi's Polvi won the bid at 2.54 yuan/piece, a decrease of 20% compared to the "4-plus-seven".With the volume of procurement is point-to-face flowering throughout the country, with more large varieties of general medicine included in the scope of collection, the original county-level drug team still need to maintain such a large scale, will be the focus of enterprise consideration.Coupled with the impact of the outbreak on hospital visits, it will be difficult to recover to the outbreak in the short term, for cost reasons and other issues, team streamlining and optimization will be the best choice. This may also be why Sanofi began to streamline county teams. For other MNCs that lay out their drug-in-the-pill teams in the grass-roots market, shrinking the team may occur frequently for some time to come.

MNC tried a new drug to sinkBut in recent years, encouraged by the hierarchical diagnosis and treatment policy, the primary health care market has become MNC's top priority.In particular, cancer drugs and other new special drugs, according to the 2020 urban and rural residents medical insurance treatment standards, Ogitini as a medical insurance variety, in the first and second-tier cities reimbursement ratio of only 50%, and if the transfer procedures, in the community / county hospital prescription, reimbursement ratio can be as high as 70%, each box can be saved (70%-50%) x 15300, that is, 3060 yuan.Taking advantage of the price advantage of primary hospitals, MNC actively sank the market, not only greatly reducing the financial burden of patients, but also led to a substantial increase in grass-roots sales.In this case, multinational pharmaceutical companies to reduce the general drug team at the same time, but also to expand the tumor drugs and other new drugs in the county market sinking strength. AstraZeneta, for example, announced the formation of a county cancer team in April. According to AstraZenecom, there is a pressing need for innovative drugs between primary cancer patients, and this is the first time a multinational pharmaceutical company has entered the county-level cancer market in China.AstraZeneza's oncology team will cover all Of AstraZeneta's oncology products, including a range of new anti-tumor drugs such as Terisha, Irriza and Liptro, as well as innovative treatments, as well as the newly launched PD-L1 Infineon.In addition to improving the accessability of tumor products in the county market, this county-level oncology team is also responsible for the platform construction of the entire county health system and the ability to provide innovative solutions to help build a healthy county system.Yu Wenxin, chief analyst at Haitong Securities and Haitong International Pharmaceuticals, said in an interview with E-Drug Managers that in fact many local drug companies have also targeted new drugs such as cancer drugs at the county-level market. Take PD-1 as an example, such a landmark broad-spectrum anti-cancer drug, the first-tier city market competition has been very fierce, who sooner layout of the county-level market, it is bound to account for the market opportunity."There must be someone in the middle who can succeed, and as for who it is, it has a lot to do with the company's organizational structure, its importance, and so on."

medicine e-commerce into a new special drug sinking toolAlthough the county-level market has broad prospects, but it is undeniable that the county-level market in the past is still dominated by general medicine, common drugs and chronic diseases, most doctors have limited awareness of tumor diseases, it is difficult to provide scientific norms of drug use guidance for cancer diseases. And this will largely be the bottleneck of the sinking of new drugs.AstraZenecom said one of the tasks of the county cancer team is to help county hospitals train academic experts through compliance academic promotion and to help county hospitals establish standardized oncology disciplines by building an academic platform for innovative drugs. As you can see, there is a long way to go in this task.In the Internet hospital policy liberalization and the rapid development of pharmaceutical e-commerce at the moment, Internet medicine may become a new special drugs to open up the county-level market an important tool.Jin Enlin, general manager of JD.com Health and Medicine Department, said in an interview with E-Drug Manager that on JD.com Pharmaceutical e-commerce platform, the proportion of new special drugs for tumors in cities below the third line is slightly larger than that of general medicine. One of the main reasons is that low-level cities of cancer patients in high-line cities to seek medical treatment, home to take medicine, so the online purchase of drugs there is a certain difficulty, and in this scenario, just can give full play to the characteristics of pharmaceutical e-commerce without space restrictions, to meet user needs.The form of Internet medicine and medicine not only enables first-tier city doctors to guide primary-level patients to use drugs, but also solves the normative problem of primary-level patients' drug use, and also solves the limitation of geographical space, leaving patients in the county-level market. As a result, it has become a new choice for many newly marketed innovative drugs. Jin Enlin revealed that in 2018 JD.com pharmacy on the line of a new AIDS drug, on the first day of the sale of several boxes, that year the online channel accounted for 1/3 of the product sales.Jin Enlin believes that a new drug on the market, compared to shop hospitals and pharmacies, in fact, the shop line channel is the fastest, can quickly cover the whole country. Hercetin, an anti-tumor biopharmaceutical that includes Roche, has also sunk into the grass-roots market through pharmaceutical e-commerce.Earlier, according to Zhang Wenjie, president of Fuhong Hanxuan, the Growth of Hessetin (Quto Zhudan) in the Chinese market in 2019 was half from cities below the third tier. Fu Hong Hanxuan will also be in the next four or five hundred people to form a commercial team to cover a wide range of markets.The general strategy of newly listed tumor products is to cover hospitals above level 3, and the competition for anti-tumor biosynthic drugs represented by qutoju single resistance has been extended to the grass-roots market below the third line, in part because Hessetin has been listed in the Chinese market for nearly 20 years, and after the price of the national health insurance negotiations dropped significantly in 2016, the problem of payment access to the primary market has been solved, and the market has sunk more rapidly. It is not difficult to guess, with the competition for biosynthic drugs such as Shumeile, Meromer and other more intense, the core market of first-tier cities has been saturated, the competition for raw drugs and biosynthic drugs will also sink to the grass-roots market. (E drug manager
)