Three questions triggered by the new policy of basic drugs: drug companies can't laugh

2013-04-15 source: the appearance of Jinling Evening News 2012 edition of national essential drugs catalogue only excited the pharmaceutical a share for a day or two In fact, around the intensive release of basic drug policies and drug bidding in the first quarter, the interest game of all parties in the deep-water area of medical reform did not stop for a moment "To enter the base drug catalog is only to get the entry certificate Enterprises have to strive to stay on the line of the national development and Reform Commission, and the maximum retail price will not be significantly reduced The provincial bidding is another "price robbery" Only if we guarantee to cut the cake can we laugh at the end " The head of a senior pharmaceutical enterprise's Government Affairs Department told reporters yesterday that pharmaceutical enterprises now have both opportunities and pressures In the evening of March 15, the Ministry of Health issued the 2012 version of the basic drug catalogue Compared with 307 drugs of 2009 edition, the capacity of the new version of basic drugs has been expanded by nearly 70%, and will be implemented from May 1 However, the lucky shortlisted pharmaceutical companies are not happy "If it's not the exclusive variety, it's quite disturbing The subsequent bidding policy is more important than entering the base drug catalog." The head of a pharmaceutical company in Jiangsu told reporters It is understood that at present, the list of base drugs only publishes the names of varieties, and specific enterprises and brands need to be determined through provincial (municipal) bidding As the bidding of basic drugs in each province basically follows the double envelope model of Anhui Province (i.e technical bid and commercial bid), the lowest bidder is selected as the only one to win the bid This means that the non exclusive pharmaceutical companies have to face the secondary bidding, the elimination process is extremely cruel, often a product is faced with more than ten competitors In order to pursue market share, it is not uncommon for the bidding price to be lower and lower In the first half of last year, the gross profit margin of the company's infusion dropped 4.3% year on year, only 42.2% In order to correct the evaluation method of "double envelope", the general office of the State Council issued on February 20, 2013 According to the opinion on consolidating and improving the basic drug system and the new mechanism of grass-roots operation, it is required not only to conduct a comprehensive review on the quality of drugs, the service and reputation of production enterprises, but also to conduct a comprehensive evaluation on drugs with obviously low bidding prices to avoid vicious competition In GBF [2010] No 56 document, it is pointed out that the core spirit of basic drug bidding is "the lowest price bid, single bid" According to the analysis of the head of the government affairs department of the above-mentioned senior pharmaceutical enterprises, in the future, the basic drug bidding will definitely increase the scoring weight of drug quality At present, the first mock exam of Beijing's basic medicines bidding policy has raised the technical threshold, which is divided into three quality levels The future mode may be popularized as a model for the bidding of basic drugs However, Zhou Zijun, one of the drafters of the medical reform plan and a professor of Peking University School of public health, revealed a hidden concern to the reporter As long as the enterprise passes the basic quality threshold such as the standard certification of drug production quality management, it means that it has considerable production capacity "If the price is low but not the standard, but the price is high, how about increasing the possibility of dark box operation?" The proportion of high base drugs used hospital impulse drug abuse? Even if winning the bid, will pharmaceutical companies be able to take advantage of the rising price and share more cakes? In order to link the bidding with the market, the national health work conference held in January this year pointed out that after the introduction of the new version of the catalogue, all localities need to stipulate the proportion of basic drugs used by medical institutions at all levels Except that all primary medical and health institutions are equipped for use, the use and sales of basic drugs in secondary hospitals should reach 40% - 50%, and the sales of basic drugs in tertiary hospitals should reach 25% - 30% However, No 14 document does not explicitly mention the proportion of basic drugs used in the second and third level hospitals, the linkage between the upper and the lower, and other policies, which means that the varieties selected in the basic drug catalog will lose the market of the second and third level hospitals if they fail to win the bid "This is not in line with the spirit of the health work conference at the beginning of the year, and the policy trend needs to be further tracked." The head of the government affairs department of the pharmaceutical enterprise pointed out to the reporter "In fact, the proportion of basic drugs used in the second and third level hospitals is far from the specific proportion mentioned in the health work conference." A researcher in Shanghai told reporters that only 10% of the tertiary hospitals in Guangzhou surveyed used basic drugs Hu Shanlian, a professor at the school of public health of Fudan University, also told reporters that before the expansion of the list of basic drugs, the proportion of basic drugs used by the third level hospitals in Shanghai was about 17% After the new version was released, the well executed third level hospitals could reach about 20% "Considering the actual situation, the proportion of basic drugs used in the second and third level hospitals is too high If it is stipulated by force, the hospital will bundle the basic drugs together when prescribing for the sake of impulse, which is against the principle of rational drug use " Is it expected that the new deal will be released when it is implemented? In the interview, some people in the industry believed that in order to increase the proportion of base drugs, it was not ruled out to introduce a supporting policy similar to "second price negotiation" The so-called secondary price negotiation refers to that the medical institutions, on the basis of the results of provincial drug bidding, once again haggle over the price of the winning drugs when they enter the list of hospital procurement, so as to change the non-standard "secret deduction" into "explicit deduction", incorporate it into the performance assessment and redistribute it The Shanghai researcher explained that at present, the basic drugs are sold at zero margin Considering the current situation that the second and third level hospitals support their doctors with drugs, the hospitals only operate drugs with relatively large profit margin If the price can be negotiated twice and the bidding price is 30 yuan, the hospital will only pay 25 yuan to prescribe the drugs with sufficient motivation Zhou Zijun, a professor at Peking University School of public health, also took a clear stand to the reporter, saying that in the process of drug purchase and sale, the government led the unified bidding and purchase, deprived both sides of the bargaining power, and curbed the normal quality and price competition of enterprises "When you have seen shopping, are you not allowed to bargain? This will increase the burden of pharmaceutical enterprises, but this is the economic law Only reasonable profit space can be reserved for drugs The second price negotiation will eliminate some enterprises with small scale and truly reflect the value of drugs " But the opposition has been heard Some pharmaceutical companies made it clear to reporters that "once the second price negotiation is fully opened, the hospital will make the life of pharmaceutical companies more difficult with the right of price negotiation In addition to doctors, we also need hospitals Hu Shanlian, a professor at the school of public health of Fudan University, said that he did not agree with the second bargaining and needed to maintain the authority of the bidding platform in various provinces and cities Once liberalized, pharmaceutical companies will not be able to bid at the bottom price, and only when there is more quantity and more price can the price be reduced The head of the government affairs department of the above-mentioned pharmaceutical enterprises told reporters that the conflict between the second price negotiation and the bidding will definitely be the second choice in the future It is expected that the second price negotiation is only a pilot project and will not be implemented nationwide "Due to the large number of policy variables, the understanding and implementation of policies vary greatly from place to place At present, everyone has a feeling of not being able to see clearly." Institutional investors to reporters frankly, in addition to a few new key traditional Chinese medicine exclusive varieties, will not rush to invest in the relative increase has been too high base drug concept stocks (Jiang Fenfen)