Can drug exchanges curb rising drug prices?

Every year is the time when Yang Shilong (a pseudonym) is the busiest time. For him, it is also the most critical moment. "This determines the good or bad business in the coming year." Yang Shilong’s current identity is the head of a small pharmaceutical company in Nanning. In the eyes of others, he is a typical case of successful transformation. He was formally involved in the pharmaceutical industry 19 years ago and started as a “medicine representative”.

The current situation of pharmaceutical companies is only 8 points gross margin “has been in the circle for a long time, and everything can be understood.” It is the accumulation of early “resources” that Yang Shilong has a place in the present. After finding his way through the doorway, Yang Shilong met a good opportunity in 2006 to buy a small pharmaceutical company and succeeded in "going ashore."

He did experience a good time. "However, medical representatives are now very competitive and the market has not done anything good before." Yang Shilong's pharmaceutical company and pharmaceutical representatives are inextricably linked, both in competition and cooperation. Pharmaceutical representatives sent by pharmaceutical companies sometimes sell to pharmaceutical companies. Pharmaceutical representatives have become the downstream industrial chain of pharmaceutical companies.

Whether it is a pharmaceutical company or a pharmaceutical representative, profits have already passed. Yang Shilong said: “Especially after 2009, the state has provided that township hospitals are equipped with and use national essential medicines, and they implement online sunlight procurement and zero margin sales. Immediately after the end of 2009, Li Keqiang, member of the Standing Committee of the Political Bureau of the CPC Central Committee and vice premier of the State Council, emphasized the need to ensure that the price of medicines fell when he examined the effectiveness of medical reforms in Anhui."

Yang Shilong said that they are making small heads. "For example, if a medicine is bid for a price of 30 yuan, it will cost our pharmaceutical company 8 points. We will use these costs to maintain the company's operations and transport and store medicines." Of course, The most critical is "maintaining customer relationships." The customer he referred to was a hospital. "If the hospital does not give you anything, then nothing can be said."

In accordance with the usual practice, we must maintain good customer relationships and celebrate holidays. "We must naturally go to the top and bottom of the customer and carry out 'stitching' outside and inside."

Yang Shilong had been dealing with pharmaceutical companies for many years, and the interests of him naturally understood. Over the past few years, from pharmaceutical companies to bidding for medicines, sales of medicines, hospitals, and finally to the hands of consumers, the “strange cycle” of “low-price competition, high-price public relations, and consumers’ payment” has been formed.

The “fattening” point for drug prices has also gradually concentrated on the two aspects of “pharmaceutical bidding and tendering” and “hospital”, and a large part of the profits obtained in other links also “automatically” flowed to these two places.

The ten-year situation of pharmaceutical representatives is getting more and more difficult. In an interview, a person in charge of a large-scale Chinese medicine pharmaceutical company in Wuhan said frankly: “We can't deny that manufacturers are now required to entrust pharmaceutical companies to tender. However, most of the fare increase is used. In hospitals, doctors, and related departments, companies accounted for less than 10% of the space for this increase. Some relatively small manufacturers are even earning money.

The statement of several medical representatives indirectly confirmed this statement. Jiang Jie (a pseudonym) is now the principal of a vocational school in Guangdong. Ten years ago, he was also a medical representative. "At that time, the purchase of medicines was different from the present, and it was generally the hospital pharmacy department that issued a drug purchase order." He said that he would "bargain" and go to the wholesale pharmaceutical market in the Mazhang District of Zhanjiang City to negotiate and purchase. "What we earn is the difference." .

Jiang Jie said: "It was very simple at first, and it was authorized by the Department of Pharmacy." Later, it slowly evolved. If you want to do it for a long time, you also need the head of the hospital to "nod". Jiang Jie metaphorically, the dean "nodded", you just got an exhibition ticket, drug sales do not sell out, the department director "to let go." However, "the department director approved, the doctor did not prescribe medicine, and the medicine still could not be sold. The village had been in the warehouse for a long time. After the expiration date, it was scrapped, so it had to be given to the doctor."

There is also the final stage, and the financial staff responsible for settlement has to “stitch up”. Jiang Jie said: “Otherwise, the list will be stuck and the money will not come.”

As the market became more and more difficult, Jiang Jie simply withdrew. When Lin Zhongxin (a pseudonym) was introduced into the market in 2007, the pharmaceutical market has reached the point where competition has become incandescent. “Overall, pharmaceutical companies and pharmaceutical companies give profits to hospitals.” He said that medical representatives did not earn as much as people think. The best year to do it was to earn more than 50,000 yuan. In general, only 20,000 of the “Yearly Years” were made. “Business trips, fares, transportation, and communications are all borne by pharmaceutical and pharmaceutical companies.”

"On holidays, small representatives like me do not say that they need to 'punry' more. It is still necessary to send a few red envelopes. All of them are forced out." Lin Xinxin feels that there is nothing to do, plus the age is already high. In 2011, he chose to leave the industry.

The drug supply exceeds the demand of 99% first to find the dean and Yang Shilong has fought for more than ten years in the circle. The most important thing is to accumulate contacts in the hospital, and the drug sale business is “deep”.

"The pharmaceutical companies are making money and things are different. The common varieties are not good, like conventional drugs like vitamin C and vitamin B6. Small manufacturers are trying to open up the situation and even lose sales. Some of the money earned is not enough public relations fees." He introduced, and some special varieties Compared with making money, pharmaceutical companies, medical representatives, pharmaceutical companies, hospitals, and doctors are all profitable.

Yang Shilong disclosed: “The gross profit of general varieties is not high, which is about 40%, but the 'maintenance' is simple, such as glucose, salt water, as long as there is a relationship between the president, enter the hospital on the line. Because as long as the infusion will be used, the doctor There is almost no rebate for the prescription.” He told reporters that the sale of this medicine is basically one step.

In contrast, in the circle, there is also a kind of clinical medicine called "Clinical Drugs." The pharmaceutical representative who runs such drugs is called "Clinical Representative". He has to open up the way from "Up" to "Down," and it lacks a link. No, “The gross profit of this drug is generally 60%, and the high one can reach 80%.”

Yang Shilong said with emotion: "I often see a department with more than 10 doctors, but there are hundreds of medicines waiting to queue up in hospitals. There are more medical representatives than doctors."

He also said: "A drug to enter a hospital, 99% of the first must first find the hospital dean, the dean to draw a big 'frame', for example, approval of 10 companies on the admission of drugs, but which one to purchase , then give the following people an 'operation space', and then the pharmacy section responsible for picking again, and so on.

Both the reform barriers and the distribution barriers “Can we establish a third-party pharmaceutical electronic trading platform and can we do a good job, depending on how much the government is determined?” I heard that Guangdong Province will build a third-party platform for drug transactions this year. Hospitals and enterprises can be likened to As stock exchanges bid and buy drugs, Yang Shilong appears calm.

The third-party pharmaceutical e-commerce platform, which is independent of the neutral service organizations of buyers and sellers, only provides a digital platform for the various services required for transactions. It provides drug information release, online purchasing, online trading, online payment, drug tracking, and ground storage and logistics.

In October 2009, the State Food and Drug Administration issued the first certificate to provide drugs to individual consumers via the Internet. In 2011, Tencent's QQ Mall introduced Jianke.com, Taobao launched the “Pharmaceutical Museum” to sell medicine on the Internet, and Jingdong handed in Kyushu Link. Later, Dangdang joined it. However, the scale of growth in this market has been limited. According to the data of the SFDA, there are only 67 companies that currently qualify for Internet drug trading services, and there are 8 third-party transaction service platform models.

It is understood that the "third-party trading platform" has not been able to form the "climate", the most irresistible is the policy barriers, according to the "Interim Provisions on the examination and approval of Internet drug trading services," only at the same time have "Internet drug trading service qualification certificate Only companies with two certificates of "Internet Drug Information Service Qualification Certificate" can carry out online drug sales.

In addition, there are also obstacles to logistics distribution. According to the "Drug Administration Law" in China, medicines are not allowed to be mail-ordered. If you commission third-party distribution, it must pass GSP certification. The pharmaceutical e-commerce companies usually do not have this qualification, nor do they have a logistics center to match them.

The dean of a DM hospital in Guangdong admitted to the reporter: “To tell the truth, I am a reluctant one hundred. It is difficult for the hospital to be the subject of bargaining. In the process of talking about the price, if there is a difference in price, who can make it clear? ?"