Jicai Failed To Select The Original Pharmaceutical Factory To Survive And Transform Into An Off Hospital Drugstore Market

Jicai has entered the third round, and the large price reduction has made the majority of pharmaceutical enterprises tremble. With Jicai stepping into the normal track, the changes in the retail end of the industry are also accelerating.

On August 20, the third batch of state-organized centralized drug procurement in Shanghai produced the results of the preliminary selection. According to Xinhua news agency, a total of 189 enterprises participated in the purchase, resulting in 125 enterprises to be selected, 191 products to be selected, and 55 varieties of drugs to win the bid, with an average price reduction of 53%.

In a round of more than one round of stimulation of procurement with volume, the response strategies of pharmaceutical enterprises show more and more differences, which brings about changes in the whole industry. On the one hand, pharmaceutical enterprises begin to actively open up the outside hospital market; on the other hand, pharmaceutical enterprises are more mature in dealing with centralized purchasing, and some foreign enterprises also choose to withdraw directly.

However, in the process of transforming prescription drugs into retail market, how to find a win-win cooperation mode between pharmaceutical enterprises and retail pharmacies is still facing various uncertainties. For pharmacies, it is expected to enjoy the industry dividend brought by centralized purchase in the short term, but in the long run, it will also promote industry concentration. For pharmaceutical companies, it is a helpless move to lay out the retail market. However, some pharmaceutical companies still have reservations about how much sales they can bring to the enterprises themselves after moving to the retail market.

Original drug "broken arm"

In the third batch of centralized purchase, the quotation of the original pharmaceutical enterprises also means that they voluntarily give up the possibility of winning the bid and automatically "withdraw" from the competitive countries. Centralized procurement has become the choice of most enterprises.

According to the results of the third batch of centralized purchasing, only three foreign pharmaceutical enterprises were shortlisted, namely Pfizer, Weicai and youshibi, while Bayer, AstraZeneca, Lilly, GSK, Squibb, MSD, Novartis and Xi'an Janssen were eliminated.

The price reduction is expected, and the collective "self abandonment" quotation of foreign pharmaceutical enterprises also has traces to follow.

According to the state regulations, each tablet can only be quoted at a maximum of 3.40%, but the price quoted by Merck is 1.401 yuan. Pfizer's original drug Viagra Viagra, Viagra, Viagra, Viagra, Viagra, Viagra, Viagra, Viagra, Viagra, Viagra, Viagra, Viagra, Viagra, Viagra, Viagra, Viagra, Viagra, Viagra, Viagra, Viagra, Viagra. Quetiapine, the original research drug of AstraZeneca, is subject to the national regulation of 200mg. The maximum price for each tablet is no more than 2.3166 yuan, while that of AstraZeneca is 7.078 yuan.

This also means that foreign investment in the original research and development of drugs to give up, cut off the original very important public hospital medical insurance market, which used to occupy a very large share.

According to the data of MI Nei network, the sales scale of terminal chemical drugs of public institutions in China increased year by year from 2013 to 2018, but the growth rate was slowing down. In 2018, the sales volume of terminal chemicals of China's public medical institutions (including urban public hospitals, county-level public hospitals, urban community centers and township health centers) was 1032.5 billion yuan, an increase of 7.36% over the same period of last year; the sales volume of terminal chemicals of public medical institutions in China entered the era of trillion for the first time.

In 2019, the total sales volume of China's three major terminals and six major markets was 1795.5 billion, with a year-on-year increase of 4.8%. Among them, the market share of public hospitals reached 66.6%, and the share of public primary medical terminals accounted for 10%. In terms of the sales of urban public hospitals alone, the sales volume of drugs in this field has reached 873.9 billion in 2019, accounting for 48.7% of the national drug market. Among them, the key areas of chemical drug market are undoubtedly focused on tumor, digestion and metabolism, cardiovascular and cerebrovascular, blood and hematopoietic system, nervous system and other fields.

According to the reporter of the 21st century economic report by a doctor of a Grade-A hospital in Guangzhou, during the implementation of the pilot project of "4 + 7" procurement with quantity, if there are original research drugs for the selected drugs, a drug regulation for the original research will be retained, and those without the original research drugs will not be introduced. If the selected drugs in the basic drug list of the hospital are the original research drugs, only one drug specification of the original research drugs is retained. The original research drug must be reserved for patients to have a choice, and at the same time guide the selection of selected drugs.

"In order to maintain the stability of the treatment effect and insist on not changing the medicine, it is not uncommon for patients to prescribe imported drugs and purchase non selected drugs at their own expense. As a result, some patients will fall in love with the original research drugs and bring fire to the out of hospital market. Even if the price is high, they will still go to the pharmacy outside the hospital to buy the original research drug." The doctor told reporters.

Under the normalization of volume purchase, the outflow of prescriptions accelerated, and the out of hospital retail pharmacy became an important undertaking party. Picture vision China

Welcome to the market outside the hospital

For a long time, the hospital market is the main sales position of prescription drugs. However, with the gradual promotion of procurement policy with volume, the unsuccessful varieties almost lost the main national sales market of public hospitals. In order to recover the market share in the past, these varieties have launched sales in the retail market outside the hospital.

At the same time, more and more pharmaceutical companies began to vigorously cultivate their own retail prescription team and lay out retail channels in advance. In the past, the drugstore market, which was regarded as a relatively small group by some prescription drug companies, has begun to glow with new opportunities.

"4 + 7 procurement with quantity is only for public hospitals. After this expansion, private hospitals have also entered the scope of centralized procurement. However, pharmaceutical enterprises only supply the winning drugs to hospitals at low prices, and the medical insurance department does not intervene in the supply price of retail channels. For retail enterprises, it has become a challenge that they have to face. In addition, behind the sharp price reduction of the bid winning drugs in the hospital, retail enterprises have to bear the pressure of the original outflow of prescriptions back to the hospital A pharmaceutical retail enterprise in South China told the reporter of the 21st century economic report.

With the expansion of purchasing with volume, the price and profit of generic drugs return reasonably, and the future cost control and supply chain management ability will become the main competitive factors of pharmacies in the future. And the layout of professional pharmacies, focusing on the layout of innovative drugs, retail pharmacies may be the direction of transformation.

"In the past, our retail chains tended to meet the demand for essential drugs. When hospitals had prescriptions, consumers bought drugs from pharmacies in consideration of convenience and price advantages, which was in line with the trend of prescription outflow. In the future, it is also an inevitable trend for chain pharmacies to strengthen their professionalism, such as the construction of new chronic disease service businesses, patient service centers, and even community clinics. The only way to solve the problem is to build a closed-loop service in the future and seize the OTC market. " The pharmaceutical retailer told the 21st century economic report.

On the other hand, in the process of transforming prescription drugs into retail market, how to find a symbiotic and win-win relationship between pharmaceutical manufacturers and pharmacies is still facing various uncertainties. For pharmacies, it is expected to enjoy the industry dividend brought by centralized purchasing in the short term, but in the long run, it will also promote industry concentration. For pharmaceutical companies, it is a helpless move to lay out the retail market. However, some pharmaceutical companies have reservations about how much revenue they can bring to the enterprises themselves after moving to the retail market.

Centralized purchase has accelerated the substitution of domestic generic drugs to the original drugs with expired patents to a certain extent.

In the past, in the hospital market, original research drugs with expired patents not only occupied the dominant position, but also enjoyed the advantage of high brand premium. Therefore, before the start of centralized purchasing, most of the expired pharmaceutical enterprises will not make great efforts to lay out the retail market outside the hospital. Nowadays, the original research drugs with expired patents are actively "close" to the retail market.

Taking the first batch of "rosuvastatin calcium" as an example, AstraZeneca, as the original research manufacturer, failed in the "4 + 7" pilot city or the expansion belt procurement in the alliance area. After missing most of the national public hospital market, the original manufacturer chose to focus on the retail market. According to CMH data of Zhongkang, in the first quarter of this year, the sales volume of rosuvastatin calcium in the pharmacy market of AstraZeneca reached 410 million yuan, a sharp increase of nearly 70% compared with the same period last year.

However, the two varieties that we are willing to cooperate with in the past are not willing to cooperate with two companies in the past In the past, it was very difficult for us to cooperate with them. " Xie Zilong, chairman of the common people of listed chain drugstore enterprises, said.

On the one hand, the transformation of centralized purchase for the industry is reflected in the steep decline of drug price, the hospital pharmacy has changed from profit plate to cost plate, and the hospital gradually changes its attitude towards prescription outflow, which gives retail pharmacies the opportunity to undertake; on the other hand, prescription manufacturers will accelerate cooperation with pharmacies, manufacturers of substandard varieties will actively deepen cooperation with retail pharmacies, and the resources of manufacturers will also incline to pharmacies To promote the development of large chain drugstores.

However, for pharmaceutical companies, compared with hospitals, the distribution of retail market outside the hospital is relatively scattered. In addition, the weak pharmaceutical service capacity of pharmacies themselves has restricted the process of pharmaceutical factories' layout of retail market to a certain extent.

In recent years, many pharmacy chains (such as DTP) provide more value for patients. Different from the traditional retail pharmacies which mainly sell OTC drugs (OTC drugs), DTP pharmacy mainly sells high margin professional drugs, new specialty drugs, self paid drugs, etc., and is equipped with licensed pharmacists to provide professional guidance and services, which is an advanced mode of retail pharmacies.

"I think that after the normalization of centralized purchase, the retail industry tends to be more centralized, because pharmacies with sufficient volume have certain bargaining power with upstream prescription pharmaceutical companies, while ordinary small and medium-sized pharmacies are difficult to obtain medium and high gross profit of prescription drugs. Therefore, in this context, centralized purchasing accelerates the centralized development trend of the retail industry. " Gao Yi, chairman of Yifeng pharmacy, said.