Centralized procurement attacks pharmaceutical companies in all directions to survive in this way

01 Future centralized procurement: all-round, no dead ends

The amount of information given by Chen Jinfu, deputy director of the Medical Insurance Bureau, is very huge.
It sets the tone for the future national + inter-provincial alliance's volume-based procurement model, and sets the tone for the future omni-directional and dead-end centralized procurement model.
As a reminder, it has also done some sorting out for the optimization of future rules and implementation policies for volume procurement
.

For enterprises, after understanding the trend of volume procurement, they should strive to be the trendsetters in this wave of reforms and walk in the forefront of all reforms
.
For volume-based procurement, clarifying the overall volume-price relationship behind volume-based procurement is often the key to winning this challenge

However, the relationship between volume and price is far more than the simple agreement that the purchase volume corresponds to the winning price on the surface.
Changes in the total amount, opportunities and obstacles in the competition for margins, etc.
, should be important factors that enterprises must deeply understand when considering the relationship between volume and price
.

02 Exploration of margin space beyond centralized acquisition

Today, the author makes a simple classification of these situations, trying to understand some of the operational logic of volume procurement in the market and policy boundaries
.

We first substitute a mathematical model for assignment.
Suppose that a certain variety A produced by multiple companies is included in the purchase with volume, the overall sales of the entire variety before the purchase with volume is X, and the overall sales after the purchase with volume is x.
, the agreed purchase quantity after the selection is a, the overall residual market after the purchase with quantity is y (y=xa), and the use ratio of the selected drugs in the residual market for the purchase with quantity is k
.

Then, we can simply derive the following formula:

The actual purchase amount of the selected drug = a+y*k

Actual purchase amount of non-selected drugs = y*(1-k)

Based on the current implementation, after purchasing with quantity, the value of a is basically a fixed quantity
.
Then, the remaining amount (y) and the use ratio (k) of the selected drug in the surplus market must be the two largest variables after purchasing with the amount

The reason why it is called a variable is because these two values ​​are often undetermined before the bid opening, and it is often necessary to execute the result after execution, just like opening a blind box
.

But as "The Theory of Relativity" says: In the macroscopic and low-speed world, if you have all the information, you can clearly predict anything in the future
.

With the continuous execution and optimization of volume purchases, some logics have gradually become traceable.
These inherently elusive market variables, in some cases, also have a certain degree of analyzability:

From y=xa, we can know that the growth of the surplus market is basically equal to the growth of the overall market of the product.
For this, we can make the following classifications according to the market changes of the total volume:

Among these three situations, the second situation is the model preset by policy makers, and the problems caused by too much left or right are not what policy regulation wants to see
.
When the sales volume of generic names declines seriously after centralized procurement, it may not only be impossible to complete the agreed quantity, but also may lead to the direct abandonment of production by the unselected enterprises, which will lead to the risk of monopoly and shortage in the future

With the in-depth development of national procurement, it is not uncommon for products that can come up with a better market space to attract investment after the national procurement is selected.
What’s more, before the opening of the bid, it is publicly announced that the product will be selected and the investment promotion work is started
.

The reason for this is partly because there is still an attractive free market for these products, which are themselves in the growth stage, beyond the agreed purchase volume
.
At this stage, the government has issued a series of supporting policies for the implementation of procurement with volume, more to give priority to ensuring the completion of the agreed procurement volume, and in the face of a wider margin market, the selected products also need to be promoted through market promotion.

03 Flexible purchasing authority for hospitals

In the past briefing, we did not hear many new changes in the landing policy:

Medical insurance still emphasizes continuing to promote the priority and rational use of selected drugs and high-value medical consumables in centralized procurement.
On the basis of previous policies, it strengthens the standardized construction of the platform (technical level supervision), and emphasizes the policy of surplus retention (incentives medical institutions to use selected drugs)
.
The health system, among the indicators of public hospital performance assessment, has established an assessment indicator for the proportion of the use of drugs that have won the bid in the national centralized procurement

But when we consider the problem from the perspective of the hospital, we find that this matter has changed a bit:

Question 1: Suppose a medical institution does not report the quantity of Drug A, but after the centralized procurement, due to the clinical development, Drug A needs to be used.
Under the existing policy, is it determined to give priority to the selected drugs in the centralized procurement?

Question 2: Assuming that drug A already has two brands of M and N in the hospital, and neither of the two brands mentioned above was selected after the centralized procurement, then after the centralized procurement, the hospital should choose to kick M in order to maintain the first product and two regulations.
or N?

Question 3: Assuming that after the centralized procurement of drug A, multiple companies are selected, due to the increase in clinical demand for drug A and the low proportion of the hospital's reported volume, the hospital has completed the annual agreement procurement volume within 3 months, then after the completion of the agreement After purchasing the quantity, which selected company should the hospital use first?

There are no clear standard answers to these questions
.
Because it is a boundary issue between policy and market

For question 1, the policy requires that the selected medicines be given priority, but how to give priority to it is the problem of the hospital;

Regarding question 2, the policy requires that the selected products for centralized procurement after the quantity report must complete the agreed purchase volume, and must meet the first-grade double-standard, but in order to ensure the first-grade double-standard, the hospital has the freedom to kick M or N.
Of course, the hospital can also do both Those who are not guilty, kick them all out, and then enter one back through channels such as the Pharmacy Council;

For question 3, in the case of multiple companies being selected, after completing the agreed purchase volume, some provinces may differentiate the preferred products based on price, quality level, A and B categories, etc.
, but in addition to mandatory policies In addition, medical institutions basically use the one with a more reasonable promotion policy
.

This is also the case.
Under the dual role of policy and promotion, we have seen a wide variety of hospitals in various places.
Even in the same province, some hospitals are almost completely one-size-fits-all, not giving any chance to non-selected products at all.
Some hospitals, on the other hand, changed all the selected products to non-selected products after the agreed purchase amount was completed, resulting in that the usage of non-selected products was much larger than that of selected products
.

04 Exploration of strategies for survival under the centralized procurement of pharmaceutical companies

The value of k may be equal to 100, or it may be infinitely close to 0.
This is not a category considered by policy makers, but it is the result of what actually happens in the market
.

In other words, the core of the pharmaceutical market is still the supply and demand relationship between companies and patients, and all current policies are still in the category of regulatory policies, and there is no absolute mandatory increase in the proportion of high-selection products in the remaining market (k).
value) supporting policies, some are just incentive policies (such as balance retention) and related policies (such as performance appraisal)
.

For these control policies themselves, they should be used as a tool for the operation of the enterprise market to help medical institutions and grassroots medical insurance units make a reasonable interpretation
.

For the market, price, channel, product, and promotion are still the core elements of marketing principles.
After an enterprise is caught in the prisoner's dilemma, it should first start with the pharmacological properties and epidemiology of the product, and infer the next few years.
Based on the growth of generic dosage forms, we can then judge the value of its real margin market, and then based on the existing margin policy, we can obtain the policy advantages of the selected products in terms of channels and promotions
.

Combining the two, the sales strategy in the surplus market after losing the election, and the sales strategy in the market after the price reduction is selected
.
And choose the optimal one from the two sales strategies as the optimal market volume-price relationship after purchasing with quantity

It is expected that the spring breeze blows and wakes up