Four types of players layout DTP pharmacy sword finger prescription outflow 100 billion market

The arterial network has done a series of content related to prescription outflow before, and discussed the policy background, main undertaking mode, future scale and the transformation of drug sales structure of prescription outflow Hospital side shops, trusteeship dispensary, DTP pharmacy, prescription sharing platform, Internet plus medicine are the main ways to undertake the outflow of prescriptions DTP pharmacy is especially worthy of attention in many modes with its professional services and new special medicine supply and support capabilities In the first mock exam of DTP pharmacy, we will discuss the characteristics of DTP pharmacy What problems can this format solve? How does DTP pharmacy develop with the reference of American pharmaceutical retail market? Who are the players in DTP pharmacy in China? How is the development? What role does DTP pharmacy play in the context of separation of medicine? Compared with other models, can DTP pharmacy play a dominant role in the separation of medicine? Integrated retail business: Pharmacy and professional pharmacy DTP / DTC is the abbreviation of direct to patient / direct to customer, that is, direct to patient drug marketing mode Its purpose is to shorten the circulation path of drugs, so that patients can easily get drugs in the professional drugstore outside the hospital after obtaining the prescription, and generally with professional pharmaceutical services, patient management and other services It is more consistent with the retail drugstore in the format, and it is an integral twin of the pharmaceutical retail format DTP pharmacy originated in the United States in the 1990s There are two main reasons: first, the differentiation of pharmaceutical circulation and retail formats, and the evolution to a professional direction; second, pharmaceutical companies hope to reach patients in a more direct way, and improve their market control The main characteristics of DTP pharmacy in the 1990s, after decades of rapid development of the pharmaceutical retail market in the United States, the industry concentration increased rapidly By the end of the 1990s, the chain rate had exceeded 50% At this time, differential competition became particularly important, and professional pharmacy emerged Professional pharmacies provide patients with services other than drug supply, chronic disease management and drug welfare management, which improves patients' stickiness and loyalty, and stands out in the competition among thousands of stores DTP pharmacy is a kind of professional pharmacy With the mode of specialty pharmacy and PBM pharmacy, the system of professional pharmacy has been formed In addition, since the 1970s, the United States has also carried out a series of "medical reform", and cost control has become the theme of government health insurance and commercial insurance Under the pressure of cost control, the price of drugs has been compressed, bringing pressure to drug companies In this context, pharmaceutical companies want to reduce the circulation of drugs, reduce the cost of the process, so that drugs can reach patients in a more economic way The rise of DTP mode is brought by the combination of professional pharmacy mode and the demand of pharmaceutical enterprises In the process of continuous integration of the two, gradually achieve the "multi win" result: pharmaceutical enterprises have opened up new channels, DTP pharmacy has obtained stable income and established a foothold in the market, and gradually developed high value-added pharmaceutical services, patient management, chronic disease rehabilitation and other services American experience: drug stores and professional pharmacies are well separated in the United States About 70% of prescriptions are completed outside the hospital As a comparison, the retail structure of drugs in China is about 7:2:1 The main pharmaceutical retail units in the United States include monomer / chain drugstores, specialty drugstores, PBM organizations, supermarket drugstores, etc The network of retail pharmacies and professional pharmacies with developed main pharmaceutical retail channels in the United States is the basis of "medicine separation" The high concentration of retail pharmacies industry in the United States and the perfect management system provide the basis for the undertaking of hospital purchased drugs In addition, some insurance companies will cooperate with PBM (drug welfare management) to provide drugs through their drugstore network or mail order From the perspective of chain drugstores, Walgreens, CVs and riteaid ranked in the top three, with the number of stores accounting for 34.20%, 30.90% and 12.30% respectively, and the top three accounted for 77.4% of the market Walgreens and CVs are both important PBM service providers CVS accounts for about 30% of the PBM market, while expressscripts and Walgreens account for about 20% and 10% of the PBM market From the perspective of market structure, pharmacies and professional pharmacies are divided into two parts Take 2016 data as an example, the market size of prescription drugs of the top 15 pharmaceutical retail units in the whole year is about US $300 billion, and that of CVs, Walgreens, riteaid and other chain drugstores is about US $160 billion; PBM and specialty drugstores such as CVs, ESI, optumrx, primetherapeutics, duplomatpharmacy and so on share the rest of the market There are four types of players in DTP pharmacy in China Under the similar policy background and industrial background, domestic medicine retail is gradually moving to the American mode, and the concept of DTP pharmacy is beginning to prevail in China There are four factors that affect the development of pharmaceutical retail business: policy factors, separate and continuous implementation of medicine, zero plus, control of drug proportion and a series of other factors make hospitals have the power to extend the prescription to social pharmacies; under the implementation of hierarchical diagnosis and treatment, the channels of medical treatment and patients sink, the demand for drugs sinks, and pharmaceutical enterprises pay more attention to the grass-roots market; Due to the industrial environment, the format of retail drugstores has become more mature, the market is developing towards vertical and horizontal integration mode, and professional drugstores can bring differentiated competition; As for the payment end factor, the coverage of medical insurance of drugstores has been improved, and patients can enjoy the same reimbursement treatment both inside and outside the hospital From the perspective of commercial insurance, there are some modes of "drug + insurance" cooperation between commercial insurance and drugstores, such as curative effect insurance, chronic disease management, etc.; at the individual level of patients, they want to get better treatment and pharmaceutical services, and are willing to pay for them; Technical factors, mainly Internet plus medical mode, can gather patient's needs and enlarge channel influence through the Internet Internet hospitals + drugs, pharmaceutical and electronic business outlets, shop ordering stores, and intelligent pharmacies are the main models The reasons for the rise of DTP pharmacy are that there are basically four types of game player in DTP pharmacy, including pharmaceutical industry, circulation enterprise, retail enterprise, Internet plus medicine enterprise Data source of main institutions of DTP pharmacy in China: arterial network database, enterprise annual report Pharmaceutical distribution and retail enterprises are the main operators of DTP pharmacy The reason is that DTP pharmacy needs to have sufficient connection with pharmaceutical enterprises, and supply chain resources are very important Getting the agency right of new special drugs of pharmaceutical enterprises can help DTP pharmacy to obtain scale patients and sustainable resources Secondly, DTP pharmacy needs professional medical guidance and pharmacist service ability, and the connection with the hospital can help DTP pharmacy Room to get a prescription and in-depth service Pharmaceutical distribution and retail enterprises have cultivated the market for many years, generally with rich industrial resources and hospital resources Under the background of separation of medicine and sinking of channels, DTP pharmacy sponsored by pharmaceutical distribution and retail enterprises can help hospitals to undertake the demand of new special medicine supply outside the hospital, and develop new sales channels for pharmaceutical enterprises at the same time DTP pharmacy is essentially the natural transformation of resources owned by pharmaceutical circulation and retail enterprises under the transformation of pharmaceutical sales channels and sales methods However, the new mode of Internet plus medicine can not be ignored On the DTP track, the Internet plus pharmaceutical enterprises rapidly gathered the needs of the whole country through the aggregation ability of the platform, which is higher than that of the offline store's "three km coverage" At the same time, it can also manage remote patients through APP, website, and provide integrated services for patients It should be pointed out that Internet tools and platforms are essentially a technology Traditional medicine circulation and retail enterprises are actively applying this technology The companies including national medicine, medicine and Huarun are actively distributing the Internet plus medicine platform, which is an important direction for empowering the DTP pharmacy mode Under the background of separation of medicine, it is not complicated for hospitals and pharmacies to meet the outflow of hundreds of billions of prescriptions in the out of hospital market That is to say, hospitals return to the nature of medical treatment, separate the unnecessary drug supply function, and drug supply is provided by pharmacies and other units After the division of labor is clear, the hospital reduces the pressure of pharmacy operation, and the ambiguous problem of "supporting doctors with drugs" can be improved before The pharmacy provides better pharmaceutical services for patients through systematic operation Of course, the separation of medicine is a systematic problem, involving the transformation of the hospital income structure, the embodiment of the value of doctors' services, the overall settlement of medical insurance, the problem of patients' habit of purchasing medicine, etc., which can not be achieved overnight It is impossible for the hospital to completely separate the pharmacy, so that the inpatients and emergency patients will lose their security The reasonable prediction is that the domestic drug retail channel will go to the American structure, that is, the proportion of internal and external channels is about 3:7 Although this is a long-term goal, the scale of "prescription outflow" can be calculated In 2016, the scale of China's drug market was about 1.5 trillion, up 8.3% year on year 68.4% of the hospitals are in grade hospitals, 22.2% are in drugstores, and only 0.3% are in online drugstores Based on this, assuming that the drug market maintains a growth rate of about 8%, by 2020, about 10% of the prescriptions will be dispensed outside the hospital, the outflow of prescriptions will reach about 140 billion in 2020 Prescription outflow + new drugs coming out, DTP pharmacy with huge increment is not all prepared for prescription outflow From the perspective of beneficial factors, new drugs will accelerate the coming out, increase the coverage of commercial insurance, improve the level of self financing, etc., which will stimulate the continuous improvement of DTP pharmacy market scale The important product structure of DTP pharmacy is new specialty drugs for tumors, autoimmune diseases and other chronic diseases that need to be taken for a long time In terms of drug supply, with the implementation of policies such as zero tariff for anticancer drugs and priority review and approval for innovative drugs in China, the supply of new specialty drugs will increase DTP pharmacy will be an important channel in the transition period from being approved for listing to entering the medical insurance Even after entering the medical insurance, DTP pharmacy can continue to maintain the channel advantage through medical insurance reimbursement From the perspective of commercial insurance, according to the data of CIRC, the annual compound growth rate of health insurance market scale is 42% in 2011-2016 In 2017, as of November, the original insurance premium income of health insurance business reached 410.554 billion yuan, up 6.87% year on year It is estimated that by 2020, the health insurance market will reach 1 trillion yuan The rapid coverage of commercial insurance is conducive to improving the level of social security, increasing the coverage of new specialty drugs, stimulating the sales of new specialty drugs, and promoting the DTP pharmacy mode In addition, with the increase of the first mock exam, the nation will invest more in health care services For some drugs that can really raise the level of treatment, the willingness to pay for themselves will be more intense and favorable to the DTP pharmacy According to the annual report and public data of listed companies, the scale of domestic DTP pharmacy in 2017 is about 13 billion yuan, and the growth rate of DTP pharmacy scale will be higher than the growth rate of pharmaceutical retail market It is estimated that the scale of domestic DTP pharmacy will reach about 19 billion yuan in 2020 DTP pharmacy scale calculation data source: IMS, arterial network sorting typical cases of DTP pharmacy As one of the pharmaceutical retail innovation businesses, Guoda pharmacy began to lay out DTP pharmacy in 2014, adhering to the consistent accumulation of Guodian group and Guodian in the pharmaceutical circulation and retail business for many years, as well as the deep connection with the upstream and downstream of the industrial chain such as industry and hospital, the DTP business of Guoda pharmacy grew rapidly According to the annual report, at the end of 2016, there were 16 stores in DTP pharmacy of Guoda pharmacy, 24 stores were newly added in 2017, with a total number of 40 stores 2017