One vote system is coming! Under the cold winter of capital, the pharmaceutical circulation industry has changed dramatically!

Recently, the Department of system reform of the State Council issued the notice on further promoting the experience of deepening the reform of medical and health system in Fujian Province and Sanming City, which said: "medical insurance is encouraged to directly settle accounts with production enterprises." According to the document, 11 provinces in Jiangsu, Anhui, Fujian, Shanghai, Zhejiang, Hunan, Chongqing, Sichuan, Shaanxi, Qinghai and Ningxia will gradually promote one vote system This means that the "one vote system" will be gradually promoted in all provinces It is directly settled by drug manufacturers and medical institutions, and it is called "one vote system" because only one invoice is issued in the process Origin of one vote system "One vote system" first appeared in a small number of pharmaceutical factories Only a small number of drugs are produced for specific medical institutions, with simple process and convenient transportation No need to distribute enterprises, are self-produced and self-selling Advantages and disadvantages of one vote system The "one vote system" can eliminate the intermediate circulation link to the greatest extent, squeeze the surplus water in the circulation process of consumables, prevent false invoices, and reduce the pressure on patients and medical insurance funds The product source shall be traced back better, and the situation that the fake is replaced by the bad is eliminated But the disadvantages are also obvious The main problem is the collection Without the capital turnover of circulation enterprises, production enterprises will face great pressure Two vote system has just been implemented Why is it so eager to transition to one vote system? In the past, with the help of the so-called bill passing company, reducing the cost of invoice and avoiding the risk of withdrawal were the two main purposes of bottom price invoice Before replacing business tax with value-added tax, the invoicing cost of the invoice passing company was far lower than that of the production enterprise Therefore, the enterprise chose the base price for invoicing and asked the dealers to find the invoice company for invoicing, so as to save costs Moreover, the expense of the sales of commission money must be withdrawn through channels Most enterprises are unwilling to bear this risk, and can only be solved by the dealers themselves Therefore, the ticket passing company has assumed the role of withdrawal After replacing business tax with value-added tax, the billing cost of the ticketing company is no longer superior to that of the enterprise, and the enterprise no longer looks for the ticketing company, but directly opens on its own, so the cost increase is inevitable; on the other hand, the demand for cash withdrawal still exists, and most of the enterprises will be handed over to the dealers for handling in consideration of risks, and the dealers will look for the ticketing company or set up their own companies to be responsible for the payment Now, the withdrawal cost and risk will increase, and the increased cost of these two parts is finally reflected in the drug price So what is the impact of the new one vote system on all parties in the industry? Under the "one vote system", how to seek new profit growth points for commercial companies and how to build brand and marketing network for pharmaceutical enterprises have become the focus of discussion in the industry 1 Commercial companies have a large number of contacts and resources They can create new profit growth points by establishing retail terminals, purchasing pharmaceutical enterprises and API enterprises, etc; 2 In a short time, the "one vote system" is difficult to cover primary medical areas, pharmacies and small medical institutions Commercial companies can continue to make efforts in these three markets; 3 Pharmaceutical companies without innovation ability and commercial companies without terminal channels will be out of the game, and the industry concentration will be further improved; 4 Pharmaceutical companies need to establish their own business team and marketing network, and the human cost will increase; 5 Whether the medical insurance has the ability to advance the payment is one of the key factors for the smooth implementation of "one vote system" of drugs; 6 Big data, artificial intelligence and information technology can promote the smooth implementation of "one vote system" of drugs Medical institutions and production enterprises directly settle the payment for goods, and the production enterprises distribute the goods by themselves or by entrustment The pharmaceutical production enterprises only issue an invoice once to the medical institutions, so the pharmaceutical circulation enterprises will no longer need to advance money to pay for the purchase of drugs to the pharmaceutical enterprises, nor will there be a large number of hospital accounts receivable Therefore, the capital demand of circulation enterprises is greatly reduced, so as to reduce the financial cost of pharmaceutical circulation enterprises However, the income structure of medical distribution enterprises will be greatly adjusted Its operating revenue and operating cost will be greatly reduced, the original drug sales revenue will be converted into transportation revenue, and the original drug purchase cost will be converted into transportation cost Pharmaceutical distribution enterprises will become transportation companies in the transportation of drugs Due to the existence of traditional wholesale business of pharmaceutical distribution companies, the comprehensive cost of transportation allocation will be far lower than the traditional small and medium-sized logistics companies without scale effect, so in the pharmaceutical field, the core value of transportation still exists However, due to the lack of funds, the pharmaceutical circulation enterprises can no longer exploit the residual value of the use of funds, and ultimately realize the further reduction of the cost in the process of drug price circulation However, with the third-party logistics represented by Shunfeng and post entering into the pharmaceutical distribution basin, the living space of small and medium-sized pharmaceutical distribution enterprises will be further compressed Pharmaceutical distribution companies charge several distribution fees according to the value of goods, while the third-party logistics companies rely on the weight, volume and distance of goods to measure The social logistics of this fee is lower than the traditional pharmaceutical logistics And social logistics is every key information in the process from warehouse out to distribution, which is incomparable with traditional medicine logistics No matter when the one vote system will come in an all-round way, from the perspective of industry trend, pharmaceutical circulation enterprises and natural persons must take precautions, and follow the market trend transformation to have a better development, or they will face cruel elimination Drug price middlemen have been criticized for a long time "Drug delivery - national general agent - provincial agent - drug bidding procurement - District, city, county agent - pharmaceutical company - hospital - patient" is the traditional drug circulation mode After a drug leaves the factory, it needs to go through multiple links of circulation and several turnover of several commercial companies to reach the hospital and patients Every circulation will produce personnel salaries, medical agent fees, bidding fees, advertising fees, public relations fees, agent profits and other costs After adding the codes layer by layer, the actual sales price of drugs is far from the factory price And, in this kind of circulation mode, there are even enterprises that sell tickets and launder money The hospital is not only the settlement Party of drug money, but also the speaker of drug prescription Too much power of the hospital is very easy to cause the corruption of power rent-seeking Changing the settlement party to the medical insurance organization may be able to solve the problem of over use of drugs and poor advance production and management of drug enterprises It's just that the industry is not ready to ask the largest payer for money in a single step, and doesn't know how to deal with the health care sector effectively Medical insurance has become the settlement party, which means that the medical insurance party has the right to approve the use of drugs, and the medical insurance party can be the third party supervising the hospital, so the use of drugs will also be reviewed by the medical insurance bureau In the past, pharmaceutical distribution companies have two major functions: advance funds and distribution If the one vote system is implemented, there are two direct results for pharmaceutical companies: First, pharmaceutical companies will face a large number of medical institutions If they want to achieve efficient docking and information exchange with hospital terminals, they must establish a professional business team and build a comprehensive marketing network However, integrating the existing pharmaceutical distributors in the market is not a faster choice.