Pharmaceutical enterprises take advantage of the landing of "purchasing with quantity" and are busy with the layout of new track

On April 16, medical network reported that Mr Li, a resident of Shenzhen, has been suffering from hypertension for many years On March 10, he once again came to a top three hospital in Shenzhen to prescribe irbesartan, a antihypertensive drug Mr Li used to eat imported irbesartan tablets This time, the doctor asked him if he would like to replace the Irbesartan tablets made by domestic manufacturers The price was much lower than before Mr Li happily agreed to the doctor's new prescription, but he was surprised when he paid In the past, he spent more than 100 yuan every month to buy medicine, and the cost of taking medicine almost every day was 5 or 6 yuan But this time, he only spent 8.4 yuan on the original day to buy 20 days of medicine, which is equivalent to 0.42 yuan every day In addition to the drug price, Mr Li's dosage has also changed from one pill a day to two pills a day Moreover, the doctor asked Mr Li to take blood pressure frequently at home If he found that the blood pressure was unstable after taking the medicine, he should come to the hospital in time to find a doctor Mr Li used to take imported irbesartan tablets, which were manufactured by Sanofi The price of each box of irbesartan tablets (7 tablets * 0.15g) is 39.9 yuan Now Mr Li takes irbesartan tablets, which are produced by Zhejiang Huahai Pharmaceutical Co., Ltd (hereinafter referred to as "Huahai pharmaceutical"), a local pharmaceutical company The price of each box of irbesartan tablets (42 tablets * 75mg) is only 8.37 yuan According to the data of PDB of China Pharmaceutical Industry Information Center, Sanofi's ambowei occupies most of the domestic market share, while Hengrui's drug Giga (irbesartan tablets) also has high competitiveness in China In contrast, the pharmaceutical products of Huahai Pharmaceutical Co., Ltd originally accounted for less than 5% of the market According to data from minenet, in the third quarter of 2017, the sales volume of Sanofi's ambove drug in public hospitals in key cities was 48.43 million yuan, and the sales volume of Hengrui's drug Giga was 2.35 million yuan, while the sales volume of Beiyue in Huahai pharmaceutical industry was only 170000 yuan What changed all this was the "4 + 7 volume procurement" that everyone in the biomedical industry talked about "Many doctors didn't take" 4 + 7 volume purchase "seriously, but when the hospital informed them, they realized that" 4 + 7 volume purchase "would really affect everyone in the industry, not only the patients, but also the doctors." A medical representative told the economic observer "4 + 7 volume procurement" refers to the selection of pilot varieties from the generic drugs that have passed the consistency evaluation (i.e the generic drugs must be consistent with the efficacy and quality of the original research drugs), and the organization of drug centralized procurement pilot in 11 cities across the country to exchange quantity for price The state guarantees that the bid winning enterprises can obtain 60% to 70% of the market share of the above 11 cities According to an internal notice of a top three hospital in Shenzhen obtained by the reporter, Shenzhen is scheduled to officially implement the national organization for drug procurement at 00:00 on March 28, 2019 The circular mentioned that the first batch of drugs purchased by state organizations included 25 kinds of drugs In the hospital system, 25 kinds of purchased drugs have been marked as "national recommendation", and doctors in each ward and outpatient should give priority to the use of these 25 kinds of purchased drugs, and inform or explain the patients at the same time For the doctors who do not give priority to purchasing drugs, the hospital will talk with the responsible doctors and punish them accordingly according to the plan The medical representative told reporters that many hospitals had not purchased the drugs produced by domestic manufacturers who won the bid of "4 + 7 with quantity purchase", and doctors in the past would prefer the original research drugs produced by imported manufacturers when using drugs Now, because of the relevant regulations of the hospital, doctors will give priority to the use of winning drugs when prescribing, although it is likely that doctors have no previous experience in the use of this drug "A lot of doctors have expressed their concerns to me that one of the original drugs can control blood pressure, but now two or more are needed Patients may not understand that doctors change their medicine or patients have formed medication habits, which will become unstable factors in the doctor-patient relationship." The medical representative told reporters In terms of how to replace the winning drugs in clinical practice, 11 cities, from the government to the local health and Health Commission and the medical insurance bureau, have issued supporting measures to ensure the implementation of "4 + 7 volume procurement" On March 11, the Beijing Municipal Commission of health and Health issued the notice on doing a good job in the clinical allocation and use of selected drugs in the centralized purchase of drugs organized by the state (hereinafter referred to as the "notice") According to the notice, for the special population with high risk of dressing change, such as chronic patients, the elderly, and patients with mental illness, there should be a detailed replacement plan, standardize the drug use behavior of doctors, and gradually use the selected drugs in large quantities For some patients who are highly dependent on drugs or do not accept the drug change program, the notice points out that they should properly handle and respond to patients' complaints according to the principle of "one thing, one discussion", and on the basis of full evaluation, they can independently develop the drug use program and make explanations Some people in the industry said that hospitals do not force doctors to use the winning drugs to avoid doctor-patient conflicts and digest the hospital's original inventory However, no one can give a definite answer to the question whether the patients can still import the original research drug in the hospital Compared with Shenzhen, Shanghai, which first landed in "4 + 7 volume procurement", has found a batch of original research drugs, including bolutin and Werder, among the top three hospitals in succession Some hospitals have said that at present, the hospital can only prescribe domestic generic drugs, and are not sure whether it will restore the supply of original research drugs Countermeasures of pharmaceutical companies: if patients can no longer get the original research drug from the hospital, where will they go? Almost all interviewees in the pharmaceutical industry gave their positive answers to the reporters The retail pharmacy outside the battlefield of "4 + 7 procurement with quantity" has become a new way out for the unsuccessful pharmaceutical enterprises Some analysts pointed out that "4 + 7 procurement with volume" guaranteed 60% to 70% of the shares of the winning pharmaceutical companies in public hospitals, thus depriving the public hospitals of the sales opportunities of the unsuccessful pharmaceutical companies Some enterprises that take hospital terminal as the main sales channel are bound to face transformation and turn to retail market In order to sell products in pharmacies, pharmaceutical companies will also actively connect with the construction of pharmacy prescription outflow Enhua pharmaceutical, Huasen pharmaceutical and other companies announced that they would adjust the company's organizational structure and promote the reform of marketing system China Resources pharmaceutical also said in the annual report that the company will optimize the logistics layout, accelerate the development of third-party logistics business, continue to promote innovative business models such as hospital logistics intelligent integration, DTP, e-commerce business, consolidate the market leading position of pharmaceutical distribution solution providers, and actively promote the concentration of China's pharmaceutical distribution industry Since the trial implementation of the "4 + 7" policy, major pharmaceutical companies have begun to actively increase direct supply with retail pharmacies The purchasing channels of pharmacies will be broadened, and the varieties of sales will be more diversified Retail pharmacies can also choose varieties with higher gross profit rate, and actively reduce the price of pharmaceutical factories, which will strengthen the bargaining power of retail pharmacies and help to improve the gross profit rate of drug sales However, according to the information obtained from several retail pharmacies visited by reporters in Shenzhen at present, there is no obvious price increase in retail pharmacies in Shenzhen The head of a large chain drugstore also told reporters that because the drugs in the chain drugstores are distributed by the company in a unified way, the company has not yet received the notice on the adjustment of drug prices, and the price of prescription drugs is stable On April 1, Xie Bing, chairman of the board of directors of China biopharmaceutical, said at the company's 2018 performance conference that the second batch of "4 + 7 with volume procurement" products are expected to be announced this summer and implemented at the end of this year According to the prediction of mienei.com, if the pilot area of belt purchase is to be expanded, 8 cities may be added, and if the variety is to be increased, 42 drugs are likely to be shortlisted The impact of the first batch of "4 + 7 volume procurement" is not over yet, and a new round of larger range and more varieties of volume procurement has gradually become popular It is the best way for pharmaceutical enterprises to increase investment in drug R & D and promote the R & D and listing of innovative drugs According to data from tonghuashun, as of April 11, 110 listed companies in the A-share biomedical industry published their 2018 annual reports Among them, the R & D investment of 48 pharmaceutical enterprises is more than 100 million yuan, among which Hengrui pharmaceutical ranks first with 2.67 billion yuan; Fosun Pharmaceutical is 2.5 billion yuan; Shanghai Pharmaceutical and Kelun pharmaceutical have more than 1 billion yuan In terms of growth rate, 96 of the above 110 companies increased their R & D investment According to the annual report of China biopharmaceutical, the company invested 2.09 billion yuan in R & D in 2018, an increase of nearly 500 million yuan compared with 2017 There are 497 products under research In 2018, 18 new products of the company were approved for listing The company plans to launch more than 20 new 1.1 drugs and 10 biological drugs in the next five years, with 10-15 new products listed each year According to the data of 2018 annual report of another leading pharmaceutical enterprise, Sinopharm group, the company's R & D expenses totaled 1.58 billion in 2018, up 70.6% year on year In addition to strengthening its R & D capabilities, the company has successively introduced small tumor molecules or antibody drugs, as well as diabetes drugs, from Tianjing biology, Yingchuang technology, Yongshun technology, Shanghai Pharmaceutical Research Institute, etc The management said that it would continue to acquire new drug molecules in the late clinical stage to enrich the research and development pipeline At the investor exchange meeting at the beginning of the publication of the first batch of volume purchase list, Sinopharm group also said that the R & D capability of a company will be the key to its survival.