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In recent years, policies involving the adjustment of medical insurance personal accounts, the standardized supervision of licensed pharmacists, centralized procurement with quantity, and hospital outpatient coordination have been successively introduced and actively implemented, and the standardization and importance of the out-of-hospital drug retail market have gradually increased
.
At the same time, in the past two years, the relevant policies in the field of Internet medical care have been continuously improved, and the policy opportunities are expected to continue to empower the out-of-hospital drug retail market, and it is expected that the next 3~5 years are expected to become a period of rapid development of
the pharmaceutical chain retail industry.
Drug online sales supervision continues to strengthen, online and offline integration trend is significant Since the outbreak of the new crown pneumonia epidemic, "Internet +" medical-related documents have been intensively introduced
.
In 2020, the National Medical Insurance Administration issued the Notice on the Comprehensive Promotion and Application of Medical Insurance Electronic Vouchers, and the National Health Insurance Bureau and the National Health Commission issued the Guiding Opinions on Promoting "Internet +" Medical Insurance Services During the Prevention and Control of the New Crown Pneumonia Epidemic, proposing measures to promote Internet diagnosis and treatment, online medical insurance settlement and other measures
.
At the same time, the standardization of electronic prescription and online drug sales has been strengthened
.
On March 15, 2022, the General Office of the National Health Commission and the Office of the State Administration of Traditional Chinese Medicine jointly issued the Detailed Rules for the Supervision of Internet Diagnosis and Treatment (Trial Implementation), clarifying that medical institutions should issue prescriptions for Internet diagnosis and treatment activities by the receiving physician himself, and strictly prohibiting the use of artificial intelligence to automatically generate prescriptions, provide drugs to patients before prescription issuance, and conduct unified prescriptions for commercial purposes, further standardizing online prescription issuance
.
On May 9, the Comprehensive Department of the State Food and Drug Administration solicited comments
on the Regulations for the Implementation of the Drug Administration Law of the People's Republic of China (Draft Amendments).
The draft proposes that third-party platform providers shall establish a quality management system for online drug sales and must not directly participate in online drug sales activities
.
On September 1, the State Administration for Market Regulation issued the Measures for the Supervision and Administration of Online Drug Sales, clarifying that those engaged in online drug sales shall be drug marketing authorization holders or pharmaceutical trading enterprises with the ability to ensure the safety of online sales of drugs; Online pharmaceutical sales enterprises shall operate
in accordance with the approved business methods and business scope.
In the future, the regulatory consistency of Internet platforms and offline pharmacies will help promote the development of industry norms and achieve healthy competition
.
In recent years, leading pharmaceutical retail enterprises have begun to vigorously deploy their own online retail business and Internet hospital diagnosis and treatment system, and are expected to divert traffic to the online diagnosis and treatment system through the advantages of the regional membership system in the future, creating a closed loop
of online and offline Internet diagnosis and treatment 。 Considering that patients have a stronger sense of recognition and trust in local offline public hospital doctors (local members connect with local doctors), the membership system of chain leading enterprises is mature and has the advantages of offline store layout and drug supply chain profit model, it is expected that the new retail ecology based on the localized Internet diagnosis and treatment model of chain leading enterprises has strong development certainty, and the docking of medical insurance online paid diagnosis and treatment system is expected to become a new growth point
in the industry in the medium and long term 。 Outpatient mutual assistance guarantee mechanism is advancing rapidly, and the incremental space of retail pharmacies can be expected In April 2021, the General Office of the State Council issued the Guiding Opinions on Establishing and Improving the Outpatient Mutual Assistance Security Mechanism for Basic Medical Insurance for Employees (hereinafter referred to as the "Opinions"), which clearly includes eligible retail pharmacies in the settlement scope of the pooled fund, expands the scope of payment, and includes eligible "Internet +" medical services into the scope of
basic medical security.
The Opinions make it clear that personal accounts can be used to pay personal expenses incurred in medical treatment at designated medical institutions and the purchase of drugs, medical devices and medical consumables at designated retail pharmacies, and explore the use of individual contributions
such as family members' participation in basic medical insurance for urban and rural residents.
It is expected that after the implementation in the future, the scope of personal account payment is expected to be expanded, and the payment amount for chronic disease drugs is expected to increase
.
In addition, the "Opinions" clarifies that eligible "Internet +" medical services are also included in the scope of basic medical security, and designated retail pharmacies can play a more important and active role
in the process of basic medical security services in the future.
The "Opinions" make it clear that the personal contribution part of the active employee will still be credited to his or her personal account; The individual accounts of retirees are transferred from the pooled fund according to a fixed amount, and the amount of the transfer is gradually adjusted to about
2% of the average level of basic pensions in the year when the reform is implemented in the pooled area.
Each coordinated area can set a transition period of about three years to gradually achieve the reform goals
.
Under such circumstances, the channel value of leading pharmaceutical retail enterprises is further highlighted
.
For example, the Hebei Provincial Medical Insurance Bureau issued a notice in May this year to include eligible designated retail pharmacies in the pilot scope of outpatient insurance, and open direct settlement of outpatient expenses (by the end of 2022, at least 1~2 designated pharmacies for outpatient protection must be identified in the counties/cities/districts under the jurisdiction of each coordination area), and the pharmacy docking outpatient coordination model has begun to gradually land
。 It is expected that in the future, the existing medical insurance stores across the country will face a standardized reshuffle, and the operating pressure of small and medium-sized chain enterprises relying solely on regional and inherent medical insurance resources will increase, the industry concentration is expected to accelerate, and the stores with the ability and qualifications to connect with outpatient coordination will continue to concentrate
on the head enterprises.
Leading enterprises with standardized operation capabilities and professional service capabilities are expected to increase the space for cooperation with upstream industrial enterprises, achieve all-round and professional deepening cooperation in categories and channels, and diversified service formats such as DTP, ultra-chronic disease pharmacy and new retail business are expected to usher in vigorous development
。 The "dual channel" of drugs is steadily advancing, and the value of out-of-hospital channels is further highlighted In May 2021, the National Medical Insurance Administration and the National Health Commission issued the Guiding Opinions on Establishing and Improving the "Dual Channel" Management Mechanism for National Medical Insurance Negotiated Drugs (hereinafter referred to as the "Guiding Opinions"), which clearly focuses on including drugs with high clinical value, urgent needs, high cost and low substitution into the "dual channel", and at the same time explicitly includes designated retail pharmacies in the scope of medical insurance drug supply guarantee from the national level (the payment standard is unified with medical institutions)
。 In September of the same year, the National Medical Insurance Bureau and the National Health Commission issued further notices, explicitly requiring all provinces, autonomous regions, municipalities directly under the central government, and the Xinjiang Production and Construction Corps Medical Insurance Bureau and Health Commission to "solidly promote 'dual-channel' management"
.
After one year of trial implementation, the national promotion of "dual channel" has become a high-certainty trend
.
The Guiding Opinions clarify the procedures and principles for the selection of designated pharmacies, propose that informatization should be connected with the medical insurance information platform and electronic prescription platform, that a storage and distribution system that meets the requirements should be established in drug management, and stricter measures
should be taken in the supervision of medical insurance funds.
From the perspective of regulation and competition, it is expected that industry leaders with scale and management advantages are expected to connect with more varieties
.
Coupled with the supervision of licensed pharmacists, tax supervision, social security payment and other regulatory measures accelerated and strictly implemented, pharmacy classification and grading and related industry normative policies are expected to be launched
.
The Guiding Opinions clearly improve the unified payment policy to ensure that drugs are reasonably paid, reduce the burden on patients, and optimize handling and management services
.
The pharmaceutical retail industry is expected to undertake the national negotiation of drug landing through prescription circulation, and at the same time provide patients with more professional pharmaceutical services, which can better contact the diversified payment system of commercial insurance and promote the reallocation
of medical insurance resources.
At the same time, it is expected that after the implementation of the policy, the bargaining power of retail channels will be further enhanced
.
It is expected that leading enterprises with professional service capabilities that take the lead in docking prescription circulation platforms are expected to increase cooperation space with upstream industries, achieve all-round and professional deepening cooperation in categories and channels, and diversified formats such as DTP and ultra-chronic disease pharmacies are expected to usher in vigorous development, and the value of off-hospital channels is further highlighted
。 As of the beginning of 2022, there are more than 100 "dual-channel" stores owned by Laobai, Yifeng Pharmacy and Da Shenlin, and the follow-up national negotiation of varieties is expected to bring about the outflow of patients in the hospital and drive the sales growth of other categories, and the incremental contribution of "dual-channel" stores is worth looking forward to
。 Performance suppression factors gradually eliminated, full year recovery growth with high certainty Due to the base effect of strong sales of epidemic prevention materials in 2020 and the restriction of sales of "four types of drugs" (antipyretics, cough medicines, antibiotics and antiviral drugs) in some regions, the revenue and profit growth of the pharmaceutical retail sector fell in 2021
.
In the first quarter of 2022, the overall revenue growth rate of the sector has recovered, and industry earnings are expected to return to a rapid growth track
in line with market expectations.
In recent years, the national centralized procurement of drugs has continued to advance, and at the same time, due to the impact of the new crown pneumonia epidemic, the admission of some hospital departments has been limited in stages, and a large number of drug needs of patients with chronic diseases have flowed to out-of-hospital channels
.
Leading listed companies are expected to achieve the retention of incremental consumer groups by virtue of their layout advantages and professional service capabilities
.
In the medium and long term, traditional Chinese medicines, non-drugs, etc.
are expected to maintain strong demand for a long time, while the bargaining power of pharmaceutical retail channels is enhanced under the promotion of national centralized procurement, "dual channel" and outpatient coordination, and the growth rate and profitability of higher store numbers are expected to be guaranteed
for a long time.
(Author: CITIC Securities)
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