The cross-provincial centralized procurement of tens of billions of decoction pieces is launched, or it may face two major challenges!

Figure 1: On March 3, the data reporting of the centralized collection of Chinese herbal medicines in 19 provinces was officially launched.
On January 6, 2022, the Shandong Internet Chinese Medicine (Material) Trading Center (hereinafter referred to as the Trading Center) led 19 provinces and 86 cities in traditional Chinese medicine The joint centralized procurement was officially launched, covering 9,547 medical institutions worth 10 billion yuan of Chinese herbal medicines (including formula granules), Chinese patent medicines and other types of Chinese medicines
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On March 3, the data reporting of TCM decoction pieces of medical institutions participating in the centralized procurement officially started, which means that the inter-provincial centralized procurement of TCM decoction pieces has entered the bidding preparation stage
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After the medical institution data is filled in and the data is standardized by the trading center, the process of enterprise registration, product bidding quotation and bid evaluation can be started
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If there are no special factors, the author predicts that the winning result will be produced within 3 months
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The centralized procurement of decoction pieces can be said to be a major event in the domestic traditional Chinese medicine circulation field, and it is also a good opportunity for the industry to reshuffle, and the decoction pieces companies to occupy the market and even "overtake on the curve"
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As the earliest practitioner in China to participate in the centralized procurement of medicines and the construction of an e-commerce platform for Chinese herbal medicines, the author believes that the first joint centralized procurement of Chinese herbal medicines may face two major challenges of "quality level" and "price fluctuation" for the following reasons: 1.
Quality level It is not clear and may lower the quality level of traditional Chinese medicines in medical institutions.
In this centralized procurement, the trading center proposes to solve the problems in the circulation of traditional Chinese medicines (materials) through the five core systems of "quality control traceability, quality insurance, total price negotiation, transaction settlement, and smart pharmacy".
Many industry pain points, and finally achieve the "quality, upgrade, and stable supply" of the supply of traditional Chinese medicine (materials) in the alliance provinces and cities
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This general direction is correct, but it is extremely difficult to implement the quality level division of centralized procurement varieties.
It is easier said than done to achieve the "greatest common divisor of the demand side" in the joint centralized procurement of 19 provinces? The first is the diversity of species sources.
As we all know, TCM decoction pieces are the weapon of TCM clinical practice, and it is also the result of clinical practice
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Such practical experience and historical precipitation have resulted in the diversity and multi-layered sources of raw materials for Chinese herbal medicines.

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Figure 2: Domestic sales growth of Fuzi from 2015 to 2020 Figure 3: Comparison of supply prices of Fuzi decoction pieces in different production areas in China Pay attention to the source of traditional Chinese medicine
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In 2020, the demand for this variety of decoction pieces by domestic urban medical institutions is more than 860 tons, of which more than 340 tons of raw materials come from 5 aconite decoction pieces factories in the Jiangyoudao production area in Sichuan, and the rest are from Yunnan, Shaanxi and other places, the price is from 45 yuan.
(Kilogram price, the same below) to 260 yuan (not included in the specification difference, such as Zhongba Fuzi's Pao Tianxiong price is higher)
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And such a price difference is a comprehensive reflection of the authenticity of provenance, historical inheritance, processing technology and regional labor costs, all of which have their historical rationality
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If we simply limit the winning bid price for 1-2 centralized procurement, then which production area and which specification should be withdrawn from the stage of history? What's more, Lijiang in Yunnan and Liangshan Prefecture in Sichuan (mainly Muli County) also carry the heavy responsibility of targeted poverty alleviation with Chinese herbal medicines
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Secondly, there is the issue of regional differences in consumption levels.
From the monitoring of the big data platform of Tiandi Yuntu, the consumption level of domestic traditional Chinese medicines can be roughly divided into three echelons: one is Beishangguang and coastal provinces such as Zhejiang, Jiangsu and Fujian; the other is Shandong and Hebei , Henan, Sichuan and other central provinces; the third is the northwest and southwest provinces
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Among them, Guangdong, Shanghai and Zhejiang have the highest requirements for the quality of decoction pieces
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Even in Guangdong Province, there is a huge difference in consumption levels between the Pearl River Delta region and the western and northern Guangdong regions
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If the demand of these 19 provinces is pulled at the same level according to the price, and in line with the general principle of reducing medical insurance expenditure, the final result will be that the developed areas will follow the underdeveloped areas, thus lowering the overall quality of medicine in medical institutions.

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Regarding this issue, in the centralized collection document of decoction pieces published earlier, what the author sees is the simple quality level division of "complying with pharmacopoeia standards + total pieces + piece selection", which does not reflect the differences in production areas, processing techniques, etc.
Can it meet the individual needs of nearly 10,000 medical institutions in 19 provinces? 2.
The price of raw materials of traditional Chinese medicine fluctuates frequently, and it is difficult to guarantee the supply after winning the bid.
Figure 4: Price fluctuation of aconite from 1988 to 2021.
In the past five years, under the background of the shrinking of the professional market for traditional Chinese medicinal materials and the reduction of intermediate circulation links, "hoarding and hype" has become a The main profit method of traditional traders, the price of raw materials of Chinese medicinal materials has repeatedly been out of control
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According to the statistics of the big data platform for the pharmaceutical industry in Tiandi Yuntu, from 2018 to 2021, the amplitude of the composite 200 index of the domestic Chinese herbal medicine market was as high as 18.
96%.
Healthy and sustainable development of the pharmaceutical industry
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As shown in Figure 4, as a short-cycle variety, the price of aconite has remained stable for the past 30 years.
However, after the new production in 2014, some aconite processing enterprises joined hands with roasted seeds and nuts to increase the price to more than 115 yuan in 2015.
Production areas such as Sichuan expanded wildly, and eventually the price fell below 20 yuan after new production in 2018, and farmers suffered heavy losses
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On the one hand, in the past two years, working with roasted seeds and nuts traders to achieve excess profits by controlling the prices of raw materials of Chinese herbal medicines and attacking competitors has become the main way of survival and profitability for many domestic decoction pieces companies
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Under the premise that the production and sales connection system is not yet perfect, the large-scale joint procurement of 19 provinces, with clear targets and clear procurement quantities, will inevitably open the door to this kind of "hoarding and speculation" behavior; on the other hand, those with empty inventory Once the price of traditional Chinese medicine raw materials is deliberately inflated by speculators, how will the winning bid be implemented? Everything is difficult at the beginning.
In order to prevent the above risks, the author has the following suggestions: First, in terms of quality, as far as possible, the needs reported by medical institutions should be the main platform staff such as trading centers may wish to work harder, split more targets, and add more quality field, rather than simply meeting the minimum threshold of "Pharmacopoeia standards"
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Second, bid evaluation experts should be as close as possible to actual combat.
Traditional Chinese medicine experts participating in bid evaluation and evaluation, preferably more buyers, pharmacists and pharmacists from the front line, have a full understanding of traditional identification experience and quality judgment
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The third is quality priority and price assistance.
The weight of quality in the scoring criteria should be at least 50%, and then refer to indicators such as quotation, distribution capacity and enterprise scale
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As for quality requirements, in addition to the subjective judgment of bid evaluation experts, objective and rigid requirements such as origin, growth period, processing method and sheet size should also be introduced
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Fourth, let clinical TCM fully participate in the centralized procurement process.
The author suggests that in terms of centralized procurement needs and selection of bid evaluation experts, the proportion of clinical TCM experts should not be less than 30%.
Especially in pediatrics, surgery and other departments, they usually have more prominent individual requirements for the quality of decoction pieces
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Due to the complexity of the field of TCM decoction pieces, the author has always believed that under the premise that the production and sales docking system (with the traceability system as the core) is not yet perfect, the joint centralized procurement of TCM decoction pieces should be cautious and should be based on full demonstration and pilot.
in full swing
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But now that it has been put on the agenda, it should be continuously improved as the work progresses
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(The author is the chief analyst of Tiandi Yuntu Pharmaceutical Big Data Platform)