The national development and Reform Commission finds out the cost of drugs, and the drug companies collude with each other for joint defense

"In order to understand and master the cost, price and relevant information in the process of drug production and circulation, and formulate and adjust drug prices in a timely manner, our commission decided to carry out cost price surveys on some enterprises." Under the order of the development and Reform Commission, which specializes in market pricing, 60 domestic and foreign pharmaceutical enterprises had to hand over their account books to assist in "sample investigation" In China, the phenomenon of high drug price has been criticized On July 2, the general office of the national development and Reform Commission issued a notice to launch a new round of four-month cost price survey of pharmaceutical enterprises Many large foreign enterprises, well-known listed companies and high margin star enterprises have been covered, and almost all of them are the main force of the list of essential drugs There are two directions of this investigation: the factory (port) price investigation for the majority of distribution pharmaceutical enterprises, and the special cost investigation for large pharmaceutical enterprises The former includes Keyuan Xinhai, Shuanglu pharmaceutical, Sinopharm distribution, Shanghai Yongyu, Guangzhou Pharmaceutical, Guilin Sanjin and other well-known enterprises In the special cost survey, GSK (GlaxoSmithKline) Tianjin, Tianjin Baite, anstelai, bringer Ingelheim, Sanders China, Beijing feisenyuskabi and many other foreign capital, as well as Shanghai Kaibao, Jiangsu Hengrui, humanwell pharmaceutical, Zhengda Tianqing, Kelun pharmaceutical, Yangtze River Pharmaceutical and other domestic first-line pharmaceutical enterprises, were all "named" by the national development and Reform Commission Although the cost survey conducted every two or three years has no direct relationship with drug price reduction, medical reform has been carried out in the deep-water area In the climate of national requirements for stabilizing drug prices and controlling drug costs, revealing the real cost of drugs may become a key link for the final implementation of drug price reduction What's more, the launch of this round of investigation coincides with the exposure of GSK, Sanofi, Baite and other large pharmaceutical companies one by one These enterprises are suspected of large-scale bribery of medical personnel in China's actual sales, and transfer the bribery costs to the drug price invisibly, which has aroused the involvement of relevant departments and the public's high concern It is reported that through on-the-spot visits, the development and Reform Commission conducted a detailed investigation on the production, sales, cost and price of all drugs of the enterprises involved in 2010-2012 for three consecutive years The investigation was conducted in four batches before and after, and has now progressed to the second batch In addition to covering enterprise history, main products and market conditions, production capacity, production and operation overview and other basic contents, the most important thing is to check and analyze the financial system, financial statements, account books and materials behind the whole process, as well as various vouchers, bills, contracts and other contents related to the investigation, which are often "tricky" Investigating whether it will compress the "moisture" beyond the actual cost of drug price has aroused the high "vigilance" of many enterprises "Period expenses (including a large number of marketing expenses) and production costs are undoubtedly the core of this survey, which can also be regarded as the biggest secret of the enterprise In order to keep the current high gross profit from being compressed in the future, or to not expose the defects of the current sales agent, it is not uncommon for enterprises to cooperate passively or even collude with each other to falsely report the cost " On August 8, Liu Peng, an insider of a large pharmaceutical enterprise, told reporters, "especially the cost of importing high-priced drugs, exclusive varieties of traditional Chinese medicine and selling drugs through agent system is the most difficult to get real data." On July 24, the general office of the State Council released the notice on the main work arrangement of deepening the reform of the medical and health system in 2013, which proposed for the first time to resolutely investigate and deal with the behavior of withholding in the purchase and sale of drugs However, the difficulty of this investigation is how to clarify the "real" selling expenses Because of the huge medical market in China, it is difficult for pharmaceutical companies to promote to hospitals only by their own sales teams After years of development, there are currently two different ways of sales One is the self-supporting system of the enterprise The pharmaceutical representatives are recruited, trained and managed by the pharmaceutical enterprises themselves, which must directly follow the internal compliance requirements of the enterprise The other is the bottom price agency system, in which the pharmaceutical enterprises hand over the drugs to special agents for distribution and promotion at the bottom price of the drugs after production "Generally speaking, at present, both foreign and domestic enterprises usually promote the self built teams of key products For the non key products of large pharmaceutical enterprises and the enterprises with small size, the base price agency system is used for outsourcing sales " A senior executive of a large domestic pharmaceutical company who was subject to the cost survey told reporters "The agency system often involves three or even four levels of agents Each level of agent can be separated from the supervision of pharmaceutical companies There are cases of tax evasion and commercial bribery everywhere." In the huge chain of pharmaceutical distribution, agents have been playing a crucial but extremely difficult role Strengthening management and reducing redundant agency channels should effectively avoid excessive markup in the process of drug distribution However, "the enterprise side will worry that once the state requires manufacturers to supply goods to the market at the base price, most of the manufacturers and middlemen will be cut off; and a large number of dealers will try their best to" balance the accounts "for their own interests." Liu Peng said According to its introduction, many base price agency enterprises, in the face of the cost investigation of the national development and Reform Commission, will communicate with agents at all levels in the lower reaches in advance to "raise the price", and "prove" to the investigators that the actual cost should be such a high level through the practice of unified caliber and sub parent account books, in order to avoid the price being suppressed This method of covering up the proportion of price increase and rebate accounts has long been the usual "countermeasure" for pharmaceutical enterprises of all sizes to deal with inspection "The factory price survey involves so many enterprises Those production and distribution, and even enterprises and enterprises will collude with each other to make offers and cooperate with the outside world." Liu Peng revealed, "to put it bluntly, it's the people of these enterprises who know that the above people can't find out the problems in which aspects, so they have targeted fortification." Virtual increase in cost: strong agents have drug enterprise managers revealed that the sales expense rate of bottom price agents is only 3% - 4% compared with the sales expense rate of 40% of self built teams For example, for the ex factory drug price of three or four yuan, the agent may make its purchase price in the hospital as 10 yuan Under the team system, because drug companies need to be responsible for the cost of their own promotion team, the factory price may be set at 67 yuan, and finally the same price is 10 yuan into the hospital "But the latter model seems to be considered a lot of 'compliance'." In fact, the self confessed "grievance" drug companies bottom price agent system sales, but has always been the relevant departments in reducing drug prices when a "very difficult bone to chew." Once an agent of a large pharmaceutical listed company in East China threatened to publicize the bribery scandal once the other party terminated the cooperation, as a guarantee for continued cooperation Before that, many listed companies had encountered strong resistance from agents when they wanted to recover the right of agency and distribution The interest disputes between them are also reflected in many aspects Previously, the Ministry of health and other six departments issued the opinions on further standardizing the centralized purchase of drugs in medical institutions, which changed the "bidding by wholesale enterprises" to "direct bidding by drug manufacturers" However, in the actual bidding process, it is still very common for agents to work for them On the other hand, with the promotion of the two ticket system, more and more pharmaceutical enterprises begin to choose to implement the "commission system" management on pharmaceutical agents, that is, manufacturers no longer issue invoices for agents at the base price, but issue full tickets at a high price, and return the Commission to agents after receiving the payment As a result, the sales volume of the enterprise can be increased by three or five times, the profits and taxes paid will be increased correspondingly, and the image benefit will be improved At the same time, the agents will continue to resist because the "cheese" is cut As a result, this investigation also tries to squeeze the inflated cost of agents The above-mentioned executives said frankly that the base price agency system is not a bad thing If the agents only play the value-added function well, there is not much risk in this mechanism The key lies in how the enterprises and agents balance and cooperate with each other "If the enterprise has been extensive management of agents before, now it must be worried about problems in the investigation of the national development and Reform Commission, so it will try to whitewash." Exclusive varieties of traditional Chinese medicine: many Chinese patent medicine enterprises are hindered by cost investigation, which is also listed in the cost investigation list In the 2012 edition of the catalogue of national essential drugs issued in mid March 2013, there was a "Carnival" of Chinese patent medicine and Chinese herbal pieces, with 40 new exclusive varieties of traditional Chinese medicine alone Taking Guangyao group as an example, Baiyunshan and huangkouyanqing granules, Baiyunshan zhongyixiaoke pill, changyanming tablet, Baiyunshan Qixing huatuozaiban pill and Wanglaoji Baoji oral liquid, which are the exclusive traditional Chinese medicine varieties of the group, were selected into the new version of the basic medicine catalogue In addition, Tianshili's blood nourishing Qingnao Granules, Guizhi Fuqin capsules and Yaobitong capsules of Kangyuan pharmaceutical, Lianhua Qingwen capsules and Shensong Yangxin capsules of Yiling pharmaceutical, Yindanxinnaotong soft capsules of Guizhou bailing, Sanjin tablets of Guilin Sanjin and Xiaotong paste of Qizheng Tibetan medicine have also been selected However, in the field of traditional Chinese medicine injection with high gross profit as its prominent feature, enterprises that repeatedly copy the "virtual increase cost method" mentioned above in order to maintain high gross profit are more radical than chemical enterprises This time, Shanghai Kaibao was questioned by the outside world because of the huge difference between gross profit and net profit According to the data of Shanghai Kaibao in the first quarter of 2013, the gross profit rate of the company is as high as 84%, while the net interest rate is only 20% In financial management, the difference between them is usually composed of sales, R & D, management and financial expenses According to the results of the last round of cost investigation of the national development and Reform Commission, in 2010, a Chinese medicine enterprise under investigation was identified by the national development and Reform Commission with four major problems: high price of raw and auxiliary materials; large loss of raw and auxiliary materials; high level of manufacturing cost except raw and auxiliary materials and packaging materials; high level of expenses during the period The focus of the NDRC's investigation will be on the situation of high marketing expenses and poor cost control After several rounds of drug price reduction for several years, the exclusive variety of traditional Chinese medicine, which has enjoyed independent pricing and rarely encountered the administrative price reduction of the national development and Reform Commission, also spread the news of price reduction in 2013 However, due to the different prices and quality systems in the Chinese herbal medicine market, the development and Reform Commission and other superior departments encountered considerable inconvenience in the investigation of the enterprise's procurement cost and production cost "Each raw material of each traditional Chinese medicine is widely distributed, and there must be price differences when purchasing in different regions In recent years, hot money hype fierce raw materials of Chinese medicine, such as Panax notoginseng, for example In some places, the purchase price is very high, while the price of Panax notoginseng sold in some production areas is so cheap that even people have doubts " Shi lichen, partner of Peking University Zongheng pharmaceutical, told reporters that it is more difficult to investigate the cost of traditional Chinese medicine manufacturers and exclusive varieties "There is such a big difference in the purchase price of raw materials The manufacturer may purchase the cheapest, but the reported price is definitely the highest Once the enterprise does not cooperate, how can it find out the real cost? " In another case, during the two years from 2009 to 2011, the wholesale price of Huai yam was once fried from 3.5 yuan / kg to 55 yuan / kg, and then it was quickly returned to about 10 yuan / kg Similar