The trillion market is under pressure!

Medical Network News on August 11th.
Affected by policies such as mass procurement, national medical insurance negotiations, and rational use of drugs, superimposed on the effects of the new crown epidemic, the size of the terminal market of China's public medical institutions will decline for the first time in 2020, and the drug market structure will also change
.
Regional medical terminals are affected by economy, medication habits, etc.
, and their medication structures are also different.
Then, what are the differences between the medication structure of regional medical terminals and the national market? What are the changes in the medication structure? Change breeds opportunities.
What opportunities can it bring to retail pharmacies? In the afternoon of 24 July 2021 Meath will "enjoy intellectual Meath: · Winning region is king" conference, Director of the Center meters Intranet hospital Zhou Chunxuan resolved under the influence of the New Deal, two Jiangsu, Shandong Pharmaceutical province's public health care The changes in the drug structure of the terminal have provided five enlightenments to the development of the drug retail market
.

Medical terminals are under pressure, and the status of pharmaceutical retail terminals has risen.

China is a large country with a population of 1.
4 billion.
The base of medical and health needs is huge, and the huge patient base has created a huge demand for drugs.
Data from Minai.
com shows that during the "13th Five-Year Plan" period, China's drug sales The scale has increased year by year, from 1.
5 trillion yuan in 2016 to 1.
64 trillion yuan in 2020
.
However, due to multiple factors such as the epidemic situation and policies, its growth rate has been declining year by year, with negative growth for the first time in 2020
.
In recent years, the frequent occurrence of medical reform policies has had a certain impact on the drug market of the medical terminal: the national medical insurance catalog has expanded, and the medical insurance products have an absolute dominant position in the market; the basic medicine catalog has continued to expand, and the proportion of the basic medicine has also increased significantly ; State talks medicines exchanged prices for the market to get through the “blocking point” of admission; the state’s centralized procurement has been normalized, and the prices and market share of state-produced varieties have been hit by a double blow; the key monitored varieties have fallen off a cliff
.
The sudden new crown epidemic has made the medical terminal drug market "exacerbated" and has become the "culprit" of the sharp decline in the size of the terminal market
.
According to data from Mi Nei.
com, the terminal market of China's public medical institutions will reach 1.
210.
7 billion yuan in 2020, a year-on-year decrease of 12%, and its share in the overall pharmaceutical market is declining year by year.

.
The growth trend of drug sales in the four major terminal markets of China's public medical institutions from 2018 to 2020 (unit: 100 million yuan) From the perspective of public medical terminal market segments, urban public hospitals account for the largest proportion and are also heavily influenced by policies.
The market share is increasing year by year Declining trend; Affected by the promotion of hierarchical diagnosis and treatment and the sinking of drug sales terminals, community health service centers (stations) are the only channel that contrarian growth, with a year-on-year growth of 6.
1%, and their market position continues to improve
.
Affected by the epidemic, users have changed their drug purchasing habits, and superimposed policies have solved the difficulties of medical insurance payment.
Internet medicine has ushered in a period of development, stimulating the expansion of the retail pharmacy terminal market, and the proportion of the overall drug market has continued to increase, and its market position has continued to improve
.
2020 is the closing year of the 13th Five-Year Plan, and 2021 is the beginning of the 14th Five-Year Plan.
The Chinese pharmaceutical market is gradually emerging from the haze of the epidemic, maintaining stability has become the main theme of the market, innovative products continue to be listed, and medical insurance funds are constantly changing.
The pace is accelerating.
At the same time, stricter hospital access, centralized procurement, and pricing pressure from medical insurance negotiations have led to more prescription outflows.
Therefore, the future of the out-of-hospital market is worth looking forward to
.
Mi Nei.
com expects that in the next five years, the growth rate of the out-of-hospital market will be higher than that of the in-hospital market
.
Pharmacies are the main channel to undertake the out-of-hospital market, which will bring more development opportunities to the pharmaceutical retail market
.

Major pharmaceutical provinces have a large scale of drug use, with a high proportion of chronic disease drugs and anti-tumor drugs.

Jiangsu and Shandong are both major medical provinces with a large scale of drug use, and the growth rate is slightly higher than the overall level of the country
.
The public medical institution terminal is the first carrier of the big health industry.
The number of visits and hospitalizations in public medical institutions in the two major pharmaceutical provinces accounted for about 80% of the total
.
Driven by the needs of patients, the sales of public medical terminals in Jiangsu Province in the past three years have exceeded 70 billion yuan.
In 2020, the impact of the epidemic will decline by 5.
84% year-on-year; the sales in Shandong Province have exceeded 65 billion yuan, and the year-on-year decline in 2020 will be 8.
16%.

.
Jiangsu and Shandong have a high degree of concentration in the public medical terminal market.
Drug sales are mainly concentrated in the top-ranked products.
The total market share of TOP200 products exceeds 50%, and the total market share of TOP500 products exceeds 70%
.
As these varieties are successively incorporated into centralized procurement, it will have a great impact on the medical terminal drug market in the two provinces
.
2018-2020 Terminal Drug Sales in Public Medical Institutions in Jiangsu & Shandong Province (Unit: 100 million yuan) Segmented terminal market, in the past three years, Jiangsu and Shandong urban public hospitals accounted for the largest proportion of drug sales, both reaching more than 60%; community health Service centers (stations) are the only market that maintains an upward trend year by year, and Jiangsu has a higher proportion than Shandong
.
From the perspective of medication route, injections account for a relatively large proportion in Jiangsu and Shandong, both reaching more than 50%, which is higher than the national level; the proportion of internal medicines in Jiangsu and Shandong is lower than the national level, especially in Shandong Province
.
In recent years, Jiangsu and Shandong have continuously advocated rational use of drugs, and the proportion of injections (especially traditional Chinese medicine injections) has declined significantly
.
From the perspective of drug types, chemical drugs dominate in Jiangsu and Shandong, accounting for more than 70%, which is higher than the national level; biological drugs account for a relatively small proportion, but they are increasing year by year
.
Chemical drugs are mainly prescription drugs, and the double-span varieties account for a relatively small proportion, but the growth is better
.
The implementation of the policy will have an impact on the public medical terminal market in Jiangsu and Shandong
.
With the expansion of the medical insurance catalogue, the proportion of medical insurance products has increased significantly, the sales of the products transferred into the medical insurance have increased significantly, and the sales of the products transferred out of the medical insurance have decreased; the new version of the basic medicine catalog has been adjusted, and the proportion of the basic drugs has increased significantly, which will help promote Hierarchical diagnosis and treatment; the proportion of original research drugs is relatively low, but with the advancement of policies, the development of original research drugs ushered in the golden period of development, and the era of meager profit of generic drugs has come in an all-round way
.
From the perspective of different disease treatment categories, medical insurance assistance, deregulation of drug supervision, accelerated aging process and changes in the disease spectrum have promoted the market growth of chronic disease drugs, with the largest and steady increase in sales; the sales of critical anti-tumor drugs have increased.
The speed is fast, medicines for minor illnesses are on a downward trend, and the proportion of sales of health-optimized life>
.

　　Empowering the out-of-hospital market, five inspirations to help the development of retail pharmacies
Affected by the impact of pharmaceutical e-commerce, the increase in the number of pharmacies, increased competition, and stricter medical custody control policies, the development of retail pharmacies is facing challenges; at the same time, with more and more innovative drugs Approved for listing, stricter hospital access and centralized procurement, national medical insurance negotiations, etc.
have brought pressure to lower the price of medicines, resulting in faster prescription outflows, and the importance of the out-of-hospital market has become prominent.
As the main channel to undertake the out-of-hospital market, retail pharmacies have new Development opportunities
.
By analyzing the changes in the structure of regional medical terminals, these changes can bring inspiration to the development of retail pharmacies
.

　　Revelation 1: Adjust the variety layout of different types of pharmacies according to the best-selling products of different channels.
The top
15 products in the four major markets of Jiangsu medical terminal are differentiated: urban public hospitals mainly use anti-tumor drugs and cardiovascular and cerebrovascular drugs; county-level public hospitals focus on heart Cerebrovascular drugs are mainly used, but anti-tumor drugs are few; community health service centers (stations) and township health centers mainly use chronic disease drugs, and the central cerebrovascular drugs are mostly used, but the two major markets are not closely matched
.
The four major markets overlap and top-ranked varieties are worthy of attention by retail pharmacies, including nifedipine controlled-release tablets and valsartan capsules
.
Enlightenment 2: Layout of the products that have not been collected and abandoned, especially the sales of brand-name domestic drugs and original research drugs that are included in the collection.
The sales of selected products have been exchanged for volume, and sales have increased to varying degrees, while those that have not been selected And the original research drug market fell sharply
.
In order to stabilize sales revenue, unselected varieties and original research drugs are actively exploring the out-of-hospital market.
Therefore, retail pharmacies may consider deploying prescription drugs with high brand awareness and long DOT
.
Sales growth of the alliance and the second batch of collectively-sourced varieties in the terminals of public medical institutions in Jiangsu and Shandong
Enlightenment 3: Layout of newly-listed innovative drugs and original research drugs with expired patents to meet the needs of consumption upgrades.
Innovative drugs face the two thresholds of bidding and medical insurance after they are launched.
It is difficult to enter the hospital for sales within one or two years.
Usually, they will be deployed in the out-of-hospital DTP market and retail Pharmacies have just filled the window period for new drugs from launch to medical insurance; due to the impact of policies such as centralized procurement and national talks, sales of original research drugs have fallen sharply.
Therefore, they have actively deployed out-of-hospital markets, and the outflow of prescriptions has brought pharmacies Come development opportunities
.
Enlightenment 4: Seize the opportunity of the dual channels of national talks and explore the products suitable for pharmacies.
The adjustment of the national medical insurance catalogue is normalized.
The medical insurance access negotiation mechanism is becoming more and more mature.
The “channel” policy is introduced to open up this “last mile”.
Related companies are actively deploying out-of-hospital markets.
Retail pharmacies can screen products with short listing time, high clinical value, urgent needs for patients, and low substitution, and follow up the “dual channel” management in a timely manner.
Strive to obtain the "dual channel" qualification
.
Five revelation: to adjust the pharmacy chronic disease with terminal chronic disease medical best-selling varieties of drugs class, high-value layout of chronic disease clinical drug varieties in recent years, affected by the aging process, the living environment and life>
.
Retail pharmacies have the advantages of convenience and professional services.
They can be deployed according to the hospital's best-selling chronic disease drugs, focusing on the layout of the clinical guidelines or expert consensus of evidence-based medicine, and the chronic disease drugs with high clinical value
.

　　Jiangsu and Shandong chronic disease drugs (except injections) TOP5 products