National procurement is normalized, and agents choose products to make five major changes!

Source: Medical Network

Three batches of four rounds of national procurement carried out mass purchases of 112 varieties, saving more than 50 billion yuan in medical insurance funds. Recently, the fourth batch of national procurement has started, and the bid will be opened on February 3. Under the situation of the normalization of national centralized procurement and the diversification of local centralized procurement, how to reconstruct the products of agents?

01. Chronic diseases turn to "chronic diseases + specialist"

The first batch of “4+7” city medicines was purchased in a total of 25 varieties, including 9 drugs for chronic diseases such as blood pressure lowering, blood lipid regulating, blood sugar lowering, cardiovascular, etc., accounting for 36%, including the blood lipid regulating drug atorvastatin calcium tablets , Rosuvastatin calcium tablets, antihypertensive irbesartan tablets, amlodipine besylate tablets, irbesartan hydrochlorothiazide tablets, lisinopril tablets, losartan potassium tablets, enalapril maleate There are 6 varieties of sharp tablets. The second batch of 32 nationally-sourced chronic disease drugs includes 7 varieties including acarbose, accounting for 21%. The third batch of 55 nationally collected varieties includes 8 varieties including vildagliptin, metformin, valsartan and pitavastatin. Three batches of national sources have almost exhausted the commonly used chronic disease drugs.

The amount of drugs used for chronic diseases is large, and the national annual sales of a variety can be as little as 1 billion yuan and as many as several billion yuan. After the manufacturer wins the bid, it settles directly with the medical insurance. If there is no intermediate link, what should the agent do? First of all, agents must clearly understand the situation, the general trend of national policies, cheer up and quickly adjust product structure.

Secondly, take advantage of having made chronic disease products and quickly find similar products. The first imitation products continue to emerge, such as vildagliptin with quantity, vildagliptin and metformin compound preparations without quantity, and the first imitations of sitagliptin, metformin and linagliptin have come out. Most of the statins that regulate blood lipids are carried, and ezetimibe tablets have also been copied. As long as you get the manufacturer's products, you can maintain the original team.

Third, shift to specialty medication. For example, pediatric products, obstetrics and gynecology products, ENT products, orthopedics products, etc., the sales of specialty products are not as large as chronic disease drugs, and they are relatively easy to enter the hospital, and the risk of carrying the volume is small. By making a few more products, the sales of the original chronic disease products can be reached. The more products there are, the stronger the ability to resist risks. I would rather have annual sales of 100 million yuan for 10 products than 100 million yuan for one product.

02. Injection turns to "injection + oral medicine"

In the first three batches of national sources, there are not many injections. The first batch of "4+7" city centralized procurement catalogs has 3 varieties of injections, pemetrexed disodium, flurbiprofen axetil, and dexmedetomidine; the second batch of national procurement catalogs has only one variety, namely injection Paclitaxel; the third batch of national collections has 3 varieties of azacitidine, levetiracetam and moxifloxacin. There are only 7 varieties in the three batches of national sources. For the injection market, which has the largest share of hospital medications, it is only a drop in the ocean, with a small share. However, the fourth batch of volume procurement catalogue has 44 varieties and 90 product specifications, and the injection has 8 varieties and 18 product specifications, which is much more than the first three batches.

In addition, on May 14, the State Food and Drug Administration issued a document requiring all generic chemical injections to be evaluated for consistency in quality and efficacy. All injection products are required to be reviewed, which means that injection products will enter the centralized procurement in the future. The author has learned that there are 456 injection products from three or more manufacturers. Once all 456 products have been reviewed, they will inevitably constitute full competition and meet the conditions for centralized procurement. There is a high probability that all of them will be centralized procurement. Therefore, the good times for the agents of injection products are not long.

The agents who make injection products are all big drugs. Because of the large sales volume of injection products, such as antibiotics, cardiovascular injections, neurosurgery injections, and anti-tumor injections. There are many varieties with annual sales of more than 10 million yuan in the top three hospitals. Therefore, agents who make injections are generally unwilling to make oral medicines, because it is difficult to obtain oral medicines compared with injections, and it is also difficult to make them larger. However, as national centralized procurement, regional alliance centralized procurement, and provincial centralized procurement move forward, injections have been pushed to the forefront. Agents should quickly adjust the product structure, from specializing in injection products to "injection + oral medicine". On the basis of stabilizing the sales of existing injection products, quickly find oral products and optimize the product structure.

03. Chemical medicine turns to "chemical medicine + Chinese patent medicine"

Most of the agents like chemical drugs, which is determined by the market. The sales volume of chemical drugs is large and it is easier to enter the hospital, and hospitals also prefer it. However, the sales of Chinese patent medicines are relatively small, it is difficult to enter the hospital, and the cycle is long. The hospital prosecutor generally controls the Chinese patent medicine first. However, the 112 varieties of the first three batches of national procurement are all chemical drugs, and more chemical drugs will enter the national centralized procurement in the future.

Although proprietary Chinese medicines have shortcomings, they also have their advantages. The exclusive varieties of Chinese patent medicines have a long life cycle. It is normal for a variety to be used for 10 or even 20 years, with long flowing water and enduring durability. In contrast, agents of chemical medicines have suffered heavy losses in centralized procurement in recent years, especially for agents with fewer varieties.

Facing the normalization of centralized procurement, agents that originally specialized in chemical medicines or mainly chemical medicines must quickly adjust their product structure and transform to "chemical medicines + proprietary Chinese medicines." Choose the department you are good at. Those who used to do orthopedic medicines can choose some orthopedic varieties of Chinese patent medicines, and those who used to do cardio-cerebral vascular chronic diseases can choose some varieties of Chinese patent medicines. The field remains the same, and the department remains the same. Even if it is a proprietary Chinese medicine, the amount will be faster because doctors and experts are familiar with it.

The author believes that the ideal product structure of a successful agent must be a combination of long and short (long-term varieties and short-term varieties), a combination of Chinese and Western (Chinese patent medicine and Western medicine), and a combination of injection and oral medicine.

04. Consumables turn to "consumables + medicines"

In addition to the centralized procurement of medicines, the centralized procurement of equipment has also sounded the clarion call. On October 16, the National Organization for High-Value Medical Consumables Joint Procurement Office officially released the "National Organization for Centralized Procurement of Coronary Stents". On November 5th, the high-profile first national-organized procurement of high-value medical consumables was opened in Tianjin. As the first product to promote the reform of high-value medical consumables, the bid price of coronary stents has plunged, from an average price of 13,000. It is estimated to save 10.9 billion yuan in medical insurance costs based on the amount of intended purchases.

High-value medical consumables such as stents, steel plates, steel nails, hemostatic powder, dressings and other hospitals consume more. After the drug "zero markup", consumables have become the main source of income for hospitals. The large amount of consumables, high prices, and high profits are popular with agents. The relationship between high-value consumables agents and hospital directors is very strong, and pharmaceutical agents cannot compare with them. The consumable agents have made a lot of money over the years.

Centralized procurement of coronary stents opened a precedent for the national centralized procurement of high-value consumables. Medical steel plates, steel nails, hemostatic powder, etc. will be followed closely, and national centralized procurement of consumables will also become the norm. How to re-layout the product structure of such agents? Transition to "consumables + medicines". Agents who do high-value consumables generally look down on medicines, thinking that medicines are too cheap, just like being used to abalone and ginseng and not being used to eating side dishes. But now the situation is changing. If the product structure is not optimized, not only abalone and ginseng, but even side dishes may not be eaten in the future.

Agents should give full play to the advantages of their connections in the hospital and quickly import some drugs from the same department to make the product structure more reasonable. The dean and clinical department are the same, except that the consumables are in the equipment department and the drugs are in the pharmacy department. The deputy dean in charge may be different. But with the support of the clinical department and the chief dean, these problems will be solved.

05. Medical insurance shifts to "medical insurance + self-paid" products

Whether it is medicines or consumables, most agents are fond of medical insurance products, because medical insurance products are relatively easy to enter the hospital and have a large sales volume. However, with the normalization of the centralized procurement of medicines and consumables, medical insurance control fees become more and more strict, and medical insurance products will become more and more difficult to manufacture. To this end, agents must adjust the product structure in time, from medical insurance products to "medical insurance + self-pay" products.

Self-financed products are paid by the patient, do not occupy the medical insurance fund, the risk of centralized procurement is small, and the price is more autonomous. How to do self-paid products? One is to officially enter the hospital. Admission to the hospital through the pharmacy committee or device meeting, and the clinician prescribes. Self-paid products do not occupy the share of medical insurance, and most hospitals are relatively easy to accept. At the same time, self-financed products are priced independently, and hospitals also have certain profit margins.

The second is to enter the pharmacy near the hospital. The doctor prescribes to the patient, and the patient goes to the pharmacy to get the medicine (or consumables). This model is currently relatively common.

The third is DTP pharmacy. Currently DTP pharmacies are in the ascendant and are booming. The difference between DTP pharmacies and general pharmacies is: First, whether to seek three-party cooperation and whether to upgrade the service. Second, whether to integrate the market and whether to follow the policy closely. Third, whether to refine the management and whether the implementation is sinking. Upgrade is the upgrade of service and innovation, integration is the integration with market and policy, and sinking is the sinking of management and execution. The three complement each other and rely on each other to create a new type of main medical service platform.

The fourth is the third terminal. The third terminal has become an important terminal channel for many companies to compete for. The market potential is huge, and self-paid medicines have great potential in the third terminal.

For agents, centralized national procurement is a nirvana, and how to adjust product structure to adapt to national policies is a serious issue facing them. Natural selection, survival of the fittest. Only the phoenix bathing in flames can rebirth from Nirvana.