Chinanews client, Beijing, October 20th (Reporter Zhang Ni) Recently, a series of bribery cases by pharmaceutical companies have been intensively exposed by the media.

The hospital staff with purchasing power receive tens of millions of rebates at every turn, and the annual sales costs of pharmaceutical companies are staggeringly high, and these costs will eventually be passed on to the medical insurance fund and patients.

　　Can the gray chain of interests be completely cut off after the country has played a series of combined punches to curb the inflated drug prices?

How should pharmaceutical companies and pharmaceutical representatives adapt to the new environment?

Data map: A patient uses the face recognition system to make an appointment with an expert number under guidance.

Photo by Wang Guangzhao

Intensive exposure of bribery cases by pharmaceutical companies: some hospital personnel received tens of millions of kickbacks

　　Holding the "power" to purchase drugs, pharmaceutical sales representatives came to visit, and gift cards followed...

　　Recently, a video from the website of the State Supervision Commission of the Central Commission for Discipline Inspection revealed that Wang Xiaojun, a former pharmacy staff member of the First People’s Hospital of Tonglu County, Hangzhou City, Zhejiang Province, took advantage of his position to work with others to seek benefits for drug companies in the introduction of new drugs and drug procurement. The details of the bribery case that received a kickback of more than 10.19 million yuan.

　　Among them, only two drugs such as Laoxycephalosporin for injection have brought Wang Xiaojun and others up to 3.25 million yuan in "benefits".

Many drug dealers stated that Wang Xiaojun's rebate was as high as 40% of the retail price of the drug.

　　Of course, this case is not alone.

　　According to a verdict previously exposed by the media, a doctor from Shangshui County People’s Hospital in Henan Province took advantage of his position to prescribe 35,962 boxes of "Buchang" Naoxintong capsules in 3 years, and illegally accepted drugs from the sales clerk of Shaanxi Buchang Pharmaceutical Co., Ltd. The rebate is RMB 125,000.

　　The relevant person in charge of the Price Recruitment Department of the National Medical Security Administration previously stated that according to publicly available court judgments, more than half of the 100 compulsory drug companies nationwide from 2016 to 2019 were found to have directly or indirectly given rebates. The most frequent companies involved more than 20 cases in three years, and the rebate amount in a single case exceeded 20 million yuan.

　　"It's no secret that high and low consumables, medical devices, and medicines all have rebates." Wu Peng (pseudonym), who works in technical support and sales for a medical device agent company, revealed to a reporter from Chinanews.com in an interview.

　　Wu Peng, who has been engaged in the medical industry for many years, said that although volume purchases are gradually spreading across the country, some pharmaceutical equipment is still not involved, so there must be a gray chain of interests that has not been completely cut.

In addition, apart from sales, there is still room for accepting bribes in the payment collection and settlement of hospitals to companies, and these costs will eventually be passed on to patients.

　　“Sometimes when a salesperson meets some doctors, the other party does not ask how the product is, but first asks what the company’s'policy' is. The so-called'policy' is the rebate ratio." Wu Peng said, usually, the sales representatives themselves get far less commissions. The percentage of rebates sent to "insiders" is high, and the company's sales cost can be imagined.

　　And Yang Xin (pseudonym), who resigned from a public hospital and entered a pharmaceutical company as a pharmaceutical representative many years ago, told reporters that the entry threshold for pharmaceutical agents was not high. The core that really determines the work performance is that the medical representatives work in various departments of major hospitals. "Personal resources", and transfer of benefits is naturally an indispensable "stepping stone."

Data map: There is a long queue in the registration hall of a hospital.

Photo by Yang Bo

Can the policy combination cut off the gray chain of interests?

　　High rebates have kept the sales expenses of major pharmaceutical companies high.

According to previous media statistics, the average sales expense ratio of listed pharmaceutical companies exceeded 30%.

　　Taking Buchang Pharmaceutical as an example, in 2019 alone, Buchang Pharmaceutical's sales expenses reached 8 billion yuan.

　　Hengrui Pharmaceutical's sales expense ratio in 2019 is 36.61%, which is only in the middle of the industry among more than 230 pharmaceutical manufacturing companies (including API companies) in the Shanghai and Shenzhen stock markets.

　　Xiao Jiangping, director of the Competition Law Research Center of Peking University, previously analyzed to the media that in the past, many drugs had falsely high prices, that is, some drugs were very cheap ex-factory prices, but after several steps, they were very expensive when they reached hospitals and patients. Caused by commercial bribery.

　　In fact, in recent years, in order to combat commercial bribery in the pharmaceutical industry, relevant state departments have successively introduced a series of policies and control measures.

　　Take the national centralized drug procurement as an example. At present, it has moved towards normal operation. The centralized drug procurement has been carried out in three batches, involving a total of 112 varieties, with an average drop of 54%.

　　In addition, the purchase of high-value medical consumables tapes has also begun.

Recently, the Beijing-Tianjin-Hebei medical security bureaus have jointly signed the "Beijing-Tianjin-Hebei Pharmaceutical and Medical Consumables Centralized Procurement Cooperation Framework Agreement." The three places plan to form an alliance and reduce the price of medical consumables through mass procurement.

　　In terms of combating commercial bribery in the medical field, in September this year, the National Medical Insurance Bureau announced the "Guiding Opinions on Establishing a Medical Price and Recruitment Credit Evaluation System", giving rebates or other improper benefits, tax-related violations, etc. in the purchase and sale of medicines. Such behaviors are listed as untrustworthy items in the directory list.

　　The relevant person in charge of the Price Recruitment Department of the National Medical Security Administration stated that outstanding problems such as rebates and monopoly price increases in the pharmaceutical sector have long existed, which are an important reason for high prices, and cause problems such as excessive growth of medical expenses, which distort the business environment and Industry ecology, weakening industry innovation motivation, one of the purposes of establishing a credit evaluation system is to promote a reasonable return of pharmaceutical product prices.

　　In addition, a document published before the National Day this year has attracted widespread attention from the medical community.

　　On September 30, the "Administrative Measures for the Recordation of Medical Representatives (Trial)" formulated by the State Food and Drug Administration was announced.

Among them, it is clearly stated that medical representatives shall not undertake the task of drug sales, implement sales activities such as collecting payments and processing purchase and sales bills.

　　In addition, the document clarifies the main tasks of medical representatives, including four aspects: formulating medical product promotion plans and programs; transmitting medical product-related information to medical staff; assisting medical staff in rational use of the company’s medical products; collecting and reporting on clinical use of drugs Situation and hospital needs information.

　　The above-mentioned "Measures" shall come into effect on December 1, 2020.

　　The "sale with gold" that was once regarded as an unspoken rule in the industry was ordered to stop, and there is not much time for the retention of drug companies and the 3 million domestic pharmaceutical representatives to seek transformation.

Data map: The newly opened "smart pharmacy" on the streets of Kunming attracts citizens to experience.

Photo by Ren Dong, China News Agency reporter

The days of "Lying down to make money" are over!

How do pharmaceutical companies and drug agents survive?

　　In fact, for pharmaceutical companies, the impact has been accompanied by the continuous fermentation of the previous start of volume procurement, and transformation has become an inevitable choice for survival.

　　If you want to gain an advantage, companies must squeeze out "water". In terms of optimizing the personnel structure, a huge sales team has become the first target of "surgery".

　　Take Xinlitai, which previously participated in the national centralized drug procurement, as an example. Its 2019 annual report shows that the sales staff of Xinlitai has dropped from 2,108 at the end of 2018 to 1,666, a decrease of about 20%.

　　At the same time, pharmaceutical companies have also put more energy into R&D.

　　The data shows that leading companies such as Hengrui, Fosun, China National Biotech, CSPC, Shanghai Pharmaceuticals, and Kelun have a R&D threshold of more than 1 billion yuan in 2019, and all have different degrees of growth compared with previous years.

　　More critically, the centralized procurement model reduces the sales expenses of enterprises by ensuring the clinical use of selected drugs, and helps pharmaceutical companies abandon the traditional marketing model.

According to an earlier report by the "People's Daily", the sales staff of selected products in key enterprises have been reduced by an average of 49%, and the proportion of sales expenses in the sales amount has dropped from 40% to 5%-10%.

　　For individual medical representatives, for a long time in the future, they are destined to experience a "throttle period" of career transformation.

　　"After the start of centralized drug procurement, some businesses have gradually been affected. Since the second half of last year, many of my colleagues have resigned in order to find new development space." Yang Xin told reporters.

　　Yang Xin said that before, many colleagues thought that the impact of volume purchases was limited and would not affect the entire large market, but now, the previous predictions were too optimistic.

Now, Yang Xin himself is also considering changing jobs.

　　"Returning to the public hospital system is no longer possible. Either continue to search for a'New World' in pharmaceutical companies, or change careers completely." Yang Xin said.

But she also admits that no matter which choice, it is not a small challenge for her who has reached middle age.

　　As for Wu Peng, whose main energy is on technical support, mass purchases have not had much impact on him for the time being.

He is relatively optimistic about the future development.

"Regardless of reform, technical support is indispensable for any medical institution. This is actually what enterprises should provide."

　　In his view, reform is the inevitable way out for this industry. In the future, he hopes that the health industry he is engaged in will also be healthier.

(Finish)