Internet Medical Series Report: Can cut off the medicine benefit chain

In May this year, the news that "the sale of prescription drugs on the internet is expected to be released" blew up the drug dealers. According to most media reports, the good news from the State administration of Food and Drug Administration (hereinafter referred to as the Department of Drug Administration) Law Division drafted the "Internet Food and drug management measures (draft)", is likely to fall before and after the 2015 New Year's Day landing.

At present, China's Internet trade in medicine is tightly regulated, not only for trading companies to impose licensing controls, prescription drugs are also banned online sales. Public data show that China's market share of prescription drugs is about 800 billion yuan, while over-the-counter drugs are only 200 billion yuan. If the market of prescription drugs is liberalized, it means that the market space of the pharmaceutical dealers will expand from 200 billion to trillions.

More importantly, China's "drug-Nourishing Medicine" system has been a long time, the resulting high prices of drugs has been difficult to solve. In recent years, the National Development and Reform Commission has made more than 30 price cuts on drugs, but it still has little effect. In the media reports, the Internet sales of drugs are placed high hopes that technology can be forced to change the medical reform.

In the future, can the pharmaceutical and electrical business really take up this role and cut off the pharmaceutical profit chain and let more people enjoy cheaper medicines?

Pessimists: There won't be much change in 5 years.

Gao (a pseudonym) in charge of sales in a large pharmaceutical company is not optimistic about the pharmaceutical electric business. In answer to NetEase technology "now feel that the medical and electronic business of traditional medicine sales have any effect", he said: "A little feel no!" "In 2013, China's pharmaceutical manufacturers were less than 1% of the pharmaceutical market," he said.

Gao entered the pharmaceutical sales industry in 2000. He recalls that drug sales are probably in two stages, with a watershed of about 2000 years.

Prior to 2000, drug sales were mainly through three channels: hospitals, pharmacies and drug stations, the three-channel drug sales ratio is about 60%, 30%, 10%. Drugs sold through hospitals need to be given to medical representatives and prescribed doctors. Drug sales through pharmacies, advertising and other promotional costs. Drug station is like Kyushu Tong, such as pharmaceutical commercial circulation enterprises, this way the drug added relatively few.

November 2001, the national implementation of drug centralized Tender Procurement conference held in Haikou. The meeting was convened by the six ministries and departments of the State Council, Shing and Ministry of Health, State Planning Commission, National Economic and Trade Committee, State administration of industry and drug. Since then, the drug centralized tendering and procurement work in full implementation.

"After this, drug procurement more standardized, the market pattern has undergone some changes." "Gao recalls, mainly through the hospital sales of drugs, the proportion of drugs through the drug station to reduce the proportion of drug sales through pharmacies basically flat (due to different policies, some places rise, some places down, overall flat).

"Throughout the process, the drug from the factory to the consumer hands, the link between the addition is always there, but the degree of difference in different periods." Gao told NetEase Technology.

In the process, Taobao was founded in 2003, China's e-commerce began to flourish. But Gao told NetEase technology, as a drug production enterprises, and there is no incentive to put drugs online to sell.

"Because we need to maintain market order." "He told NetEase Technology," drugs on the internet need to spell price, if I put the drug low price on the internet, that a little bit of sales will ruin our years of running the team and the entire market order. Medicine into the hospital, into the pharmacy every step is added, these are paid by us, if the price is broken, who will pay? ”

Gao told NetEase technology, enterprises will have relevant measures to maintain drug prices, if you find which sales channel prices are very low, the company will be traced. Each drug packaging has a bar code, you can find out from which channel outflow. Once detected, the corresponding sales channels will face penalties. In order to facilitate the implementation of penalties, many drug companies will allow dealers to pay "margin", meaning to ensure that the market does not break the order.

But, he admits, such controls do not guarantee 100%, and he did find his drugs sold at a low price online. "The channel is more complex, it is inevitable that someone did this single ran." "But as long as the big picture is in control, a small amount of such drugs will not affect the overall situation," he said. ”

For the future, the release of prescription drugs, Gao that the situation is not optimistic in the short term. He came up with a list of 6 difficulties: first, customers are concerned about the authenticity of drugs; second, the drugs sold online pharmacies do not have insurance reimbursement; third, the prescription drug sales need to be prescribed, which is tantamount to the hospital to rob Business, the hospital will protect prescription information; Finally, the logistics warehousing problem, medicine is different from general consumer goods To avoid light and other special storage conditions, we need to build the corresponding logistics system, the whole country has not established enough to ensure the safety of the logistics standards; five, whether prescription drugs or over-the-counter drugs, the general need to comply with the Doctor; VI, if there is a problem, the attribution of responsibility is not clear.

Besides, he counted his fingers: "Drug prices belong to the development and Reform Commission tube, drug tenders and channels to the Health Planning Bureau, Drug safety access to the drug Supervision Department, out of the accident to the safety Supervision Department, the Ministry of Health care, to let these departments linkage, is not an easy thing. ”

Finally, Gao concluded: "I do not deny the development of pharmaceutical electrical business, the speed of development of the Internet is not from one to two, but geometrically." However, at present, our development stage and management level is not enough to support the development of pharmaceutical electrical business norms. I don't think there will be any big changes for at least 5 years. This is my attitude--not optimistic, not negative. ”

What is the bottleneck of the pharmaceutical electrical business?

As for Gao, Ningong, director of China's online Pharmacy Council, admits that the current development of pharmaceutical dealers is indeed facing difficulties.

He recalls that although the end of 2005 Jing Wei Pharmacy Network on the first access to the Internet Drug Trading Service qualification certificate, but the beginning of the Internet to buy medicine consumption habits did not form, until the 2011 days after the Cat Medical Museum online, the pharmaceutical dealers began to grow rapidly. "Not before, because there is no flow." "Let the light speak.

He believes that even if the sale of prescription drugs open, the actual operation is still difficult. In addition to the problems mentioned by Gao, there are two questions:

First, where does the prescription come from? "Drug sales accounted for 50% of the hospital's income," he said. What if this part of the money is taken away and the state's finances cannot be made up? "To prove that, Beijing, a large chain pharmacy in charge of the media interview said:" When the retail pharmacy industry sales prescription drug release, the hospital for the prescription outflow took a series of defensive measures, electronic medical records are not through the hands of patients, all in the hospital's computer system to generate a save, so even now, You will find that the pharmacy's prescription drug sales are still very tragic and the prescriptions are not flowing. ”

Second, online pharmacies mainly rely on price to win, but in fact prices do not always win. For example, the price is too low will make the drug safety is not guaranteed, unlike the general consumer goods, the medicine in case of problem is vital. For example, now the pharmacy prescription drug prices may be 30% lower than the hospital, but many people do not go to the pharmacy to buy medicine, because at the pharmacy can not be reimbursed. In addition, many over-the-counter consumers rarely buy on the internet, because the disease may soon be taken, but it is the most convenient to buy from their nearest pharmacy. In foreign countries, chronic patients in the online pharmacies to buy more medicine, and this part of the population need long-term medication, drug prices are more sensitive, but at home, this part of the population of the Internet is not much.

"A lot of drug dealers are selling their money in order to do it, but once the scale of this method is enlarged, it will be very bad, so there is no profit model for the drug dealers," he said. "Let the light speak. Correspondingly, most of the pharmaceutical dealers are not profitable at present.

Ninguang will tell NetEase technology, the current market pattern of pharmaceutical dealers, about half of the sales are in the day Cat Medical Museum platform, the remaining half of the sales by the remaining 100 more than the other pharmaceutical dealers share. Now do most of the drug dealers are the original pharmacy, the country ranked the top 10 of the chain of pharmacies, currently only 3 in the pharmaceutical electrical business.

According to the foreign successful experience, Ninguang will think that the pharmaceutical electricity business in the existing policy environment is not no hope, the future should be in service, this is the current Chinese pharmaceutical manufacturers weaknesses.

For example, he said, for example, a diabetic, in fact, if you want to really take care of the body, in addition to medication, need to lose weight, do a lot of exercise, change lifestyle, this requires a lot of management and services. Foreign practice is to send blood glucose meter to patients, rely on the paper to make money, regularly remind patients to test, the frequency of patient testing determines the size of the business. Therefore, "without service there is no scale". Ninguang will be to NetEase technology points out: "Scale is not by price can be done, and now a lot of doing pharmaceutical electrical business from the past to turn over the electricity industry, do not understand the pharmaceutical industry, pharmaceutical and electrical companies have its professional." ”

Optimists: Markets always have a way

However, the previous difficulties in the Chinese Pharmaceutical Enterprise Management Association E-commerce expert Gu Jun seems to be insufficient fear. "Where the consumer is, the merchant has to go." He said, "There are two kinds of opinions about the medical and electronic business, and there are many reasons for it to be relatively conservative. ”

Gu Jun is an optimist, and he believes that the rapid development of pharmaceutical dealers should look at three aspects:

First look at the hospital, the key is the prescription can be socialized. In the existing system, the quality control prescribed by the doctor's prescription is the quality control of the hospital storehouse, the doctor has made the choice of the quality regulation when prescribing the prescription, so how to enter the hospital is very important. To cut off this connection, first of all to solve the socialization of doctors, doctors free practice, become a social person, their income will not rely on pharmacies, doctor's income and hospital decoupling, prescription natural socialization.

Second, look at Medicare. Now the sales of pharmaceutical dealers do not go, one reason is that online pharmacies can not be reimbursed to buy medicine. Medical insurance is an important purchase of drugs, if the online pharmacies to buy medicine can be reimbursed, the situation will be completely different. Medicare will be able to pay for the drug dealers on the premise that health care can be reasonable charge, the premise is to have a scientific way to determine what the disease is suitable for what medicine. This should be done by a professional service organization and a professional team. In this respect, Medicare and "insurance" are somewhat similar. At the specific operational level, prescriptions are also critical. If the prescriptions are in the health care center and can be shared at pharmacies, hospitals and health care centers, consumers who buy drugs online simply enter their own health-care information and the prescriptions will show up, so prescribing them is not a problem. At present, information about hospitals and health care centers is shared, and the problem is that information is not shared across the health care centers.

The third is to look at the drug itself, in fact, now is to see which product regulations can be taken the lead in online sales. Suitable for sale on the internet there are so many types of "long Tail medicine": one is the treatment of chronic diseases of drugs, this type of drug patients need to take long-term, price-sensitive; one is the high price, health insurance and can not be reimbursed medicine; one is the nearest pharmacy can not meet, can only be bought in the big hospital high-end drugs, such drugs patients always run to the hospital to buy Time-consuming and laborious, high procurement costs, which include not only urban patients, but also the vast number of rural patients. "Online prescription drugs are a concern because they contain a lot of long tail drugs," he said. Gu Jun told NetEase Technology.

For drug manufacturers to maintain the "market order" and the measures taken, Gu Jun that to maintain the exclusive and unique products, can, but in the long run. He told NetEase technology, most of the drugs produced by domestic drug manufacturers are generic (innovative drugs that can be copied during the patent protection period), which are difficult to maintain their uniqueness, generally have several similar functions of drugs, these drugs are competing fiercely, enterprises are difficult to maintain high prices. "For example, there are more than 10 kinds of aspirin. Gu Jun, for example, "wise companies should rush to grab the key words, so as to increase traffic and sales." ”

Even for the sharing of prescriptions, Gu Jun that there are a number of possibilities after the policy has been liberalized. "The domestic big hospital is conservative, unwilling to share, the private hospital may share." In fact, a lot of diseases, the first need to prescribe a doctor, and then as long as the continuation of the party can, the continuation of the party can go to private hospitals. "As long as the policy is loosened and the market is interesting, there are always ways to do it," he said. ”

His advice to the business is: "You can think sooner or later, but don't refuse." He told NetEase technology, in fact, he is now exposed to a lot of enterprises, are considering entering the pharmaceutical, consider what kind of business model, "are afraid to be left behind."

Has the traditional interest pattern been shaken?

The difference between the two attitudes of pharmaceutical and electronic business has caused a stir. According to the media reported this June, China Pharmaceutical Business Association, China Pharmaceutical Materials Association, China's Over-the-counter drug association, the state-wide pharmacy, Peace Pharmacy, mouthwash, such as the civilian large pharmacy, more than 10 trade associations and well-known drug retail chain-related people, moved to Hunan, Beijing, the State administration of drugs to release prescription drug internet sales.

The above trade associations and drug retail chain companies put forward three objections.

First, the Internet to sell drug access threshold and business scope simply let go, will seriously threaten the safety of people to use drugs, leading to counterfeit drug flooding. This year, "the ten typical cases of food and drugs" pointed out that the use of the Internet to carry out food and drug crime has increased momentum.

Second, the drug storage and transportation conditions are difficult to meet the requirements, endangering the internal quality of drugs. If we blindly reduce the entry threshold of online pharmacy, the transport conditions of drug delivery are worrying, which may endanger the intrinsic quality of drugs.

Third, online pharmacies are far more complex than physical stores, under the existing conditions, it is difficult to implement effective supervision of online pharmacies. At present, the medical institution information system is not fully connected with the outside world, and the prescription outflow of medical institutions has institutional obstacles. Online pharmacies can not directly get the prescription, only through video, fax and other means to pass paper prescriptions and audit, the authenticity and legality of the prescription is difficult to identify, even the prescription is not really have the right to the prescription is difficult to inquire.

At that time, the report of the economic Reference newspaper reporter noted that the majority of drug retail chain companies with the above objections have a large number of physical pharmacies, such as the national Pharmacy has more than 2000 direct stores, but its online pharmacy development is flat. and the online pharmacy development momentum More prominent China Resources Health Network, good pharmacist NET, pharmacy network and other enterprises did not attend, also did not raise objections.

In practice, the traditional interest pattern has actually been loosening.

Sea King star in 2011 began to enter the field of pharmaceutical and electrical business. Sea Wang star E-commerce general manager Zhong Zhihua told NetEase technology, online pharmacies cost less than the entity is mainly rent and labor costs, so the price is lower than the physical store is mainly this part. At the same time, many online pharmacies in order to attract traffic, the sales to do, but also in the short term to let the sale of the method, the price will be placed relatively low, may be flat into the flat out, or the price is lower than the purchase price.

Zhong Zhihua Frankly, the low prices of online pharmacies do often attract drug manufacturers to demand the price. "According to my understanding of the situation, very few pharmaceutical production enterprises can be successful in price, the success of a few to more than 10 or so." Many of the commonly used drug prices are difficult to maintain, a lot of basic drugs and ordinary drugs after the factory, turn to the online pharmacy, you do not know where to come out. "Zhong Zhihua said. He told NetEase technology, online pharmacies are willing to reduce the logic is this: Suppose that the online pharmacy to obtain a guest's cost is 50 yuan, and if the sale of this medicine loss of 40 yuan, it is equal to earn 10 yuan; The guest bought this medicine, may also buy other medicine, this time buys the next time may also come, such general pharmacy does not lose the good. As for the opposition of the drug producers, Zhong Zhihua admits: "This is a game process." ”

He told NetEase technology, the current Sea King stars online pharmacy turnover accounted for the total business of the king of the Stars in the proportion of about 5%-6%, at the same time, the online pharmacy turnover began in 2011, each year is 2-3 times the previous year, the growth rate is very fast.

At the same time, it is worth noting that the medical electric Shangjian a net. China Pharmacy and Pharmaceutical Research Center data show that 2013 Health Net sales scale of 380 million yuan. Jian Yi Network is the China Resources Group Pharmaceutical E-commerce Pilot Enterprise, China Resources Group under the China Resources Medicine is a large pharmaceutical manufacturing and distribution enterprises.

China Resources Jian A network CEO Tao told NetEase Technology, health nets online sales of drug prices lower than 15% below the line. For the price difference problem, Tao to NetEase technology, "the electricity quotient can enhance the goods turnover rate from the efficiency, actually can improve the efficiency than the traditional mechanism." "Therefore, Tao that this is a drug production enterprise sales model of an innovation," it is in addition to selling goods, but also the functions of media and customer relationship management functions. From the business model, we can not only look at the status quo, but also to see trends, the drug of electronic commerce is an inevitable trend. Like Kodak did not pay enough attention to digital cameras, fear of affecting the sale of film, so now the sharp decline. We must conform to the trend. ”

Pharmaceutical dealers currently account for less than 1% of drug sales, but according to the Chinese online Pharmacy Council's statistics, its sales are soaring, 2011 this number is 400 million yuan, 2012 to 1.7 billion, 2013 is 4.2 billion, is expected to reach 6.8 billion 2014.

NetEase technology at the same time interviewed the day Cat Medicine Museum, good pharmacists and shop No. 1th, now these pharmaceutical electric business platform for the sale of prescription drugs to open up a positive preparation, including strict access standards, licensed pharmacists team formation, logistics and distribution.

"In fact, there is nothing missing, there is no policy." "Gu Jun said.

(Responsible editor: Mengyishan)