Medical network on April 21 - drug purchase around "two votes" is to speed up the ground. In addition to the already implemented reform provinces such as fujian, anhui and other places, sichuan and hunan province recently also has launched the "two votes" scheme. The economic information daily, reporters learned that in many interview "two votes" that can reduce the drug circulation of the intermediate links, improve drug firms concentration, lower drug prices, and is beneficial to strengthen the supervision of drugs. However, cracking drug sales chaos, drug prices artificially high moisture extrusion is still a long way, needs supervision to ensure that the policy effectiveness, and combined with the combination of medicine and health care system reform is implemented. 

 

Pharmaceutical producing enterprises face transition opportunity 

 

"Two votes" is refers to the drug from the production enterprise to open an invoice of enterprises and circulation enterprises to open an invoice of medical institutions. Released earlier this year on drug procurement in the public medical institutions in the implementation of the implementation of the "two votes" opinion notice (trial) (hereinafter referred to as the "notice"), clearly in the public medical institutions and drug procurement to gradually implement the "two votes", encourage other medical institutions to implement the "two votes", comprehensive reform pilot provinces and public hospital reform pilot city public medical institutions should take the lead in implementation of "two votes", encouraging other area to implement the "two votes", in the national push for 2018. 

 

Drug prices artificially high has long been a problem, is the current reform must solve a problem, is also a strong calls for the people. And "two votes" is an important reform measures medicine field, its purpose is to reduce the drug circulation, make the middle price transparency, further reducing drug prices artificially high, ease the burden. 

 

After Shanghai, liaoning, ningxia and other provinces and cities "two votes" after landing, sichuan and hunan province has also recently introduced a "two votes" implementation plan. According to reporter understanding, at present throughout the country, health reform pilot provinces such as fujian, chongqing, anhui, shaanxi, qinghai and other already formally launched the "two votes" of specific measures, and gradually began to implement, and other provinces and cities are still in the process of the rules. From the various provinces and cities have already released the "two votes" official documents or draft, due to the national policy of "two votes" direction is relatively clear, various provinces and cities policy scale is not large, is almost consistent with the provisions of the state, the individual provinces and cities such as chongqing relax appropriately on the definition of inspect production enterprise. 

 

Public medical institutions to implement the "two votes" drug purchase is deepening the reform of medical health system, a major measure to promote healthy development of the pharmaceutical industry and the reform of the enterprises is a polity policy. Anhui is among the first province to implement the "two votes", according to the policy, the anhui province association of the pharmaceutical industry, pharmaceutical production and operation enterprises and medical institutions held a seminar for many times, drug firms is generally believed that the "two votes" is the key to "seize the drug prices artificially high"; Bring some past the affiliated, ticket business to fall, "to let the market really clean"; Let the drug circulation process specification, link compression, cost is reduced, "to make people really benefit". 

 

Hunan health to do full-time commissioner of health and family planning commission, deputy director of economic restructuring Wang Xiangsheng also said in an interview with reporters, "two votes" is helpful to standardize the distribution order, improve the efficiency of circulation, reduce drug artificially high prices. To purify circulation and governance in the field of drug circulation, in accordance with the law to crack down on illegal callings, commercial bribery, tax evasion and other illegal activities. 

 

The implementation of the "two votes" brings pharmaceutical production and management enterprise bigger challenge, is also the transformation of business opportunity. The personage inside course of study thinks, "two votes" guide the enterprise merger and reorganization, the policy of keen enterprise to do bigger and stronger; In terms of concentration of ascension, for production enterprises may not be too obvious, but is bound to greatly improve the concentration degree of logistics enterprises. The reporter understands in the interview, "two votes" landing gear upgrades will promote the health care industry, forward-looking manufacturers have to deal with in advance. Kyushu, such as communication, people f medicine, sinopharm large medical companies such as depending on "two votes" for the development opportunity, even in rural and remote areas, have advanced layout, the market share. 

 

"With the expansion of the" two votes "pilot, deepening reform, drug companies must actively, can no longer rely on traditional medicine trade pattern." A drug companies in sichuan, head of the sales department, told reporters that "two votes" caused by the volatility of medicine circulation enterprises. Many pharmaceutical companies began to merger and reorganization, and some have even transition find another way out. Guo-liang Yang, vice President of the center in wuhan city hospital, told reporters that "two votes" is expected to introduce, the hospital more than 50 drug distributors will usher in "shuffle". A small company in the future will be difficult to survive, big companies will become more and more strong. 

 

In addition, the "two votes" improve the concentration degree of the drug companies, will be more conducive to drug regulation. "On a few big drug firms, grabbed regulatory gap, don't like the pattern of small scattered, before more conducive to the regulation." Health and family planning commission of sichuan province commissioner of drug policy and system for basic drugs Zou Bo said, two votes will be in the field of current drugs to blow a fresh wind, the previous layers of premium, doctor rebate rules will be broken, benefit the masses, doctor innocence, supervision more effective, form a win-win pattern. 

 

For the hospital, "two votes" makes the hospital drug procurement will directly face the few, the powerful drug distribution ability of large pharmaceutical circulation enterprises, which will lower the hospital medicine management difficulty, save drug procurement and management costs, improve the efficiency of the pharmaceutical logistics extending operation management, to develop comprehensive hospital management level. 

 

Extrusion prices water is still a long way 

 

However, if just rely on the "two votes" to reach the crack sales chaos, governance, drug prices artificially high, squeeze out water price target is still a long way to go. Guangdong health development planning commission, said an official with the one with the implementation of the "two votes", corporate marketing strategy will be changed accordingly, decreases the intermediate links, part of the production enterprises will choose leave or commission merchants mode, high floor price premium link up were used, so as to set aside the medicine for the medical expenses, need more supervision to ensure the effectiveness of "two votes". 

 

A big head, told reporters he started into the drug business industry since the 1980 s, 1996 years or so, a doctor's prescription fee is probably drug prices 5% to 10%, now is about 20% to 30%. The reason for a lot of votes, bribery is to cover up the doctor. Big drug firms listed financial audited by an accounting firm, but the doctor did not give any company financial credentials when receiving kickbacks, so much by pharmaceutical agents, circulation enterprise make out an invoice, so you can put the money into the enterprise's legal costs. The chief says, after the reform of public hospital compensation didn't keep up with, the doctor's treatment is very low, have drug kickbacks as one of the necessary income rebate is becoming more and more high. "Two votes" later, the doctor's prescription for demand is not so disappear, so companies are in choosing a work-around. As part of pharmaceutical production enterprise incorporated medicine generation of staff, in the form of personnel salary to clinical kickbacks to open out, or some meeting, open the money kickbacks in the consultancy fees. 

 

The personage inside course of study tells a reporter, some drug companies in the "two votes" after landing, relief formed a dozen companies such as culture, advertising, intermediary agent, for "money laundering". They are concerned about the "two votes" three consequences: one is high margin rules can occupy the market, continue to produce; The second is a part of the margin is very thin gauge to disappear from the market; 3 it is to dare to tax evasion of pharmaceutical enterprises can survive. 

 

It is worth noting that in fujian province "two votes" after landing, multiple drugs, the phenomenon of the raised ex-factory price and sold in fujian province and "two votes" ex-factory price nearly six times the highest. The personage inside course of study says, this is because the doctor ChuFangQuan decides the drug sales, production enterprises in order to obtain competitive advantage, must through high pricing reserved for doctors in bidding and rebates. To provide doctors with rebates, must wash out cash for drug kickbacks, and wash out cash in one of two ways: one is "high driving mode", the drug from the factory to go to the hospital just two votes, one vote, even wash out for cash rebate by production enterprises, the current 65% of varieties have been adopted by this way; 2 it is "low driving mode", drug from the factory to go to the hospital need three votes, four, wash out for cash rebate by circulation enterprises, 35% of the varieties in this way. 

 

A small to medium sized medical equipment production company in wuhan zhongnan district sales manager even suggested that the "two votes" is to tax burden by dealers on to manufacturers, however, makes the producers costs rise, and cannot solve the disordered competition market, price is not transparent. The fourth hospital pharmacy in wuhan city, deputy director of the liu said, four quantities with a hospital on March 1, procurement, implementation of the "two votes". "Two votes" reduces the circulation between price and cost reimbursement, but also cause drug supply coverage is not complete, producers are not a positive response or a shortage of some medicines. 

 

More measures to crack sales chaos "go hand in hand" 

 

Under the "strong medicine" to see curative effect. The personage inside course of study is generally believed that "two votes" is still in the provinces need to continue to be born in the process of gradually improve, gradually thinning, and combined with the combination of medicine and health care system reform is implemented. 

 

Guangdong province who the relevant person in charge of development planning commission told reporters that the effective implementation of the "two votes" to achieve optimal procurement order, and through the consolidation procurement order to reduce the distribution costs, to a certain extent governance commercial bribery. However, the cost is determined by many factors, only hope that the implementation of the "two votes" to significantly reduce its not reality, and the part of the drug kickbacks space is large, the health care industry still save corruption has many causes, in addition to actively promote the "two votes", the new reform of other effective measures to also want to go hand in hand, multi-pronged, actual effect can be achieved. 

 

"Enterprise not afraid, afraid of unfair, more honest more law-abiding more bad luck." Several drug companies, said an official with the fair market rules, open and transparent competition is should fulfill the responsibility of the government. There are also people who believe that you can follow the pattern of developed countries to the doctor's rebate into transparent mode, such as America's medical practitioners of generic medicine is a clinical prescription fee, but the rebate points all drug firms must be the same, once has the enterprise more than rules, is the commercial bribery, must be punished by law. At the same time, drug firms think that the doctor's ChuFangQuan can no longer is "land" outside the law, have to in order to get high kickbacks for clinical rational drug use, disorderly to prescription of the doctor. 

 

In addition, the drug companies should be resolved as soon as possible in public hospitals, debt collection, and hysteresis old problems. Such as reference of zhejiang province in the implementation of the "two votes" experience, cleverly turn "two votes" into a "votes", namely the pharmaceutical production enterprise respectively two tickets, ticket to go to the hospital, a delivery ticket to circulation enterprises. And the local government has set up a similar "alipay" among the bank accounts, mat endowment to drug firms collection by the bank, hospital, returned the money to the bank again if delay interest occurs, drug firms lead rapidly. 

 

Some experts believe that the "two votes" should be combined with the combination of medicine and health care system reform is implemented, such as drugs, drug payment standard, drug centralized purchasing price information to trace and public hospital reform, etc., finally purifying the circulation environment, further guide the formation of modern Chinese medicine circulation system. 

 

Guo-liang Yang, vice President of the center in wuhan city hospital, told reporters that "two votes" landing process, in order to sustainable development of the policy, still need to intensify efforts to "3 d linkage", still need to speed up the reform of medical insurance in particular. Currently limited to payback periods, total amount control factors, surely with closing hospitals face considerable pressure. At the top of the relevant national health insurance payment system design has been quite perfect, looking forward to place can speed up the pace. Zou Bo thought, also need to strengthen "two votes" be born of multi-sectoral cooperation, establish department linkage mechanism, refine the relevant industry standards at the same time, especially according to the provincial situation, formulate detailed measures, on the premise of guaranteeing timely supply medicines, detailed implementation, orderly progress.