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The two-vote national program was announced today! Full interpretation of the seven core issues!

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The two-vote national program was announced today! Full interpretation of the seven core issues!

[Abstract]:
MedicalNetworkJanuary9th Thetwo-votenationalversionwasofficiallyannouncedtoday! AccordingtotheinformationreleasedbytheNationalHealthandSafetyCommissionofficialwebsiteontheeveningofJanuary6,today,theim
Medical Network January 9th
 
The two-vote national version was officially announced today!
 
According to the information released by the National Health and Safety Commission official website on the evening of January 6, today, the implementation of the "two-vote system" in the procurement of pharmaceuticals in public medical institutions (trial)" (hereinafter referred to as "two-vote system" ") will be officially announced.



 ▍ Core question one: What is the “two-vote system”?

 
According to the information transmitted by the network, in the final official version, the two votes will be set up in “regulating the order of drug circulation, compressing the circulation, reducing the high and high drug prices”, and “purifying the circulation environment, combating the “ticket laundering” and strengthening the supervision of the pharmaceutical market”.
 
In recent years, the voice of the whole society has become more and more high. The final problem has become the most familiar six words of the public: “difficult to see a doctor” and “expensive medical treatment”.
 
On the other hand, over the years, the situation of “small and scattered” in the field of drug circulation in China has not been fundamentally changed. The long chain of drugs, the disorder of circulation, the management of money, the laundering of money, the sale of short selling, and the sale of gold have pushed up the drug. price.
 
In this context, through the "two-vote" financial means to manage the ills of the pharmaceutical circulation industry, it has become a common entrance and choice for the private and regulatory levels.
 
▍ Core question 2: How is the "two votes" fixed?
 
Saibailan was informed that the final version of the “ticket” was determined by the national version. “The pharmaceutical manufacturer will open an invoice to the circulation enterprise, and the circulation enterprise will open an invoice to the medical institution.”
 
Among them, the wholly-owned or holding commercial companies and the domestic distributors of overseas pharmaceuticals established by pharmaceutical production enterprises or group-type enterprises integrated with science, industry and trade can be regarded as the same as the production enterprises, but only one in the country. A commercial company, a domestic general agent, and the fare increase must be controlled within a certain range.
 
It is particularly worthy of the company’s attention that the transfer of drugs between wholly-owned (controlled) subsidiaries or wholly-owned (holding) subsidiaries within a pharmaceutical distribution group-type enterprise may not be considered as one vote, but at most one invoice may be allowed, and the fare increase shall be controlled. Within a certain range, the specific markup rate is stipulated by each province (autonomous region, municipality). Encourage public medical institutions and pharmaceutical manufacturers to directly settle drug payment, pharmaceutical production enterprises and circulation enterprises to settle distribution costs.
 
▍ Core question three: In what scope is the “two-vote system” implemented?
 
According to the previous state's multiple statements on the two-vote system, the two-vote system will be first opened in public hospitals and medical reform pilot provinces, (districts, cities), and time should be fully pushed across the country by 2018.
 
It is particularly noteworthy that from the date of issuance of the document (January 9), the new drug procurement activities of public medical institutions should be implemented in accordance with the two-vote system.

 

 ▍ Core Question 4: How should production, distribution companies and medical institutions implement the “two-vote system”?

A: It is reported that pharmaceutical production and distribution enterprises selling drugs should issue special VAT invoices or VAT ordinary invoices (hereinafter collectively referred to as “invoices”) in accordance with the relevant provisions on invoice management. The project should be completed. The drugs sold shall also be accompanied by the accompanying counterparts in accordance with the requirements of the GSP, and the names of the purchasers and sellers of the invoices shall be consistent with the accompanying goods, the flow of payment, and the amount.

When a drug circulation enterprise purchases a drug, it shall take the initiative to request an invoice from the drug manufacturer, and the invoice must be issued by the drug manufacturer. When the goods arrive at the inspection, the invoice, the supplier's accompanying goods list and the actual purchased medicines, specifications, quantity, etc. shall be checked, and the inspection and acceptance records of the purchased drugs shall be established, so that the votes, goods and accounts are consistent. If the invoice and the accompanying counterparts do not meet the relevant requirements of the State, or if the contents of the ticket or the goods do not match, the income bank shall not be examined.

Invoices and related bills incurred in the purchase and sale of pharmaceuticals shall be kept in accordance with relevant regulations.

When a public medical institution checks the income of a drug, it must verify that the ticket, the goods, and the account are consistent in order to be put into storage and use. It is necessary not only to request and verify the invoice from the circulation enterprise that distributes the drug, but also to require the circulation enterprise to issue a stamp. The original seal is a copy of the purchase invoice provided by the manufacturer, and the relevant contents of the drug circulation enterprise name and drug batch number of the two invoices are mutually verified, and the public medical institution pays the drug payment certificate and is included in the financial file management. A copy of the purchase invoice for each drug product is provided at least once. Encourage qualified areas to use electronic invoices and verify the “two-vote system” through informational means.

▍ Core question 5: What impact will the two-vote system have on pharmaceutical circulation?

The impact of small and medium-sized businesses is good for big business. The two-vote system is inevitably staged in the circulation field.

According to public data, there are currently more than 13,000 circulation enterprises for wholesale licenses of medicines in China, and less than 5% of enterprises with annual sales exceeding 50 million yuan. The degree of concentration is far different from that of developed countries.

According to the policy design, after the implementation of the “two-vote system”, some enterprises have basically broken the cycle of capital expenditure through the passing of commercial companies, so that the space for the long-term surviving companies to survive is compressed and the function of the ticket is disintegrated. In May this year, the “VAT reform” tax reform policy was implemented nationwide. A large number of commercial companies that survived by scalping lost their original value under these combined policies and faced elimination. The number of circulation enterprises will be greatly reduced.

The drug distribution group-type enterprises specified in the "two-vote" national documents and the wholly-owned (holding) subsidiaries or wholly-owned (holding) subsidiaries may not be regarded as one vote, and will clearly identify the group-type drug circulation enterprises. At the same time, with the implementation of the policy, a large number of agent-type pharmaceutical commercial companies, small and medium-sized pharmaceutical commercial companies are bound to need to transform or seek to be merged, and will further accelerate the merger and reorganization opportunities for large pharmaceutical circulation enterprise groups, and further improve the concentration of drug distribution.

A circulation expert further stated that a series of domino-like effects will be generated quickly - the "two-vote system" will break the circulation law of the pharmaceutical market, and the industry cost will increase to some extent; a large number of agency-type businesses will be eliminated; Distribution-oriented commercial companies are welcoming development opportunities and can be directly supplied to terminals; while large-scale pharmaceutical businesses will quickly locate market-level outlets to seize the market, and the price-adjusting industrial enterprises will face challenges. Enterprises with high-return or self-operated networks will face opportunities. Commercial companies that survive by scalping will be eliminated because they lose their original value.

▍ Core Question 6: How will the two-vote system change the pharmaceutical industry?

With the "two-vote system" operation, different types of pharmaceutical industry will face different changes in the living environment, and it is just a few happy families.

Among the enterprises with public hospitals as the main target market, the bottom-price agent investment marketing model will be the biggest impact, while the high-opening and self-supporting teams will usher in more opportunities.

This policy will have less impact on the out-of-hospital prescription market and the third terminal, and the OTC retail market and private medical care will also have a good market adjustment opportunity.

However, the industry will also face some problems together, such as increased difficulty in fiscal and tax treatment, at the same time, increased sales costs, lower profit margins; more difficult marketing management, such as a large increase in the number of first-tier distribution businesses, difficulty in channel management; mixed mode Coexistence, financial processing is more difficult; third terminal distribution business choice problems are prominent; business repayment cycle changes: short-term possible shortening, long-term will become an extension trend, etc., all need to adjust and adapt according to their own circumstances.

▍ Core question seven: two-vote system + battalion change + circulation rectification, where is the agent's way out?

Under the combination of a two-vote system, a reform of the camp, and a rectification of circulation, the national general agents may gradually disappear.

As operating costs increase and profit margins decrease, professional academic promotion agents will become more and more popular, hospital-level commission agents will thrive, and channel control will weaken (GSP institutions that do not have self-operated markets and do not have distribution capabilities) The advantage of the agent is gone, and the national general agent (except the import agent) will gradually disappear.

On this topic, senior experts in the industry told Saibailan that many people in the industry have misunderstood the policies of relevant state departments, or they have some one-sided understanding. Once they think about it, they should look at the industry from the perspective of relevant government departments. The ideas will be very different.

He believes that in fact, the regulatory authorities cannot hope to deliberately suppress which industry. They hope that the industry will develop healthily and bring benefits to the people. Therefore, when these policies are introduced, it is sure to purify the industry environment and promote the healthy development of the industry. Of course, it does not rule out that because the competent authorities are too much expectation, too urgent, or other factors may have some extremes, it may cause "accidental injury" to the enterprise.

"The government's considerations are often incomprehensible to the industry. Moreover, the government has many times to openly communicate with the industry because of many considerations, so there is a misunderstanding," he said.