With the landing of the "dual channel" management, the management of medical insurance pharmacies has been completely rolled out, and the transformation of medical insurance pharmacies is imminent.
By the end of next month, there must be "dual-channel" pharmacies everywhere
According to the requirements of the National Medical Insurance Bureau, in principle, before the end of October 2021, each province should determine the list of drugs included in the "dual channel" management in its province and announce it to the public. By the end of November 2021, each province should realize that each prefecture-level city (prefecture, league) has at least one eligible "dual-channel" retail pharmacy.
In this context, various provinces and cities have recently published relevant documents to carry out the selection and landing of "dual-channel" pharmacies.
According to the documents of the National Medical Insurance Bureau, as long as the medical insurance pharmacies that meet the conditions can apply to become "dual-channel" medical insurance pharmacies. However, what is different from ordinary medical insurance pharmacies is that it is more demanding to become a "dual channel" management medical insurance pharmacy. As shown in the figure:
(Note: This information is a policy interpretation of the National Medical Insurance Bureau)
It is worth mentioning that just recently, Hebei Province took the lead and introduced the "dual channel" medical insurance pharmacy selection procedures, with the principle of "openness, fairness and justice", as long as the medical insurance pharmacy meets 11 basic conditions, it can apply to become a "dual channel" designated pharmacy.
Judging from the 11 basic conditions, it involves application conditions such as operating hours, business area, and licensed pharmacists. For example, to apply for a "dual-channel" designated pharmacy, the designated pharmacy must have an independent area, an actual operating area of more than 100 square meters and a full-time practicing pharmacist with 2 or more.
Medicare pharmacies, began to classify management
However, with the development of the "dual channel" selection work in various places, the medical insurance designated pharmacies have been completely divided into two forms, one is a professional pharmacy based on "dual channel" management (mainly selling chronic diseases and special disease drugs), and a designated pharmacy that meets the sales of ordinary medical insurance categories.
Li Zhen, a well-known professional manager (pharmacy circle), told the author that the state treats existing pharmacies hierarchically in different ways, continues to live if they can live, eliminate those who cannot seize the opportunity, and divide the original entire pharmacy into N series, gradually forming a way to meet the standards.
As for the impact of the "dual channel" policy, he said that it will lead to the classification and grading of designated pharmacies, and medical insurance will also be split (for example, chronic disease reimbursement is only limited to chronic disease pharmacies, etc.), and those who have not become "dual-channel" medical insurance pharmacies can only sell some ordinary medical insurance drugs.
In fact, as early as 2019, the medical insurance department has corresponding actions. At that time, on the basis of the designated pharmacies of ordinary medical insurance, for the use of drugs for patients with chronic diseases, various localities have successively added designated retail pharmacies for medical insurance chronic diseases.
In this regard, the manager of Cyberblue - pharmacy once posted that in the future, medical insurance pharmacies will be divided into two categories: one is a designated pharmacy for chronic disease medical insurance, which prohibits the sale of non-drugs and can enjoy the outflow of chronic disease prescriptions; the other is a general medical insurance designated pharmacy, which can be placed and sold non-drugs, but it is forbidden to swipe medical insurance cards for sale.
Compared with today's "dual channel" policy, this policy has become a key point of change, and has completely opened up the situation of medical insurance pharmacies. Looking at it another way, the original chronic disease medical insurance designated pharmacy has become today's "dual-channel" management designated pharmacy.
The performance of Medicare pharmacies has declined and competition has intensified
According to the latest data from Zhongkang CMH, compared with the previous month, the average sales of retail pharmacies in September fell slightly; compared with the average in 2019, the traffic is still relatively sluggish.
On whether the passenger flow of medical insurance designated pharmacies has declined, Li Zuobiao, a practicing pharmacist in Fuzhou, Fujian Province, told the author that the flow of customers in his medical insurance store has declined this year, and the online passenger flow has increased, and in general, there is still a decline.
"Affected by the epidemic, sales of cold medicines, cough medicines and other sales declined, in late autumn and early winter, cold medicines were originally common medicines for families, but during the epidemic period, they needed to register information such as ID cards, and some customers did not buy them." He also said that in addition to the decline in sales of such drugs, the overall performance is declining.
Li Sibo, a special contributor to the account, also said that the overall benefits of the medical insurance designated pharmacies where he is located are not ideal. Due to the control of the epidemic, the relevant drugs must be purchased with a negative nucleic acid test report within 7 days.
On the one hand, the pharmaceutical retail industry as a whole is sluggish, on the other hand, competition is becoming more and more fierce, and many newly established companies have long targeted the out-of-hospital pharmacy market. It is understood that two professional pharmacies in China have successively submitted prospectuses to the Hong Kong Stock Exchange, and there is no doubt that these companies will increase their layout with the help of the power of capital in the future.
Among them, The Center Of Technology was established in 2015, the current revenue has exceeded 3.6 billion, its Circle Center Pharmacy is one of the earliest enterprises in China to seize the out-of-hospital prescription drug market, with 251 stores, 217 located within 1 km of the hospital, 170 pharmacies for the national medical insurance designated pharmacy, 37 pharmacies are designated as dual-channel pharmacies for major illness medical insurance.
The other is Sipai Health, which was established in 2014 with a total revenue of 2.7 billion yuan, 81 offline stores, and 30 of which have been awarded the "Medical Insurance Dual Channel Qualification" by the local medical insurance management department.
At the 2021 Star Conference, Zhao Xiaochuan, chairman of NUS Pharmacy, said that the "dual channel" document issued by the National Medical Insurance Bureau is a breakthrough in the future prescription outflow, first test the water, see the service capabilities of pharmacies, and the next step may be a complete prescription outflow. He said that once the prescription is outflowed, the first bucket of gold must be the courtyard side store.
Of course, this transformation will also trigger changes in the industry, bringing new challenges to existing medical insurance pharmacies, and whether they can be transformed into professional pharmacies will determine their ability to undertake prescription dividends and affect future development.
40% of Medicare pharmacies are facing transformation
A long time ago, some well-known marketing experts said that China actually only needs 200,000 pharmacies, and the current state is excessive competition. The general international practice is one pharmacy for every 6,000 people, while China is now one for every 3,000 people, and in fact they are all surplus.
On May 11, 2021, the results of the seventh national census were announced, and the mainland population totaled 1.411 billion people. If there is a pharmacy for 6,000 people according to international practice, China currently needs nearly 235,000 pharmacies.
According to the latest news from the State Food and Drug Administration, as of the end of June 2021, the number of retail pharmacies nationwide is nearly 580,000. By the end of 2020, the number of designated pharmacies in the national medical insurance has reached 390,000.
If only 235,000 pharmacies are planned according to the 1:6,000 plan, 345,000 pharmacies (nearly 60%) face obsolescence. At the same time, even if these 235,000 pharmacies are all Medicare pharmacies, 155,000 Medicare pharmacies (nearly 40%) will face obsolescence.
At the "Third DTP Conference" hosted by Cyberlan, Ni Huping, a doctor of economics, once pointed out that "China's medical reform is a gradual reform, which must not only grasp the main contradictions, but also ensure smooth progress." Considering that the current pharmacy market has formed a deep-rooted, sales model, in the short term, shock therapy reform will inevitably lead to a big turn, a large number of pharmacies closed, and a large number of employees are unemployed, which is not what the reform is willing to see. ”
In summary, the government will not take a one-size-fits-all approach to reform, so many 345,000 pharmacies (including 155,000 medical insurance pharmacies) if they do not want to be eliminated, can only choose to transform, or make professionalism irreplaceable, become one of the 235,000 pharmacies, or expand new business formats and models...