- Categories:Media reports
- Origin:China Medical News
- Time of issue:2021-08-18
In May of this year, the National Medical Insurance Administration and the National Health Commission issued the "Guiding Opinions on Establishing and Improving the "Dual Channel" Management Mechanism for Drugs in National Medical Insurance Negotiations". Uniform payment policy for medical institutions. The promulgation of this policy will greatly promote the development of professional pharmacies in China.
Professional pharmacy, namely DTP (Direct to Patient) pharmacy. Professional pharmacies in the United States originated in the 1980s and developed relatively early. With the continuous changes of patient needs and policy environment, a relatively mature system has been formed and the market scale has grown steadily. The construction of professional pharmacies in China started at the beginning of the 21st century and is still in the early stages of development. Due to differences in the pharmaceutical market environment and policies between China and the United States, the development characteristics of professional pharmacies in the two countries are different.
Professional pharmacy is the advanced version of general retail pharmacies
The so-called professional pharmacy model refers to the model in which the pharmacy obtains the distribution rights of the pharmaceutical company's products, and the patient obtains the prescription in the hospital, directly purchases the medicine from the pharmacy and obtains professional guidance and services.
Different from the traditional general retail pharmacies that mainly sell OTC drugs, professional pharmacies mainly sell professional drugs, new special drugs, self-paid drugs, etc., and are equipped with licensed pharmacists to provide professional guidance and services. It is an advanced mode of retail pharmacies. Professional pharmacies completely connect the drug supply end (pharmaceutical companies), prescription end (hospitals) and demand end (patients), combined with the drug distribution logistics end (circulation enterprises), and become the core role in the drug circulation process.
The comprehensive pharmaceutical service system of American professional pharmacies
In the United States, professional pharmacies provide patients with a full range of pharmaceutical services such as drug sales services and pharmaceutical consulting services, including prescription drug distribution, clinical medical services, and management and coordination of insurance companies’ reimbursement of drugs for patients. Among them, the clinical pharmacy services provided to patients include rational drug use guidance, the establishment of patient files, chronic disease management, etc. These measures not only improve the accessibility of medical services, but also increase the loyalty of customers to medical insurance. To this end, insurance institutions need to pay "pharmaceutical service fees" to the pharmacy.
From the perspective of the market structure, high industry concentration is the main feature of American specialty pharmacies. The main payers for medicines in the United States are commercial insurance institutions and PBM (Pharmaceutical Benefit Management) institutions, which has led to a much higher concentration of the pharmaceutical distribution and pharmaceutical retail industries in the United States than in other countries and regions.
As far as the operating model is concerned, American specialty pharmacies can help pharmaceutical companies, commercial insurance institutions, patients, and medical institutions improve efficiency.
On the one hand, professional pharmacies help pharmaceutical companies with inventory management by closely monitoring the amount of drugs used by patients; by providing consistent and accurate data, they can help pharmaceutical companies complete REMS (Risk Assessment and Mitigation Strategies); and by providing full pharmaceutical services to ensure the Patented drugs are successful; by providing reimbursement management services, it helps pharmaceutical companies and insurance companies to formulate appropriate reimbursement paths.
On the other hand, professional pharmacies improve patient compliance and brand recognition by providing patients with full-course pharmacy services; by closely monitoring patient dosages, formulating treatment plans, and reducing personal expenses; providing reimbursement management services to help patients make the best Reimbursement strategy.
Professional pharmacies are also good for commercial insurance institutions. Professional pharmacies help commercial insurance institutions control expenditures by closely monitoring the amount of medications used by patients; by coordinating and managing drug reimbursements, they can help commercial insurance institutions formulate a reasonable reimbursement mechanism; it can also reduce hospitals’ price increases under the direct procurement model.
In addition, professional pharmacies closely monitor the amount of medications used by patients, assist doctors in treatment, and improve patient satisfaction; by formulating patient treatment plans, reduce the number of patient visits and save doctors time; reduce the risk of storage and reimbursement delays caused by medical institutions purchasing drugs on their own.
The three major construction models of China's professional pharmacies
In recent years, China has promoted the prosperity and development of professional pharmacies through a series of policies to divert traffic, build foundations, and access points. There are three main models for the construction of professional pharmacies in China.
One type is the layout of professional pharmacies in traditional medicine commercial enterprises and chain pharmacies. Traditional pharmaceutical commercial enterprises and chain pharmacies have obvious advantages in terms of channels and prices by virtue of their own development and product resource base. The second type is that some companies that have a good foundation for cooperation with hospitals develop professional pharmacies by opening hospitals. Such pharmacies often increase the stickiness of patients by improving their service levels and become the main force of professional pharmacies in China. The third type is a professional pharmacy built by Internet companies. This type of pharmacy relies on Internet tools and emphasizes specialization and synergy, and its market share continues to expand.
According to statistics, as of the end of July, the number of professional pharmacies in the country has reached more than 1,400, and the sales scale has increased from 8 billion yuan in 2015 to 15 billion yuan in 2019, with a compound annual growth rate of 15%, which is much higher than the overall pharmacies in the same period. % Growth rate. There are a large number of specialty pharmacies in chain pharmacies such as National University Pharmacy, Miaoshou Doctor, Jiubu Pharmacy, and DXN Medical Insurance's new pharmacy. On the whole, no matter which model of professional pharmacy, while effectively using upstream channel resources, it constantly improves its professional service capabilities.
Different paying parties bring differences
The difference between Chinese and American specialty pharmacies is largely determined by the difference of the payers.
In the United States, commercial insurance institutions and the PBMs they control and influence are the main payers. At present, large-scale commercial insurance companies in the United States control more than 70% of the payment market, and prescriptions are concentrated in the PBM that they cooperate with before entering retail pharmacies; at the same time, PBM is also involved in the retail of prescription drugs, becoming one of the most important prescription drug retail channels outside of pharmacies. It is the main reason for the high concentration of the professional pharmacy industry in the United States.
China’s medical insurance policy has the greatest impact on drug sales channels. The prescription rights for drugs are mainly in the hands of doctors, and prescriptions outside of medical insurance have limited influence. Therefore, hospital-side stores that are easy to establish contact with medical institutions and doctors have become the mainstream of the development of professional pharmacies, and relevant companies will focus on the layout of hospital-side stores when entering the professional pharmacy business. Therefore, China's professional pharmacies will still go through a period of free competition for a long time, and it is difficult for the industry concentration to increase rapidly in a short period of time. Professional pharmacies must not only improve their supply chain capabilities, but also continue to focus on patient stickiness and doctor services in order to seek a stronger competitive advantage. (Author's unit: Firestone Creation)
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