"The future of China's pharmaceutical market is outside the hospital." Wang Kang, chairman of Akang Health, has repeatedly said. In 2005, Wang Lizhen founded Zhenkang Medicine, based on special medicines such as tumors and liver diseases. Three years later, Wang Lizhen’s practice of selling prescription drug DTP was earlier than the “new medical reformâ€.
In March 2009, the Central Committee of the Communist Party of China and the State Council issued opinions on deepening the reform of the medical and health system to the public, focusing on the direction of “separation of medicines†and conducting various explorations on the gradual reform of the mechanism of “medicating medicineâ€. China's "medical treatment with medicine" began in the 1950s. In order to maintain the survival and development of public hospitals, the state has clarified that public hospitals can provide drugs to patients after 15% of the price increase. However, with the development of the medical system, this measure has alienated the public nature of the hospital.
For “medical separationâ€, “new medical reform†is undoubtedly a crucial step. However, the development of technologies such as the Internet has also brought new variables to the medical field. At the 80th National Drug Fair, Wang Lizhen accepted an exclusive interview with the health of the billion euros, and exchanged views on how the policy and technology reconstruct the current medical supply chain.
How to establish a new pattern of “prescription outflow�
Akon Health was reorganized in 2016. After experiencing the exploration of early specialist drug supply, medical e-commerce and other modes, Wang Lijun has defined Akang Health's service scope as “chronic, severe, and rare diseasesâ€, promoting the out-of-hospital sales of chronic disease prescriptions and CDC (chronic health care). ) The establishment and replication of patterns.
Citing the white paper “China's Health Care†released in December 2012, China has 260 million people diagnosed with chronic diseases. The deaths caused by chronic diseases account for 85% of the total deaths in China, resulting in a disease burden accounting for 70% of the total disease burden. %. With the acceleration of domestic industrialization, urbanization, and aging, the prevalence of chronic diseases and deaths has become increasingly prominent. If the "China Chronic Disease Prevention and Control Work Plan (2012-2015)" is more focused on the prevention of chronic diseases, will there be a more direct policy orientation for patients who are already chronically ill?
"From this perspective, 'prescription outflow' is a trend that will come naturally." Wang Lizhen said. In September 2017, all kinds of public hospitals at all levels in China cancelled drug additions. In the view of Wang Lizhen, this action pushed the steps of “prescription outflow†a lot. “Zero spread means that the enthusiasm of hospitals to sell drugs has declined,†added Wang Lijun. “The core of prescription outflow is to achieve drug price reduction through market competition, and then play the role of an out-of-hospital service system that regulates rational drug use and medical control fees.â€
For historical reasons, although “prescription outflows†are constantly being mentioned, there are still very few prescriptions for the market. Wang Lizhen believes that the "stick" behind it is the solidification of the original interest chain. “After many years of drug bidding, the sales channels of medicine have basically been solidified. The ranks of hospitals occupy the mainstream, and the proportion of retail pharmacies and primary care institutions is small and scattered. The problem of 'prescription outflow' is to break the original channels. The pattern, the establishment of a new circulation order, the foundation of all this is the reconstruction of the interest chain." Wang Lizhen said.
Compared with AI, Internet and other technologies to improve the quality and efficiency of medical services, Wang Liyi values ​​the role of the Internet in the pharmaceutical supply chain. In April of this year, the introduction of the "Guiding Opinions on Promoting the Development of "Internet + Medical Health"", in addition to explicitly allowing the development of Internet hospitals based on medical institutions, also revisited "prescriptions for common diseases and chronic diseases issued online" and "No. Reform opinions such as the “three-party distributionâ€.
Wang Lijun sees Internet medical care as opening up the “window†of the hospital, which makes “prescription outflow†more likely. "In a straightforward way, it is 'flowing out.'" Wang Lizhen concluded that the reduction in the proportion of medicines is a change from the medical interior, and Internet technology is an external source of power to promote the free flow of prescription drugs.
With the "small B-end" tentacle, the core management C-side "very prepared"
"The future of the out-of-hospital market is on the retail side, and the future of the retail side is in DTP+O2O." This is Wang Lizhen's pre-judgment for the domestic pharmaceutical industry. To some extent, this kind of prediction is not unrelated to the experiment of the early oncology drug DTP pharmacy.
In 2008, Zhenkang Pharmaceutical launched its own DTP pharmacy in the field of cancer, liver disease and other specialties. “The DTP pharmacy at that time was a product resource-based road, mainly providing out-of-hospital supply services for pharmaceutical industry importers.†Wang Lizhen said that the analysis of the development of domestic DTP pharmacies. The DTP pharmacy industry was born in the United States in the 1990s, on the one hand because of the differentiation of pharmaceutical circulation and retail formats, and on the other hand, pharmaceutical companies hope to reach patients in a more direct way. Nowadays, DTP pharmacy has gradually changed to the pharmacy service mode under the background of “new medical reform†in China.
"For patients with chronic diseases who have been in the drug cycle for more than half a year, it is actually appropriate to use the DTP pharmacy model for management. The establishment of DTP pharmacies can help upstream companies build an industrial chain management approach." Wang Lizhen's logic behind this thinking The starting point is that primary health care is the starting point for “prescription outflowsâ€, and the phenomenon of inverting the regional cost of medical retailing needs to be changed. "The farther away from the top three cities, the higher the cost of chronic disease, serious illness, and rare diseases." Wang Lizhen said, "This part of the population is more suitable for 'territorial treatment.'"
In fact, Akang Health's focus on DTP and O2O is focused on the service model and the scenario itself. Driven by the policy of “pharmaceutical separation†and “graded diagnosis and treatmentâ€, the future pharmaceutical market dividend will appear at the grassroots level. In July of this year, Akang Health and Minghe Zhonghe reached a cooperation to build a new retail platform for the basic foodstuffs with a small B-end as the front-end service fulcrum to meet the demand for C-side very spare drugs, so as to improve the lack of medical care at the grassroots level. Less drug-solving ability, this is a layout of the policy policy.
Conceptually, "very spare medicine" includes clinical drugs such as serious illness, chronic disease, and rare diseases, and the closest prescription for chronic diseases is the "small B-end" of retail pharmacies, community health service centers, and village clinics. “They cover a very wide range and have the potential to supply medicines and services for chronic disease prescriptions,†said Wang Lizhen.
Starting from the "Yun Yao College" to create a "full ecological" closed loop
While seeing the huge grassroots market, Wang Lijun also noticed that the corresponding loopholes need to be filled. According to research data from Minghe Zhonghe, more than 62% of primary medical institutions in recent years are often “buy no medicineâ€, and 89% of primary doctors need “consulting pharmacistsâ€. This situation makes Wang Lizhen believe that the improvement of the level of grassroots medical workers from the academic system will enable better management of chronic diseases. This is the origin of the "Cloud Medicine Institute."
“The layout of primary care, one of the fulcrums is the 'Yun Yao College'. Akang Health will integrate the multi-party resources through the 'Yun Yao College' to improve the knowledge and skills of medical staff, especially to enhance the importance and participation of pharmacists.†It is proposed that the construction of a networked, digital, personalized, and lifelong medical education and training system is one of the key points to promote primary care, especially the grassroots to better undertake the outflow of chronic disease prescriptions.
Wang Lizhen added: "'Received' requires not only the professional ability of the primary doctors, but also the supply chain 'acceptable', so we have also done a 'cloud drug library' for integration. The drug sales path, we will find that the drug catalogue outside the hospital is different, the previous prescription drug scenes have occurred in the hospital, and now after the transition path, the out-of-hospital market needs third-party enterprises to help them complete the product structure and service system. Build."
As of August 2018, Akang Health has built 17 departments and more than 1,300 disease treatment solutions in the prescription drug supply chain resources. The cloud medicine library covers 12,000 actual inventory of domestic hospital medications. It covers more than 2,500 domestic and foreign pharmaceutical manufacturers, and currently has more than 1,200 direct industrial enterprises, more than 300 businesses in various regions; 300,000 B-end customers; and more than 1 million patients with C-terminal chronic diseases.
“Akang’s plan for the next five years is to become a health data management company,†said Wang Lijun. “At the same time, it extends to the upstream and downstream of medical, pharmaceutical, insurance and other industrial chains around diseases such as chronic diseases.†Integration, Wang Lijun hopes to feed back the hospital and the pharmaceutical industry, and finally push forward the "new medical reform" from the supply chain.
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