A few days ago, the National Development and Reform Commission issued the "National Health Insurance Project Construction Plan", which mentioned that from 2017, no investment in the central budget will be arranged to support the construction of township health centers and village clinics. The news caused an uproar in the grassroots health sector. They were puzzled and worried. Why did the central government's investment in grassroots health change? How will the hospital and the village live in the future? It became the focus of online discussion for a while. However, the online media in the medical industry seems to be not very interested in this.
So, does the central government's change in primary healthcare investment really have no major impact on the pharmaceutical industry? Is there no market value to analyze and mine? The author believes that this is actually a new guide for the market development and operation of the pharmaceutical industry, which should attract the attention and attention of people in the pharmaceutical industry.
County-level hospitals continue to be the focus of medical reform
The "Planning" clearly states that county-level hospitals will become the focus of the next round of development. The specific health and poverty alleviation project construction projects for county-level hospitals include: focusing on contiguous areas with special difficulties and key counties for national poverty alleviation and development, ensuring that each county (city, district) builds 1-2 county-level public hospitals (including traditional Chinese medicine hospitals); it is allowed to build county-level hospital branches in new districts, or rely on central township health centers to build county-level hospital branches in areas with a shortage of medical resources, a large population, and a distance from the main urban area.
The "Planning" proposes the maximum amount and fixed subsidy amount for county-level hospital projects as follows: the subsidy amount for a single project of a county-level hospital construction project shall not exceed 20 million yuan in the east, 40 million yuan in the middle, and 50 million yuan in the west.
The "Planning" also points out the way for the future development of county-level hospitals: support the construction of county-level hospitals in the county where the number of beds for 1,000 people does not meet the standard and the area of business buildings is large (including the renovation of dilapidated buildings). Obstetrics, pediatrics, traditional Chinese medicine, psychiatry, geriatrics and other fields are inclined.
It is not difficult to see that the central government’s primary health investment in the future will focus on primary and county-level hospitals. The reason is very clear. The central government's huge investment in health centers and village offices in the seven years of the new medical reform has not achieved obvious results in "strengthening the grassroots". What should I do? The strong grass-roots operations such as medical alliances, multi-site practice, and counterpart support that have been or are being explored and promoted are all because of system problems and the social security, establishment, labor distribution, etc., which cannot allow experts from major provincial and municipal hospitals to truly "sink" in rural areas. Set up camps to provide farmers with high-quality medical services, large urban hospitals are still crowded, but the grassroots are scattered. The root of the problem is that the existing system is difficult and impossible to break, and the huge investment of central and local finance has not achieved its purpose due to system constraints! How to do? Therefore, the central government changed the direction of investment and reallocated the investment without changing the existing system, so as to use the government-led and planned means of the existing system to allocate medical resources with rigid policies, so as to strengthen or improve the level of primary medical care. This is what is mentioned in the "Planning" to "ensure that each county (city, district) has 1-2 county-level public hospitals (including traditional Chinese medicine hospitals); Covering areas with a large population and far from the main urban area, rely on central township health centers to build county-level hospital branches.”
It can be said that the opportunity for pharmaceutical operation has come. Because the county-level hospitals and their branches invested by the central government will undoubtedly become the monopoly medical institutions in the county in the near future, and their vertical and horizontal development will either "eat" and merge some health centers, or establish branches in crowded areas. For the county-level medical reform, it is a reasonable, fast, and effective means of medical resource allocation that can be welcomed by the general public, so that many common people’s patients are the first to be diagnosed at the grassroots level. It can effectively alleviate the "difficult and expensive to see a doctor" at the grassroots level. The author believes that this opens up or provides a new market space for pharmaceutical operations.
With the expansion of county-level hospitals and the emergence of government-supported branches or entrusted management, county-level hospitals, especially county hospitals, can become the largest pharmaceutical sales organizations or groups in the county. In 2015, Yuanyang County People's Hospital in Henan Province accounted for 56% of the county's total outpatient visits and 68% of hospitalizations. The amount of medicines used was 20 times that of the 14 township health centers, and the annual sales of medicines were 42 million yuan. . Just imagine, if the next step is supported by policies and special funds for county-level hospitals, they will merge other central health centers or build new branches in the county, plus the implementation and constraints of the hierarchical diagnosis and treatment system, the county hospital will greatly intercept grassroots patients and increase the number of first-time patients. The number of consultations and hospitalizations, as well as the purchase, inventory and use of its medicines will of course become the "medical center" of the county. In particular, the government's affirmation and implementation of the Sanming model, the two-vote system has been under pressure from the government, and the intermediate links of pharmaceutical operations have been greatly reduced. It can be said that county-level hospitals will become the direct public relations targets of major pharmaceutical businesses in the future.
Some people may say that the government is trying its best to implement diversified medical services, but it is only an increase in number. According to statistics from the National Health and Family Planning Commission in 2015, private hospitals accounted for 52.6% of the total number of hospitals in the country, but only 20% of the number of medical visits, and the amount of drugs used can be imagined. That is to say, if the central government centrally increases capital investment in county-level hospitals at the grass-roots level, county-level hospitals with unchanged systems and their branches or new hospitals will become the main target of pharmaceutical sales at the grassroots level.
Therefore, the author believes that the pharmaceutical industry should make preparations in advance, close the marketing of county-level hospitals as soon as possible, and make county-level hospitals more effective.
