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China's drug market will reach 1.71 trillion yuan
Source:南方日报
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Author:pro954f45
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Published time: 2018-08-17
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On August 16, 2017, the overall growth rate of drug end consumption was 6%. In 2018, the size of China's drug market will reach 1.71 trillion yuan, with an increase of 8.3% compared with 2017, and the growth rate is picking up. Recently, at the 2018 China Health Industry Cooperation and Development Forum (SIp), the largest annual meeting of the pharmaceutical industry in China, wu Han, President of the organizer Zhongkang Information, introduced that the growth rate of brick-and-mortar pharmacies was 8.5%, and that of non-pharmaceutical products was 7.5%.
The data report from the congress shows that since 2017, under the background of social and economic stability, the biggest factor affecting the drug market is the new medical reform policies that have been promulgated and will continue to be promulgated.
In general, factors such as the improvement of residents' health demand, the aging of population structure, and the large number of chronic diseases make the drug market show continuous overall growth, but the growth rate, growth terminal and growth category are all significantly affected by the new medical reform policy.
Drug retailing has also been affected by the vaccine incident
In 2017, China's pharmaceutical market (excluding retail medicines) totaled 1.580 trillion yuan, up 6.0% from 2016. With a compound five-year growth rate of 7.5%, urban grassroots and retail pharmacies grew slightly faster than large hospitals. Drug prices are under downward pressure due to the full implementation of zero margin and the impact of medicare price negotiations.
The operating environment is more severe. According to the comprehensive competitiveness research of Zhongkang Information, in 2017, the rental cost of top 100 chains increased by 10.7% compared with the previous year, and the labor cost increased by 16.9%, but the gross margin and net margin were lower than the operating level in 2012.
At the meeting, Xie Zilong, chairman of The Pharmacy chain, said, "The pharmaceutical industry is facing changes due to the reform of the national drug regulatory department, the intensified competition in the industry and the inflow of capital."
In addition, Xie Zilong also talked about the connection between the recent vaccine incident and the drug retail industry. "When the gate of the city burns, the fish in the pond will suffer". He believed that the vaccine incident would have a huge impact on the entire pharmaceutical industry, drug industry and drug retail industry, and the drug regulatory system would be paid more and more attention by the state.
Proprietary Chinese medicine injection showed negative growth
Drug retail growth rate, growth terminal, growth category these three aspects are obviously affected by the new medical reform policy.
From 2014, all provinces began to fully implement the zero-margin drug policy in public hospitals, and by September 2017, all provincial public hospitals implemented the zero-margin drug policy, resulting in the growth rate of urban hospitals and county-level hospitals in 2017 being only 1.5% and 3.4%.
In addition, restrictions on the proportion of drugs, charges by disease, deepening the reform of medical insurance payment, restrictions on the growth of medical expenses, and expanding and deepening the comprehensive reform of county-level public hospitals all have an impact on the scale growth of grade hospitals.
However, stimulated by the continuous growth of residents' demand for medical care, the expansion of medical insurance coverage and the expansion of medical insurance catalogue, it is predicted that the growth rate of city-level hospitals will reach 6.5% and that of county-level hospitals will reach 6.7% in 2018, with some recovery.
Under the influence of policies such as the catalogue of auxiliary drugs, the proportion of control drugs and the growth rate of medical expenses, the share of main varieties such as lIV, auxiliary drugs and traditional Chinese medicine injections in grade hospitals declined.
Among the major Chinese patent medicine injections, heart disease drugs, anti-tumor drugs and cough and cold drugs (mainly anti-inflammatory TCM injections) showed negative growth on average in 2017, with cough and cold drugs dropping by nearly 10%. It is expected that the decline in cough and cold drugs will further increase in 2018.
Drug use for chronic diseases is shifting to grassroots and retail channels
In 2017, the scale of drug use in urban grassroots hospitals reached 95.1 billion yuan, with a year-on-year growth of 8.9% and a compound growth rate of 16.0%. It is expected to grow at a rate of 14.1% in 2018, and the scale of drug use will reach 108.5 billion yuan, with a compound growth of 10.2%. In 2017, the scale of drug use in rural grassroots hospitals reached 71.2 billion yuan, with a year-on-year growth of 3.8% and a compound growth rate of 7.2%. It is expected that the scale in 18 years will reach 75 billion yuan, with a growth rate of 5.4%.
The growth of primary-level medical institutions is mainly due to the initial results of tiered diagnosis and treatment, while provinces have gradually lifted restrictions on the use of medicines at the grassroots level.
From 2015 to 2017, the share of chronic drug use in grade hospitals gradually declined, while the scale and share of primary medical institutions and retail pharmacies kept rising, among which the growth rate of chronic drug use in retail pharmacies exceeded 10%.
Prescription outflow is a hot topic recently. Taking the wuzhou model as an example, Wu talked about setting up a prescription information sharing platform for hospitals and pharmacies, where patients can choose to pick up their medicines independently. Since the launch of the prescription information sharing platform, the proportion of chronic drug use in retail pharmacies in Wuzhou has steadily increased in 2016. Since the expansion of access to pharmacies in November 2017, the proportion of chronic drug use has reached the highest point in the past two years. In July 2018, it will be piloted that prescriptions for special chronic diseases in medical insurance outpatient clinics can be directly settled in Shared pharmacies. It is reasonable to believe that this proportion will be further increased. Establishing a prescription information sharing platform for hospitals and pharmacies is an effective way to promote prescription outflow.
The growth prospect of antitumor drugs is good
The share of anti-tumor drugs continues to grow, especially for the key anti-tumor drugs listed in the medicare list, which will increase significantly in 2018. Although relevant drugs will face the pressure of price reduction after being included in the medical insurance list, the demand of patients and the policy of medical insurance reimbursement will further expand the users of relevant drugs and further increase their usage. Taking new anticancer drugs such as protein kinase inhibitors and monoclonal antibodies as examples, the average growth rate of grade hospitals from 2014 to 2018 is between 17% and 18%.
Due to the medical insurance fee, bidding and purchasing price, bidding factors such as long process, some new apt to choose the first listed in the retail pharmacy end, the high price of drugs already on the market, such as anti-tumor medicine began to transfer to retail pharmacies end, 2014-2018, average growth in retail pharmacies as high as 40% - 42%, among them the size of the retail pharmacies protein kinase inhibitors in 2017 already amounted to 25.8% of the grade hospital, 18 years is expected to more than 30%. Retail pharmacies, especially the emerging DTP pharmacies, will become an important channel for new and higher-priced drugs such as new drugs and new anti-tumor drugs.
Consistency evaluation continued, generics showed initial positive
According to data from China Health Information, as of May 2018, there have been 21 types of generic drugs, with at least one confirmed generic drug passing the conformance evaluation, and 45 (quality regulation) generic drugs passing the conformance evaluation, or regarded as passing the conformance evaluation.
The size of related generic names is expected to increase significantly in 2018. As more and more local enterprises pass the consistent evaluation, the share and price of generic original drugs will be put under further downward pressure. Taking Clopidogrel as an example, it is expected that the share of original products will decline in 2018, and the share of generic drugs that have passed the consistency evaluation will further expand, while the share of varieties that have not passed the consistency evaluation will only increase slightly. In terms of price, both the price of original research drugs and generic drugs have decreased, among which the generic drugs have decreased greatly. It is a long - term trend to substitute imported drugs by consistency evaluation.
The data report from the congress shows that since 2017, under the background of social and economic stability, the biggest factor affecting the drug market is the new medical reform policies that have been promulgated and will continue to be promulgated.
In general, factors such as the improvement of residents' health demand, the aging of population structure, and the large number of chronic diseases make the drug market show continuous overall growth, but the growth rate, growth terminal and growth category are all significantly affected by the new medical reform policy.
Drug retailing has also been affected by the vaccine incident
In 2017, China's pharmaceutical market (excluding retail medicines) totaled 1.580 trillion yuan, up 6.0% from 2016. With a compound five-year growth rate of 7.5%, urban grassroots and retail pharmacies grew slightly faster than large hospitals. Drug prices are under downward pressure due to the full implementation of zero margin and the impact of medicare price negotiations.
The operating environment is more severe. According to the comprehensive competitiveness research of Zhongkang Information, in 2017, the rental cost of top 100 chains increased by 10.7% compared with the previous year, and the labor cost increased by 16.9%, but the gross margin and net margin were lower than the operating level in 2012.
At the meeting, Xie Zilong, chairman of The Pharmacy chain, said, "The pharmaceutical industry is facing changes due to the reform of the national drug regulatory department, the intensified competition in the industry and the inflow of capital."
In addition, Xie Zilong also talked about the connection between the recent vaccine incident and the drug retail industry. "When the gate of the city burns, the fish in the pond will suffer". He believed that the vaccine incident would have a huge impact on the entire pharmaceutical industry, drug industry and drug retail industry, and the drug regulatory system would be paid more and more attention by the state.
Proprietary Chinese medicine injection showed negative growth
Drug retail growth rate, growth terminal, growth category these three aspects are obviously affected by the new medical reform policy.
From 2014, all provinces began to fully implement the zero-margin drug policy in public hospitals, and by September 2017, all provincial public hospitals implemented the zero-margin drug policy, resulting in the growth rate of urban hospitals and county-level hospitals in 2017 being only 1.5% and 3.4%.
In addition, restrictions on the proportion of drugs, charges by disease, deepening the reform of medical insurance payment, restrictions on the growth of medical expenses, and expanding and deepening the comprehensive reform of county-level public hospitals all have an impact on the scale growth of grade hospitals.
However, stimulated by the continuous growth of residents' demand for medical care, the expansion of medical insurance coverage and the expansion of medical insurance catalogue, it is predicted that the growth rate of city-level hospitals will reach 6.5% and that of county-level hospitals will reach 6.7% in 2018, with some recovery.
Under the influence of policies such as the catalogue of auxiliary drugs, the proportion of control drugs and the growth rate of medical expenses, the share of main varieties such as lIV, auxiliary drugs and traditional Chinese medicine injections in grade hospitals declined.
Among the major Chinese patent medicine injections, heart disease drugs, anti-tumor drugs and cough and cold drugs (mainly anti-inflammatory TCM injections) showed negative growth on average in 2017, with cough and cold drugs dropping by nearly 10%. It is expected that the decline in cough and cold drugs will further increase in 2018.
Drug use for chronic diseases is shifting to grassroots and retail channels
In 2017, the scale of drug use in urban grassroots hospitals reached 95.1 billion yuan, with a year-on-year growth of 8.9% and a compound growth rate of 16.0%. It is expected to grow at a rate of 14.1% in 2018, and the scale of drug use will reach 108.5 billion yuan, with a compound growth of 10.2%. In 2017, the scale of drug use in rural grassroots hospitals reached 71.2 billion yuan, with a year-on-year growth of 3.8% and a compound growth rate of 7.2%. It is expected that the scale in 18 years will reach 75 billion yuan, with a growth rate of 5.4%.
The growth of primary-level medical institutions is mainly due to the initial results of tiered diagnosis and treatment, while provinces have gradually lifted restrictions on the use of medicines at the grassroots level.
From 2015 to 2017, the share of chronic drug use in grade hospitals gradually declined, while the scale and share of primary medical institutions and retail pharmacies kept rising, among which the growth rate of chronic drug use in retail pharmacies exceeded 10%.
Prescription outflow is a hot topic recently. Taking the wuzhou model as an example, Wu talked about setting up a prescription information sharing platform for hospitals and pharmacies, where patients can choose to pick up their medicines independently. Since the launch of the prescription information sharing platform, the proportion of chronic drug use in retail pharmacies in Wuzhou has steadily increased in 2016. Since the expansion of access to pharmacies in November 2017, the proportion of chronic drug use has reached the highest point in the past two years. In July 2018, it will be piloted that prescriptions for special chronic diseases in medical insurance outpatient clinics can be directly settled in Shared pharmacies. It is reasonable to believe that this proportion will be further increased. Establishing a prescription information sharing platform for hospitals and pharmacies is an effective way to promote prescription outflow.
The growth prospect of antitumor drugs is good
The share of anti-tumor drugs continues to grow, especially for the key anti-tumor drugs listed in the medicare list, which will increase significantly in 2018. Although relevant drugs will face the pressure of price reduction after being included in the medical insurance list, the demand of patients and the policy of medical insurance reimbursement will further expand the users of relevant drugs and further increase their usage. Taking new anticancer drugs such as protein kinase inhibitors and monoclonal antibodies as examples, the average growth rate of grade hospitals from 2014 to 2018 is between 17% and 18%.
Due to the medical insurance fee, bidding and purchasing price, bidding factors such as long process, some new apt to choose the first listed in the retail pharmacy end, the high price of drugs already on the market, such as anti-tumor medicine began to transfer to retail pharmacies end, 2014-2018, average growth in retail pharmacies as high as 40% - 42%, among them the size of the retail pharmacies protein kinase inhibitors in 2017 already amounted to 25.8% of the grade hospital, 18 years is expected to more than 30%. Retail pharmacies, especially the emerging DTP pharmacies, will become an important channel for new and higher-priced drugs such as new drugs and new anti-tumor drugs.
Consistency evaluation continued, generics showed initial positive
According to data from China Health Information, as of May 2018, there have been 21 types of generic drugs, with at least one confirmed generic drug passing the conformance evaluation, and 45 (quality regulation) generic drugs passing the conformance evaluation, or regarded as passing the conformance evaluation.
The size of related generic names is expected to increase significantly in 2018. As more and more local enterprises pass the consistent evaluation, the share and price of generic original drugs will be put under further downward pressure. Taking Clopidogrel as an example, it is expected that the share of original products will decline in 2018, and the share of generic drugs that have passed the consistency evaluation will further expand, while the share of varieties that have not passed the consistency evaluation will only increase slightly. In terms of price, both the price of original research drugs and generic drugs have decreased, among which the generic drugs have decreased greatly. It is a long - term trend to substitute imported drugs by consistency evaluation.
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