Last year, the pharmaceutical market in China reached 926.1 billion yuan

Previously, the Institute of Economics and Social Sciences Academic Press of the Chinese Academy of Social Sciences jointly issued the Blue Book of Medicine “China Pharmaceutical Market Report (2012)” co-authored by the deputy director of the Center for Public Policy Research of the Institute of Economic Research of the Chinese Academy of Social Sciences and director Zhu Hengpeng. (hereinafter referred to as "Blue Book").

The Blue Book points out that the Chinese pharmaceutical market is characterized by high speed expansion, fierce competition, low industry concentration, and large policy impact. Foreign-funded enterprises play an important role in the Chinese pharmaceutical market, especially in the high-end tertiary hospital medicine market.

Market expansion

Foreign companies take advantage

The Blue Book points out that from 2005 to 2010, the compound growth rate of the Chinese medicine market exceeded 20%. According to the research report of Zhongkang Consultancy, the sales volume of retail end-use drugs in 2012 was 172.6 billion yuan. It can be calculated that the total size of China's pharmaceutical market in 2012 was 926.1 billion yuan. The Blue Book also predicts that the average growth rate of the Chinese pharmaceutical market will reach 12% between 2013 and 2020. By 2020, the pharmaceutical market in China will reach 2.3 trillion yuan. The aging of the population, the improvement of social security and the increase in residents' income are the fundamental driving forces for the expansion of the pharmaceutical market.

The Blue Book points out that the market share of domestic pharmaceutical companies has expanded at the same time as the demand for drugs has grown. However, foreign-funded enterprises play an important role in the Chinese pharmaceutical market, especially in the high-end tertiary hospital drug market, which occupies a large market share.

Research shows that from 2003 to 2011, China's pharmaceutical manufacturing industry developed rapidly, mainly in the eastern region, and Shandong, Jiangsu, Zhejiang, and Guangdong were major pharmaceutical manufacturers in China. In particular, the pharmaceutical manufacturing industry in Shandong and Jiangsu accounted for more than 10% of the national total. From the perspective of hospital terminals, the concentration of pharmaceutical companies in the pharmaceutical market of tertiary hospitals is higher than that of pharmaceuticals in the pharmaceutical market of secondary hospitals; the concentration of pharmaceutical companies in the pharmaceutical market of the eastern region is higher than the concentration of pharmaceutical companies in the pharmaceutical market in the central and western regions; The bigger the pharmaceutical company, the higher the degree of concentration.

It is worth noting that, despite the fierce competition in the pharmaceutical market, domestic pharmaceutical companies have not achieved large-scale operations soon. In the manufacturing of chemical preparations and proprietary Chinese medicines in 2008, the annual sales of more than half of the companies were between 10 million yuan and 100 million yuan; CR4 (industry's top four indicators of concentration index) were 17.01 and 10.15, respectively, and HHI ( A comprehensive index measuring industrial concentration is only 121.48 and 64.70, respectively.

"The competition situation of pharmaceutical companies in the pharmaceutical market will eventually show market share. From the ranking of companies, it can be seen that foreign-funded enterprises have a dominant position in the pharmaceutical market in China," said Cheng Jincong.

Taking 2011 as an example, the top 10 pharmaceutical companies in the pharmaceutical market share of tertiary hospitals are Pfizer, AstraZeneca, Sanofi-Aventis, Bayer-Shenling, Roche, Shandong Qilu, and Novartis Pharmaceutical. , Jiangsu Hengrui, GSK and Fresenius; the top 10 in the pharmaceutical market share of secondary hospitals are Pfizer, Sanofi-Aventis, Bayer-Schering, Yangzijiang Pharmaceutical, Shanghai Pharmaceutical Group, AstraZeneca, Novartis Pharmaceutical, Harbin Pharmaceutical Group, Novo Nordisk and Baiyunshan Pharmaceutical Group. The top 5 pharmaceutical companies in the tertiary hospital drug market are all foreign-funded enterprises, which means that foreign-funded enterprises have more advantages in the high-end tertiary hospital drug market, and gradually penetrate into the secondary hospital drug market; In the hospital drug market, domestic enterprises temporarily maintain a large space for development in the secondary hospital drug market.

Secondary and tertiary hospitals become

An important part of the market

The Blue Book points out that the Chinese medicine market is mainly concentrated in cities with rich medical resources. Data shows that China's medical resources are concentrated in the eastern region and large cities. In 2010, the medical resources in the eastern region were 1.13 times the national average, while the central and western regions were 90.85% and 91.47% of the national average respectively. Urban medical resources are 2.55 times that of rural medical resources. Beijing, Shanghai, and Tianjin are the regions with the most abundant medical resources in China. The per capita drug consumption of residents in these three regions is also the highest per capita drug expenditure for residents in China.

Statistics show that the amount of per capita drug expenditure of residents has a close relationship with the quantity and quality of medical resources. The richer the medical resources and the higher the quality of medical care, the better the medical environment. The higher the degree of security provided by the supply side (accessibility of high-quality medical services), the greater the demand for medical services for residents and the greater the expenditure on drugs.

The second and third level hospitals are the most important components of the Chinese pharmaceutical market. At present, the growth characteristics of the pharmaceutical market in China's second- and third-tier hospitals are significant: from 2006 to 2011, the hospital drug market showed rapid growth, the compound growth rate of the tertiary hospital's drug scale reached 22.29%, and the compound growth rate of the secondary hospital's drug scale reached 20.53%. The growth rate has been declining year by year. In 2007, the year-on-year growth rate of second- and third-tier hospitals exceeded 25%. In 2011, the growth rate was less than 15%, and the growth rate fell by more than 10%. The growth of the third-tier hospital drug market was stronger than that of the second-level hospitals. In the central and western regions, the hospital drug market grew faster than the eastern region. From 2006 to 2011, the average growth rates of the market scale in the central and western regions were 26.64% and 27.06%, respectively, while in the eastern region only 20.13%; large and medium-sized hospitals. The pharmaceutical market grew faster than the small hospitals.

Cheng Jin Cong pointed out that the competition in the pharmaceutical market of tertiary hospitals is fierce. Of the sample hospitals' first-supply companies in 2006, only 24.14% of the companies still maintained their largest supplier status in 2011. In the eastern region and the large-scale tertiary hospitals, the proportion of the first drug supply companies maintaining the original market advantage is relatively high.

In addition, changes in the disease spectrum of residents and advances in science and technology have also brought about changes in the types of drugs used by hospitals. From 2008 to 2011, the distinctive feature of the changes in the structure of hospital medication categories was that the proportion of systemic anti-infective drugs in the total hospital drug use declined significantly, and that of secondary hospitals and tertiary hospitals all exceeded 5 percentage points. At the same time, the proportion of anti-tumor and immunomodulators increased significantly.

The categories of drugs used in tertiary hospitals in 2011 from the largest to the smallest were: systemic anti-infective drugs, anti-tumor and immunomodulatory agents, digestive and metabolic drugs, cardiovascular system drugs, blood and hematopoietic system drugs, and nerves. System drugs.

Primary health care institutions

The proportion of drugs falling in drug revenue has changed little

The Blue Book points out that from 2008 to 2010, the pharmaceutical market in our country's public medical institutions maintained a relatively high growth rate.

The survey results show that in 2009 and 2010, the growth rate of drug income in all public medical institutions in the three sample prefecture-level cities was 23.63% and 18.69% respectively; the growth rate of drug revenue in all public medical institutions in the eight sample counties was 23.73% and 10.60 respectively. %. In 2010, the growth rate of drug revenue in public medical institutions in prefecture-level cities reached 18.69%, while that of public medical institutions in county-level public hospitals only increased by 10.60%. This is because after the implementation of the basic drug system, the growth rate of drug income at primary medical institutions has slowed down significantly. At the prefecture-level city level, the income of medicines in primary-level medical institutions accounts for only 12.50% of the total income of all public medical institutions. The proportion of medicines in township and township hospitals in counties is close to 30%. The difference in weight leads to the difference in the overall growth rate.

Analysing the pattern of drug income in all public medical institutions in prefecture-level cities and counties can be found that urban hospitals and county-level hospitals occupy an important position. From the standpoint of a single medical institution, the income of medicines in urban hospitals is 34.74 times that of grass-roots medical institutions, and the medicine income of county-level hospitals is 16.30 times that of grass-roots medical institutions. In the county-level public medical institutions, the county-level general hospitals' medicine income is 30.96 times that of the township hospitals, and the County Hospital's medicine income is 10.80 times that of the township hospitals.

Statistics show that in 2010, the pharmaceutical market in county medical institutions in China was approximately 160 billion yuan. Among them, the scale of the drug market in county hospitals is about 120 billion yuan, and the pharmaceutical market in township hospitals is about 40 billion yuan. The proportion of pharmaceuticals revenue in urban hospitals, county-level hospitals, and primary-level medical institutions in the total income of medical institutions is increasing. The data for the three in 2010 were 42.76%, 45.85% and 53.94%, respectively.

According to the Blue Book, the income of pharmaceuticals at the basic medical institutions is greatly affected by the basic drug system. According to the data on the income of medicines from township and township hospitals in eight sample counties, the growth rate of medicines in township and township hospitals reached 26.26% in 2009. After the implementation of the essential medicines system, the income of medicines had a negative growth, with a growth rate of -2.40%.

Zhu Hengpeng pointed out that the decline in drug revenues in township hospitals cannot be explained by the "zero-difference" sales of drugs that have caused the "drug prices in township hospitals to decline and the use of drugs has fallen." The data shows that from 2008 to 2010, the proportion of medicines in the county general hospitals was stable at 47%; the proportion of medicines in the county hospitals increased by 3.8 percentage points; after the township hospitals implemented the basic medicine system, the proportion of medicines did not appear. Obvious changes. “There has been no significant change in the proportion of medicines, but drug revenue has dropped significantly, reflecting the shrinking of the overall business of township hospitals in 2010.” Zhu Hengpeng said.

In fact, from 2008 to 2010, the financial input to the public medical institutions in the counties increased explosively. In 2010, the input was 2.32 times that of 2008. Most of the increase in financial investment has gone to township health centers.

Zhu Hengpeng said that the impact of the basic drug system on township health centers is reflected in three aspects: Some local governments only allow township hospitals to carry out outpatient services; after implementing the two lines of revenue and expenditure, township health centers lack operating momentum; and new rural cooperative medical compensation levels The increase has led to a higher level of medical treatment for farmers, and a large number of rural patients have chosen to go to county hospitals for medical treatment. However, in view of these circumstances, “some local governments have started to fine-tune the policies. The data in 2011 shows that the income of medicines in township hospitals has rebounded.”