The back of distant times
For those born after 70, there may be no impression in the era of planned economy, but for those who have been engaged in the purchase and sale of drugs in that generation, the purchase and sale of drugs, pricing, business model, allocation methods and so on, which are deeply branded by the times, will not be erased from their memories, and it is difficult to erase them, although more than 20 years or even half a century has passed.
In the era of planned economy, drug sales are not "marketing" at all, but a kind of "purchase and sale". Drug trading enterprises implement unified national planning, unified management below the provincial level, unified economic accounting for drug planning and allocation, and purchase and sale of "three-level wholesale and one-level retail". Distribute indicators at different levels, uniformly control the import of drugs at different levels, and distribute drugs at different levels. Drug wholesalers are aristocrats, hospitals are grandchildren, and taking medicines requires giving gifts. "In the sales department of an old pharmaceutical factory in Yulin, Guangxi, only one person has propped up the drug sales task of the whole enterprise," Shen Zeng, deputy director of the US Food and Drug Administration in Guangxi, described the dominant position of pharmaceutical companies in an interview.
In fact, the reform of pharmaceutical marketing is inextricably linked with the evolution of the history of pharmaceutical commercial circulation. Take the history of Anhui medicine circulation as an example. In the early days of the People's Republic of China, the supply of bulk chemicals was mainly handled by the Materials Department of the Health Department of the Northern Anhui Administrative Office. All drugs are supplied by the unit, approved by the leaders, and directly supplied by the pharmacy. From 1952 to 1956, three levels of Anhui, city and county companies of China Pharmaceutical Company were established one after another, and the drug management network was basically formed. State-owned pharmaceutical companies have become the main channel for drug supply. 1957, provincial pharmaceutical companies set up 9 secondary stations such as Hefei and Bengbu according to the commodity flow direction. Secondary stations are responsible for the supply of goods and business guidance of companies in counties and cities under their jurisdiction, forming a drug supply network with secondary stations as the main body and according to the natural flow of goods. This commercial form continued until 1983. During this period, the so-called drug marketing did not exist, but people engaged in drug purchase and sale still got to know their counterparts all over the country, which became a good resource for them to carry out drug marketing after the opening of the pharmaceutical industry. After 1983, in addition to state-owned pharmaceutical companies, there have also been self-employed individuals specializing in pharmaceutical business, mainly serving consumers in rural areas and remote mountainous areas. Due to the surplus of drugs, in order to compete for the limited market, the era of pharmaceutical marketing has really arrived.
The turbulent years of marketing
At the beginning of August, in a star-rated hotel in Guangzhou, banners, red carpets and soft lights set off the relaxed smiling faces of doctors who came to attend the national medical conference. The booth of pharmaceutical manufacturers in the corner of the conference has become a concentrated place for doctors to patronize, and all the medical representatives attending the conference know doctors in this way. After the meeting, a medical representative said that the meeting was not bad, but it needed to be followed up, otherwise the sponsorship of the meeting would be "wasted". As for how to follow up, there is no need for publicity.
Nash, a Nobel Prize winner and game theory scholar, once said that "when the behaviors of other competitors in the market have been determined, we have no choice". I believe that what we see in China's drug marketing today is only the result of many drug manufacturers and distributors' helpless choice, especially for the promotion of prescription drugs.
I believe that the above medical representatives are telling the truth. Because this seemingly innovative marketing method of prescription drugs is actually very common, and it is inextricably linked with sales with money. That's how the whole industry operates, tine. There's no choice. Compared with the situation of "quiet hospital promotion" in the planned economy era, the promotion now is full of a feeling of anxiety and quick success. So, when did the promotion of drugs in hospitals that we see now begin to take shape?
In the middle and late 1980s, after some multinational pharmaceutical companies settled in China, medical representatives began to appear. At that time, it usually appeared in the relevant departments of the hospital in the form of new drug promotion meeting, mainly to promote products. These big companies don't pay doctors clinical fees. Yoshida Changli, who later became the business CEO of Daiichi Pharmaceutical (Beijing) Co., Ltd., recalled the academic promotion at that time, and said that he began to try academic promotion in China on 1986. At that time, China had a strong planned economy, and no one introduced the nature, efficacy and side effects of new drugs to doctors, and no one realized the significance of academic promotion. He's with a 10 team. From Jiamusi, Mudanjiang and Harbin in the northeast, academic promotion conferences are held everywhere. They arrived at the meeting place directly with medicines and supplies by big trucks. In three months, about 13 academic promotion meetings were held. All the students listened carefully and the doctors were simple. All they got was a small electronic thermometer.
With more and more multinational companies holding academic promotion conferences, the cost of drug marketing is rising. Enterprises need to spend a lot of money, including academic sponsorship, equipment sponsorship, and even give everyone a "red envelope" at the meeting, which is euphemistically called "travel expenses" and "meals". These measures were quickly imitated and carried forward by many domestic enterprises. Later, manufacturers found that the effect was not great, because the benefits of these activities were too far away from the frontline doctors who had the right to prescribe. Slowly, the form of expenses has changed. From the reality of the hospital, only by box calculation can we catch the first-line doctors. This trend is out of control and getting worse, which has become everything we see today.
The representative of China medicine from a well-known multinational pharmaceutical company analyzed the reasons for the sales of prescription drugs with gold, and said that many foreign new products have imitations in China, but the quality of the imitations is not high enough. Products are the same as others, no one is good, and kickbacks should be given; Many products that have passed the patent period have a large number of similar imitations with similar efficacy, and almost 90% of them are domestic manufacturers, so they have to sell them with gold content in order to compete; Although a large number of traditional Chinese medicines have been clinically proved to be effective, there is no natural scientific data and authoritative literature. Doctors use drugs for reasons and evidence, and they have to take money to be flexible; The loopholes in the medical circulation management system make people take advantage of it; A large number of private agents have led to the emergence of countless "drug dealers", who are unable to carry out academic promotion and have to "operate behind the scenes"; The low income and high risk of doctors in China have been seriously unbalanced, and doctors can't get "prescription fees" from hospitals like foreign countries.
"Overmarketing" is coming.
"Holding a bag with a fake name, holding a 200-dollar bill, nodding and bowing, looking like overseas returned overseas Chinese at a distance, and looking like Hong Kong and Macao compatriots at a close distance, it turned out to be a medical representative." This jingle basically tells the faces of this group of medical representatives. They are like living in the shadow, conducting business cautiously, and maintaining subtle relationships with hospital directors, pharmacy staff, clinicians, warehouse keepers and financial personnel tacitly, for fear of offending people in the hospital, and they are always in a state of high tension. It is precisely because I have been a "medical representative" in China for more than ten years that drug marketing has become fresh, rich, diverse and even excessive.
"Rebate" and "red envelope" in drug marketing have even become "cancer" parasitic in the medical industry. Although the relevant state departments have carried out many "rectifications", they cannot be eradicated at all. In fact, there are not many choices for medical representatives, and the strategy of enterprises determines their working methods. A medical representative told reporters that it is difficult to arouse the interest of doctors simply by engaging in academic sponsorship at present. Even after winning the bid to enter the hospital, similar products still put competitors' information in the first place when competing for customers (doctors), so as to formulate targeted promotion strategies, especially considering how to form a closer relationship with doctors. In fact, what we do is not normal marketing, but "human marketing" or "relationship marketing". In the field of OTC and health care products marketing, "over-marketing" is a topic of concern to marketers at present, but in fact, in the promotion of drugs and drugs with much simpler marketing means and methods, "over-marketing" behaviors abound.
The sale of prescription drugs is a supplement to hospital separation and medical system reform. In fact, the backwardness of medical reform has seriously affected the innovation of prescription drug marketing. But at present, some enterprises have been involved in hospital pharmacies, and they buy or entrust the management of hospital pharmacies to sell their own products and the products of other pharmaceutical manufacturers. However, after all, this is only the behavior of a small number of enterprises. It is difficult to reform the medical system, and the key is the value of interests. Over the years, the promotion of value chain by drug hospitals has been deeply rooted in people's hearts. It is not easy to break the existing rules and establish corresponding new rules, but it is a matter of time before the new rules are established.