Can North Medicine really earn 1 20,000 a month?

Yes, this business really can! As far as I know, it is more than1.20 thousand, but there are only a few people. This business is not easy, and only a few people can finally gain a foothold.

Listen to what the medical representative said: "Why is the price of medicine getting higher and higher? Can't you see that the hospital building is getting taller and taller? Are some doctors' cars getting better? "

The doctor ate the fattest piece of meat.

This interest chain is not as heavy as gold and silver in rivers and lakes, but takes what is needed according to the role. "The drug price is too high. Who ate the fattest piece of meat?" Insiders said, "Of course, it is a doctor who prescribes."

According to the unspoken rules, the doctors who prescribe drugs are given a commission, and the commission ratio of small companies is 20% to 25% of the drug price; The proportion of large companies will be less, ranging from 10% to 15% of the drug price. "Big companies get less commission, but the benefits will be better. In addition to organizing tourism activities, they will also sponsor academic promotion conferences, and they will also sponsor doctors to go abroad for conferences, trainings and visits. "

A medical representative said: "The income of our medical representatives is really good. Generally, there are 20 thousand or 20 thousand or 30 thousand every month. All this money comes from drug commissions. But our income is much lower than that of doctors who take kickbacks. " Take a gynecological Chinese patent medicine as an example. The supply price of provincial agents is 10 yuan per box, the purchase price of hospitals is 39 yuan, and then hospitals sell them to patients at the price of 45 yuan. Doctors get a commission per box 10 yuan, and medical representatives get a commission of 5 yuan. Another traditional Chinese medicine for treating liver diseases, the provincial agent supply price per box 12 yuan, the hospital sells 54 yuan, and the doctor's commission can reach 12 yuan.

The medical representative also revealed that the more expensive the medicine, the more money you earn. The more you go to a big hospital, the more money you earn. Take an antibiotic for example. Sell it to patients for 132 yuan, and give two infusions each time. Every doctor can get 50 yuan's commission, while the medical representative's commission is 5 yuan. "A course of treatment is usually 7 days. How much do you think the doctor can take? In a big hospital, a slightly famous surgeon may have a commission of 30,000 to 40,000 yuan a month. "

Medical representatives said that anticancer drugs and antibiotics make the most money. "Some high-priced special drugs of one or two thousand yuan, doctors can even commission 500 to 800 yuan."

Marketing natural person, nicknamed "drug bug"

Large foreign pharmaceutical companies and domestic large and medium-sized pharmaceutical companies do their own drug sales. But at present, there are more than 4,000 pharmaceutical factories in China, 60% of which are small-scale, with annual sales below 50 million yuan. They don't have a sales team at all, and the sales of drugs must rely on people to get through all links. As a result, a special group, BLACKPINK, appeared. According to the jargon of the pharmaceutical industry, they are called "marketing natural persons" and have another nickname: "drug bugs". In fact, he is a self-employed drug seller.

"Drug Bug" is a drug agent in a small pharmaceutical factory. Don't underestimate these self-employed, they have more energy. Some of them are medical staff who have changed careers, some are senior medical representatives, and some are relatives and friends of government officials. They have no legal personality and often belong to a local pharmaceutical company.

It is reported that there are millions of "drug addicts" in China at present, and the number of clinical drugs they operate is huge. For example, "high-priced asparagus slices" are operated by "drug bugs". Of all the profits of "high-priced asparagus slices", pharmaceutical companies account for 20%, "drug bugs" account for 20%, doctors account for 40%, and the remaining 20% is the "entrance fee" of each pharmaceutical company.

"Getting tickets" is one of the shady sales of drugs. There are "poisonous bugs" and there are "tickets". Take a drug with ex-factory price 10 yuan and retail price in 92 yuan as an example. "Yaochong" buys medicines from manufacturers at the price of 10 yuan in the name of pharmaceutical company A, and then pharmaceutical company A issues invoices to another pharmaceutical company B at the price of 20 yuan. Company B pays 20 yuan to Company A, and Company A only earns 6% of the billing fee, and the rest of 9.4 yuan is returned to "Yaochong". Then Company B invoiced Company C at the price of 30 yuan, and Company B only earned 6% of the invoicing fee. By analogy, after several companies, the final price for the hospital was 80 yuan, and the hospital increased the price 15% and sold it to patients, which included the profits of 70 yuan. However, the "drug bug" only needed to give each company 6% of the billing fee, but the rebate for doctors was very high.

In the whole "marketing" process, only bills are taken, and drugs are actually sent directly from pharmaceutical factories to hospitals. Why go through so many intermediate links? Isn't it easier to sell directly from the pharmaceutical factory to the hospital in 80 yuan? But in this case, the "drug bug" can't pay one doctor after another in cash, and the "drug bug" can only get cash by "walking the ticket". It turns out that according to the financial system, hospitals pay pharmaceutical companies by check, and check settlement is also carried out between pharmaceutical companies and between pharmaceutical companies. The cash withdrawn is divided into parts and scattered among various pharmaceutical companies for easy withdrawal. At the same time, drugs with lower ex-factory price can be turned into high-priced drugs step by step through multiple "tickets", and it is always impossible to mention 80 yuan at once from ex-factory price 10 yuan. Hospitals also welcome high-priced drugs. If the drug price is very low, according to the regulations, the price can only be increased by 15%, without adding a few dollars.

It is often said that there are too many drug circulation links. After multi-level agents, the price of drugs is artificially high, thinking that pharmaceutical companies at all levels have embezzled profits. As a result, they found that most of the profits fell into the hands of "drug bugs" and then transferred to doctors.

The higher the price, the better the sales.

As soon as the price dropped, the medicine died.

Known as "death when you fall"

Another hidden rule of the pharmaceutical industry is that the higher the bid price, the better the sale.

In the bidding process, enterprises usually make public relations preparations in advance and try their best to make the bidding price higher, and the huge profits in the middle are divided up by pharmaceutical companies, medical representatives, hospitals and doctors. There is more room for such drugs to "operate". As a result, the mystery of the disappearance of many low-priced drugs has been solved: once the state requires a certain drug to reduce its price, every link in the interest chain is unwilling to reduce its own profits, so it can only compress the ex-factory price and let the manufacturers bear the loss of price reduction. If the manufacturer refuses to give in, the middle profit-driven mechanism will not work, the drug will not be sold, and the manufacturer will be injured, so many manufacturers simply choose to stop production of this drug.

In view of the high drug prices, the National Development and Reform Commission has reduced the prices of some drugs 29 times in recent years, but the people have always been "indifferent" because the price-cutting drugs have disappeared and the people are still eating high-priced drugs.

In fact, the pharmaceutical factory didn't really stop the production of this drug, but changed its name or dosage and applied for a "new drug" again. This "new drug" is often easily approved and then listed at several times the price before the price reduction. When the social reaction is strong and the price department starts to cut prices, drugs will come back to life ... and so on, the price of drugs will also spiral up.

Mingde Yu, president of China Pharmaceutical Enterprise Management Association, pointed out that as long as the hidden rules of mutual benefit among pharmaceutical companies, hospitals and doctors are not changed, it will be difficult for artificially high drug prices to return to a reasonable range.

Taking medicine to support doctors is the root of drug price demand.

Youdi Zhu, former director of the Social Development Department of the Research Office of the State Council, is the author of "Great Country Medical Reform", analyzing the medical reform in China. He denounced at the 20th China Pharmaceutical Enterprise Marketing Summit Forum held at the same time and place as Zhengzhou Pharmaceutical Expo: "Only 20% of drugs in the world are sold through hospitals, while 80% of drugs in China are sold by hospitals. There is a widespread phenomenon of using medicine to support doctors in China hospitals, and doctors have become the largest drug dealers, which has not been seen for thousands of years! " Yes, Hippocrates, Zhang Zhongjing and Li Shizhen are not drug dealers, but there are many mercenary drug dealers in their descendants! Sad! The root cause lies in the system of "taking medicine to support doctors", which is the fundamental reason for the emergence of "high-priced drugs".

In Weibo, a doctor complained bitterly: "Prices are soaring! But I have been a doctor for 15 years! The registration fee is still standing still! Is it reasonable? Has the operating cost not become reasonable for more than ten years? Are all kinds of medical expenses always reasonable? I support a substantial reduction in drug costs! But at the same time, it will increase the medical expenses that have not changed for more than ten years by at least five times! "

Dr. Eric Chong, deputy secretary-general of China Hospital Association, pointed out that most hospitals in China are public hospitals at present, and it is natural for governments at all levels to fully invest in public hospitals, but the investment is generally insufficient, accounting for only about 10% of the hospital's operating expenses. The remaining 90% rely on hospitals to raise funds by themselves and then develop themselves. When they pay their own wages, they allow hospitals to increase their prices 15% to sell drugs to patients, resulting in "taking medicine as medicine"

In all countries of the world, doctors, as intellectuals, are high-income people. In China, doctors must pay the price of conscience, morality, reputation and even breaking the law in order to get high income.

The country has obviously noticed this problem. Sun Zhigang, deputy director of the State Council Development and Reform Commission and director of the State Council Medical Reform Office, was interviewed.

He said that in the 1950s, due to the government's insufficient investment in hospitals, a drug addition policy was implemented at that time, allowing hospitals to increase their prices by 15% after taking drugs and then sell them to patients. This 15% income is used to make up for the lack of financial input. After the reform and opening up, the government did not increase investment in hospitals, but pushed hospitals to the market to make money. In order to generate income, the fastest way for hospitals to make money is to sell medicines. As a result, the original drug addition policy has gradually evolved into this profit-seeking mechanism of supporting doctors with drugs. This profit-seeking mechanism makes public hospitals deviate from the public welfare direction. As a result, the people look down on the disease, and at the same time, the people also use a lot of drugs that should not be used.

In order to really reduce the inflated drug price, we must first decouple the drug from the hospital's interests. Hospitals don't live on the rising price of 15%. At the same time, the government should increase financial subsidies to hospitals to ensure their healthy operation. Part of the doctor's income is financial burden, and the other part depends on higher medical expenses, reflecting the value of doctors. Medical expenses are paid by the state through medical insurance. This can not only protect the interests of doctors, but also make the people afford to see the disease. This may be the next direction of medical reform.