Not long ago, a former director of the anesthesiology department of Zhejiang Lishui Central Hospital, Lei Li Pei bribery case of judicial decision documents made public, which revealed the fact that a number of employees of Hengrui Pharmaceuticals wholly owned subsidiary of Jiangsu Xinchen Pharmaceuticals bribery, bribery totaling nearly 2.77 million yuan. Subsequently, the media began to question the reasonableness of its 8.5 billion yuan of sales expenses in 2019.
"With gold sales" has become the industry's "open secret"?
According to a criminal judgment disclosed by the referee network, Lei Li Pei, former director of anesthesiology at Lishui City Central Hospital in Zhejiang Province, from June 2014 to September 2019, using the convenience of his position, in the process of the introduction and use of medicines, medical devices and consumables, received kickbacks **** totaling 6,740,000, of which Jiangsu Xinchen is the most important bribery party. At present, Lei Li Pei was convicted of bribery in the first instance, sentenced to seven years in prison, a fine of 800,000, and the recovery of illegal income of 3.31 million.
The judgment also revealed the specific details of the bribe. Jiangsu New Morning sales of Butorphanol Tartrate Injection and other 5 drugs are used by the Lishui City Central Hospital Anesthesia Department, in the signing of the purchase agreement, Jiangsu New Morning raised the purchase price of each potion, and then sent Lei Li Pei kickbacks *** counting 2.36 million yuan, Lei Li Pei received, will be part of the kickbacks to the anesthesiology department, and the remaining portion of the personal ownership. In addition, in order to make good relations with Lei Li Pei, so that his department to maintain and increase the use of drugs, Jiangsu New Morning three employees have given Lei Li Pei 408,000 yuan of "thank you".
In response to media reports and questions about the incident, Hengrui Medicine released a clarification announcement on May 13, saying that the bribery incident is the personal behavior of the subsidiary employees, a serious violation of the company's management system, but also reflects the existence of loopholes in the company's management. At present, the relevant personnel have left the company, the subsidiary responsible for the leadership has been transferred from the post. Hengrui medicine in the clarification announcement listed a detailed description of sales costs, and said the company's 2019 sales expense rate of 36.61%, in Shanghai and Shenzhen more than 230 pharmaceutical companies belong to the middle level.
Industry insiders believe that pharmaceutical companies sales costs in the "travel" and "academic promotion" two has always been the high incidence of commercial bribery. The amount is huge and can not be invoiced rebates, usually hidden in the packaging in these two types of sales costs. The proportion of these two expenses is abnormally high.
During 2016-2019, Hengrui Medicine's sales expenses rose from 4.35 billion yuan to 8.52 billion yuan. Among them, in 2019, "academic promotion, innovative drug specialization platform construction and other market expenses" is 7.53 billion yuan, accounting for more than 88% of sales expenses, compared with 5.424 billion yuan in the previous year, an increase of 2.1 billion yuan; "travel expenses" is as high as 900 million yuan, accounting for 10.66%.
900 million of travel expenses has accounted for 31.24% of the operating costs for the same period, per capita annual travel costs are also higher than other pharmaceutical giants several times. Three pharmaceutical industry leaders Hengrui Medicine, Zhongheng Group, and China Resources Sanjiu 2019 average annual travel expenses for sales staff were 61,900 yuan, 15,600 yuan, and 14,700 yuan, respectively. Hengrui medicine in the clarification announcement mentioned "in recent years the introduction of more high-level academic, medical personnel to fill the sales force, sales staff travel standards have also increased year by year" and other reasons, and can not persuasively explain the huge difference in this comparison.
Compliance transition will become the new law of survival of pharmaceutical enterprises
According to industry sources, the "academic marketing" approach to drug promotion, initially some multinational pharmaceutical companies to enter China after the use of one of the marketing approach. There are also irregularities, such as the implementation of the "academic marketing" in the name of "gold sales" of drugs in fact. 2013 GlaxoSmithKline (China) was penalized 3 billion yuan precisely because of the implementation of the travel agency through the cash bribe, sponsorship of the relevant pharmaceutical industry associations and to give GlaxoSmithKline (China) was penalized 3 billion yuan in 2013 precisely because of its "gold sales" through travel agency cash bribes, sponsoring relevant pharmaceutical industry associations, and giving promotional service fees to agents. The company's main goal is to provide the best possible service to its customers, and to provide the best possible service to its customers in the future.
Hengrui Medicine listed the breakdown of "academic promotion, innovative drug specialization platform construction and other market expenses" in the clarification announcement, and the 7.5 billion yuan of market expenses in 2019 include academic activities, salaries, internal operation and training fees, of which the highest proportion is "for the company's independent research and development of innovative drugs, different phases of the development of the company's own The highest proportion is "for the company's independent research and development of innovative drugs, different stages to carry out a series of academic activities", 2019 *** counted 1.958 billion.
However, Hengrui Pharmaceuticals' source of income is mainly generic drugs rather than innovative drugs. According to its annual report, the revenue from innovative drugs in each of the past two years only accounted for about 10% of operating income. Public information shows that from the 2000 listing to date, Hengrui Pharmaceuticals also has only five innovative drugs, respectively, erliximab, apatinib, thiopental fexofibrate, pyrrolitinib, and injectable karelizumab.
As healthcare reform enters a deep water zone, anti-corruption in the field of medicine has become the focus of the work of the relevant departments. 2018, the National Health Commission, the National Health Insurance Bureau and other nine ministries and commissions jointly issued the "2018 Correcting the field of medicine purchasing and marketing and healthcare services in the field of unhealthy practices special governance work points," followed by the release of the provinces and municipalities of the anti-corruption documents of the medicine purchasing and marketing one after another. In June last year, the Ministry of Finance, together with the National Health Insurance Bureau, set up an inter-ministerial coordination working group to include 77 pharmaceutical companies on the audit list to carry out the quality inspection of accounting information in the pharmaceutical industry, which includes the phenomenon of pharmaceutical companies selling rebates to medical institutions or medical staff.
But in reality, many pharmaceutical companies entrust the sales promotion of their products to third-party agencies to establish risk isolation, and it is difficult for law enforcement agencies to link the sales promotion process to the illegal behavior of pharmaceutical companies, and pharmaceutical companies do not need to take responsibility. As can be seen from previous judgments, the subject of punishment for the crime of active and passive bribery in the pharmaceutical industry mainly focuses on medical personnel who have been bribed. For bribery behavior is also mostly recognized as business staff, medical representatives and other personal behavior.
The NHPA's new policy is expected to reverse this phenomenon. on April 24th, a copy of the NHPA's "Guidance on the Establishment of a Credit Evaluation System for Drug Pricing and Procurement (Draft)" circulating in the industry pointed out that the NHPA will make reasonable use of the relevant departments to combat and manage the results of law enforcement in the field of commercial bribery and market manipulation of pharmaceuticals, and adopt appropriate disciplinary measures for breach of trust through the commitment of the enterprises and the management of the contract. disciplinary measures for breach of trust. In addition, the pharmaceutical enterprises in the commitment to eliminate commercial bribery and market manipulation behavior at the same time, but also committed to the commissioning of services for the enterprise, the agent enterprise for their own drugs implementation of commercial bribery, market manipulation and other illegal acts, jointly and severally liable for price and procurement credit disciplinary responsibility.
The exposure draft made it clear that commercial bribery in the field of medicine will be held accountable to the pharmaceutical companies, pharmaceutical companies will no longer be able to use the rhetoric of the personal behavior of employees to clear their responsibilities, compliance transition will also become the new law of survival of the domestic pharmaceutical companies.
Editor in Chief | Lv Jiangtao