The table has detailed promotional expense inquiry details: the total amount reported in this order, the time of use of the activity, detailed remarks, approval level and so on. Here mainly shows the promotion cost details of some salesmen in Fujian Province.
Through the reporting material, we see that the promotion fee involved in some hospitals are:
Sponsored for the hospital affiliated with Putian College of non-cardiac surgery anesthesia branch meeting 1911.75 yuan.
For Xianyou County Hospital department to use hydromorphone send director and teacher tea 1500 yuan.
Putian hospital department small gathering 719 yuan.
Putian College Hospital Physicians Association spending 2189 yuan.
Putian Hospital academic 993 yuan.
Purchasing anesthesia materials for Putian College Hospital $688.
For Putian hospital department teacher children to take art photos 800 yuan.
Putian College Hospital after communicating with the answer to the director of Xie Xie to collect cases of cesarean section measurement increased by 1000 yuan.
To Putian Hanjiang District Hospital Huang director to buy cigarettes 1600 yuan
To Xianyou Boai Hospital drug kickbacks 1600 yuan.
Putian hospital dinner 1289 yuan.
In addition to this, the explosive material contains a breakdown of the promotional expenses of a businessman from February 2017-March 2017. The businessman's promotional expenses for one person were $34,500 a month.
From the explosive materials, we see that the company's salesmen, in order to promote product sales, from invitations to dinners, sponsorship activities to drug rebates, and constantly give kickbacks to hospital departments and directors for commercial bribery. We divided the destination of the promotion expenses into three categories, we can see that treats and gifts, academic appreciation and drug rebates are the main spending items:
From the amount of money, category B promotion expenses, each between 500 yuan to 3100 yuan, which more than 2,000 yuan of promotion expenses are as follows:
Category A promotion expenses single amount of 3,000, 5,000, or even tens of thousands of dollars. For example:
Screenshots of the above information are from Renfu's ERP system, and some screenshots of Renfu's WeChat manager group and workgroups from September 2017 to February 2018 were also disclosed. Inside the screenshots, it is seen that Renfu's business staff have to go to the group every day to report the day's work content with the leaders and ask the leaders to check it.
Based on the screenshots of the daily work content, it can be seen:
Hospitals ask for rebates, rebates are prioritized. "Visited the People's Hospital Purchasing, Purchasing said that the hospital is currently in contact with the various manufacturers of poisonous marijuana to request rebates, rebates will be prioritized. Learned that the State Drug Ruifen has talked to them about rebates. ......"
Under the strict investigation of the Disciplinary Commission, Renfrew asked each manager to clear sensitive information, destroy sensitive materials, delete the work group. Necessary work was replaced by home visits and appointments to do work. "Because of Quanzhou area part of the customer (pharmacy section, equipment section, dean ...) one after another Discipline Inspection Commission people check, implicated in the hospital, the first to do the following requirements: First, the regional manager ... speak of all personnel computers and mobile storage devices, especially cell phones unintentionally downloaded files, by the township of the sensitive information clear, sensitive Information destruction and report to me by phone. Second, all over the work group deleted... Third, Quanzhou Zhangzhou area, pay particular attention to... need to do the work of carrying out home visits or through acquaintances about to come out to do the work! Received please reply!"
People's Republic of China account manager's daily work content: customer service maintenance, follow up the hospital medication records. "Visit Deputy Director Lin, send tea to thank for support in painless gastroenteroscopy work. Night visit to affiliated anesthesiology department z teacher, shoot anesthesia record sheet, send fruit." "Director X of the hospital anesthesiology department, previously promised to make up for his class A section will be made up for him in other forms, he said that he understands and agrees to follow up the promotion of nalbuphine, he said that by the opportunity to go back to talk to the procurement as much as possible to fight for." "Purchase the hospital department end of the year appreciation of the buffet coupon, and then visit director Zhang, give the meal coupon, and told him that today into the 200 bottles of Ruijie, he said that recently are by the support of the use of the matter of the Pharmacy Council mentioned..."
Through academic appreciation and so on, let the pharmacy department to help on the quantity. "Visited the hospital pharmacy department director Liu Jinfa, in director Liu's side of the check Shu Fen Ruifen inventory, simple communication director Liu said that this amount of February is certainly enough, let me rest assured." "Visited the director of the pharmacy department of the maternity hospital Zhang, academic support, last month into the 300 nalbuphine..."
Learn about drug replacement. "Communicate the replacement of midazolam in Hanjiang District Hospital, the specifications are the same manufacturer is different, directly replaced with ours." "Now Kephan are kicked out, do not intend to use, the current analgesic products are our Ruifen, Shufen and nalbuphine."
(Kefen is Beijing Tide's flurbiprofen ester injection, which won the bidding in last year's expanded surface collection, with a winning price of 21.88 yuan (50mg/5ml))
Renfu anesthesia products
According to the exposed material, we see that it mainly involves the following products below Yichang Renfu:
All along, the government has been on the fentanyl-type anesthesia drugs The government has been extremely strict in regulating fentanyl-based narcotics, controlling the number of API producers to one or two, and the number of preparation producers to one or three.
Yichang Renfu Pharmaceutical realized sales revenue of about 1.8 billion yuan from anesthesia drugs in the first half of 2019, an increase of about 24% from the same period of the previous year. Its anesthesia products include anesthetics (sufentanil, remifentanil), painkillers (fentanyl, nalbuphine, hydromorphone), anesthesia sedatives (midazolam), fentanyl is squeezed by dizocin, sales revenue declined, nalbuphine, hydromorphone is a controlled drug, the market capacity is limited, midazolam market is dominated by Envac, sufentanil, remifentanil 2 anesthetics to become the main force of the company's performance growth.
According to data from MiNe.com, among the TOP20 manufacturers of terminal anesthetics in China's public healthcare institutions in 2018, Renfo Pharmaceuticals took the top spot with a market share of 18.90%.In the sales pattern of terminal anesthetics manufacturers in public hospitals in key provinces and cities in the first three quarters of 2019, the TOP5 companies had a combined market share of 66.43%, with Yichang Renfo Pharmaceuticals with 24.93% of the market share led, Shanghai Hengrui, Jiangsu Enhua two local enterprises ranked third and fifth respectively.
Absolute leader in fentanyl market
Renfo Pharma's business includes three major categories: pharmaceuticals, medical devices and condoms. Pharmaceuticals are still the company's main source of profit, and Renfo Pharmaceuticals is the leading company engaged in the production of fentanyl-based products in China, maintaining a very high market share.
Fentanyl, chemically known as N-[l-(2-phenylethyl)-4-piperidinyl]-N-phenylpropionamide, is a synthetic opioid painkiller with strong narcotic analgesic effects, mainly used in medical anesthesia. Fentanyl's contribution to medical care is extremely large, it can inhibit surgery, gynecology and other surgical procedures before, during and after the analgesia, as well as for large-scale drug exchange and minor surgery, etc., but also with anesthesia drugs, and haloperidol to make a "Valium analgesic".
Yichang Renfu, a 67%-owned subsidiary of Renfu Medicine, has become Asia's largest R&D and production base for narcotic drugs, and is also the general distributor of narcotic drugs and Class I psychotropic substances in China, with its main products including fentanyl citrate injection, sufentanil citrate injection, remifentanil hydrochloride for injection, and raw materials (collectively known as "fentanyl series products"). Its anesthesia products have a national market share of 60%, and since 2017, Renfo's "Fentanyl" has generated an annual net profit of RMB 600-700 million. In 2017, China's key hospital analgesics top ten sales drug statistics show that fentanyl-based drugs sales varieties accounted for more than 60%
Injectable remifentanil hydrochloride preparations, for example, according to the State Drug Administration website, there are only three domestic enterprises listed for sale injectable remifentanil hydrochloride. The drug's sales in China's three major terminal public hospitals in cities, counties and townships amounted to about CNY600 million in 2017, of which Yichang Renfu's market share was about 87%, according to Renfu Pharmaceuticals, citing data from Mine.com. Renfo Pharma sold 37,570,900 units of fentanyl citrate injection, 35,044,400 units of sufentanil citrate injection and 13,283,900 units of remifentanil hydrochloride for injection in 2017***, the annual report showed.
RenfoPharma is now the absolute leader of fentanyl in China. Under the high level of government regulation, the barriers to entry and technology are also quite high, but Renfo is expected to continue to maintain its oligopoly position in the future.
The recent revelation that Insys Therapeutics, a U.S. manufacturer of fentanyl painkillers, has been heavily fined by U.S. regulators to the point of bankruptcy for allegedly bribing doctors by paying them undue benefits to overprescribe such products, and that the chairman of the board of directors and executives have been criminally prosecuted and should be serving time, seems to be a worldwide problem! (Dr.2 has previously analyzed this in detail: "What will happen to drug companies that use kickback marketing to defraud Medicare in the U.S.?")
There is another serious issue, the company's ERP system openly records these absolutely non-compliant things, including inviting the department to dinner, paying for art photos of the department director's children, sending high-grade cigarettes, wine and tea to the people concerned, and even cashing in fees, so in other words, it is the company's management is aware of and allowed, and approved, and even pushed, and you can no longer push this onto the salesman, saying it is their personal behavior. You can no longer put this on the salesmen, saying that it is their personal behavior, and it is simply not possible to prove their innocence! So now that the story has broken, the regulators shouldn't play deaf and dumb and assume nothing happened, even though they knew that the whole company was violating the law and using commercial bribery to boost sales!
Also, the ERP system records things that are out of sight, but the corporate dilemma is that not recording and approving may lead to malicious reimbursement by the salesman, but recording and approving will leave a permanent chain of evidence of non-compliance! At the same time the company used to pay these expenses, it is obviously not possible to account for this chain of evidence and invoices, so what is the chain of evidence that these invoices are accounted for? Clearly money laundering and financial fraud is involved!
Including a number of drug companies to launder money to the mobile medical company, water hundreds of millions of dollars, a group of two persecution investors think that grasp the true meaning of the flock, even including BAT, do not know how to due diligence money laundering? A large number of materials have been summarized in my place, but they are because of the huge financing after betting, only money laundering more and more powerful, but also leave more and more permanent non-compliance chain of evidence, and then more and more drug companies to participate in, followed by a chain of mine may be!
No matter what the original intention of the company's internal staff of the revelations, is to vent personal anger or with the company stalemate, but this is two things with this content, a company an industry can not always rely on subterfuge smooth world, sooner or later there will be such a day, because wherever you go through, must leave traces!