By Adam Jourdan, Kazunori Takada and Ben Hirschler of Reuters
A crackdown on corruption in China's pharmaceutical sector has hurt sales at international and local firms, with many doctors at Chinese hospitals refusing to see drug representatives for fear of being caught up in the widening scandal.
Britain's GlaxoSmithKline Plc, the group at the centre of the furore, has suffered the most. Industry insiders expect its China drug sales growth to slow sharply or even reverse in the third quarter after a 14 percent year-on-year rise in the three months to end-June.
But GSK - accused by Chinese police in July of using travel agencies as intermediaries to make illegal payments to doctors - is not alone, and a number of companies say their China sales in the second half of the year may take a substantial hit.
With the country's healthcare spending forecast to nearly triple to $1 trillion by 2020 from $357 billion in 2011, according to consulting firm McKinsey, China is a magnet for makers of medicines and medical equipment.
However, a string of investigations and visits by authorities to the China-based offices of global firms has sent a chill through the industry, prompting businesses to step up internal compliance and rein in sales teams.
Corruption in China's healthcare industry is fuelled in part by low base salaries for doctors at the country's 13,500 public hospitals, the main buyers of drugs.
"There is an awful lot of confusion out there," the chief executive of French drug maker Sanofi SA, Chris Viehbacher, told a conference in London last month.
"There was more of an impact in August and we have seen less of an impact in September, but I think you will probably find, for at least the next couple of months, turbulence in the marketplace in some sectors."
Pharmaceutical sales staff say their hospital visits had been slashed - both because sales reps are struggling to get access to doctors and because firms are playing it safe.
The cutback in promotional activities has forced a number of drug companies to scrap monthly or quarterly sales quotas.
"There's a fall in sales for sure," says a Shanghai-based sales rep at GSK, who declined to be identified because he was not authorised to speak to the media.
"Because of the current situation and rumours about peers being taken away by authorities, we're going into hospitals less and less. We're worried the same may happen to us," he says, adding the lull in work meant he was spending more time drinking tea and worrying about redundancy.
Doctors ‘reeling’
Simon Li, China general manager for healthcare information firm Kantar Health, says the probes had led to a "substantial sales decline,” especially in August.
"Multinational companies have cut back on almost all their marketing activities. Some companies have told their sales reps to stay at home or take a vacation," he says.
A former drug sales rep told Reuters that doctors who would normally see at least 10 sales staff a day had been spooked by the anti-corruption drive - a view echoed by executives at multinationals in China.
"A lot of doctors were sent reeling by this and they decided they just did not want to see anybody - but more recently, things seem to be getting a bit more back to normal," says the head of pharmaceuticals at one large drug maker, who spoke on condition of anonymity because of the sensitivity of the topic.
A distributor working with foreign drug makers in China says that while GSK products had suffered an outsize hit, anecdotal evidence suggested overall growth rates for overseas drug firms had slowed to around 8 to 10 percent from some 20 percent in 2012.
A spokesman for GSK in Britain said the firm was continuing to operate its business and supply healthcare products to patients in China.
"However, as we expected, we are seeing some impact to the business as a result of the ongoing investigation," he said, declining to give specific sales projections for the third quarter.
GSK has said some of its senior Chinese executives appeared to have broken the law after police accused it of funnelling up to three billion yuan ($490.08 million) to travel agencies to facilitate bribes to doctors to boost the sale of its medicines.
The company generated a modest 3.6 percent of its global drug sales in China last year, but sees the country as an important source of future revenue.
药企整顿潮来临
作者：路透社Adam Jourdan, Kazunori Takada , Ben Hirschler, 林琦
目前中国政府对医药行业的整顿，对国际国内制药商的销量均造成不小冲击。许多医生由于担忧被卷入不断扩大的丑闻，已经拒绝会见医药代表。
外企销量大跌
根据分析师估计，自中国当局指控英国最大医药公司葛兰素史克涉嫌行贿，阻碍了其在该国销售药品以来，这家制药商的在华销量或已下降30%。
中国警方7月指控葛兰素史克中国公司部分高层向政府官员和医生行贿，法国制药商赛诺菲、瑞士诺华等外资药厂先后被曝在中国涉行贿医师。据新华社报导，中国从8月中旬起开展为期三个月的专项治理活动，其中包括调查医药购销和医疗服务领域的商业贿赂行为。
花旗表示，葛兰素史克遭指控及其他公司接受调查之后的初步反馈显示，一些跨国药企的销量自6月以来降幅高达30%或以上。
行业内部人士对路透表示，处于风口浪尖的葛兰素史克所遭受的损失比其他同行更严重，因为很多中国医院的医生拒绝见销售人员，而且促销活动也在缩减。
此前警方指控葛兰素史克把高达30亿元人民币(4.9亿美元)的资金转至数家旅行社，以贿赂医生来刺激药品销售。该公司随后也曾表示，在华的部分高管似乎已违反法律。
花旗在一份研究报告中称，跨国制药商可能需要检视目前的销售模式，而且在非专利药上可能面临定价压力。这些跨国药企目前的销售模式为严重依赖扩大规模本已很大的销售团队。
投资医药行业需谨慎
这股整顿风潮近期也已向本土药厂蔓延，《21世纪经济报道》本周稍早报导称中国胰岛素生产商甘李药业在过去五年内向医生行贿8亿元人民币；中央电视台本周亦曝光中国生物制药控股子公司正大天晴组织医生旅游和消费，涉嫌商业贿赂。
以医疗健康为重点投资方向的贝祥投资集团旗下璞舍投资认为，现阶段，投资国内制药企业需要谨慎，风投资金会更多关注医药医疗的下游产业，例如专科医院、健康及体检等。
私募基金璞舍投资管理公司董事长双镕清在接受路透专访时预计，随着国内医药行业整顿的深入，药厂更多问题的曝光，将会导致一些药厂上市进程的延误，从而令创投投资药厂的风险加大。
“葛兰素史克事件虽然矛头先对准了外资制药企业，但这个整顿将会波及行业里的所有企业，”他说，考虑到目前政策和市场波动起伏的现状，璞舍投资在选择药厂投资项目时，将会更加注意把控投资标准，不希望冒政策风险。
他进一步指出，风投资金对药厂投资本来就有较大的挑战，国内创新药研发时间长，投入相当大，而且审批进程较难把握。而当前国家大力打击药品销售的灰色地带，清理行业潜规则，使得药厂投资的风险更大。
“若（药厂）发生（商业贿赂）这种事，证监会肯定要注意，不会不管，或会造成延迟上市的负面影响。”双镕清说。
药厂向国内医院和医师行贿已成行业内普遍现象，这与国内财政对医院系统投入不足、医生待遇偏低的现状密不可分。业内人士普遍认为，仅打击药厂的商业行贿，只能取得短期效果，国内医药医疗体系需要更深入的体制改革。
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