4 7 A new wave of drug price cuts triggered by volume purchases is setting off......
On March 5, Shanghai Sunshine Pharmaceutical Procurement Network issued the "(2019) No. 16 Notice on the Price Adjustment of Some High-priced Agreed Drugs in the City Organized by the State for Centralized Procurement of Drugs" (hereinafter referred to as the "Notice"). The notice shows that a number of "4 7 belt procurement" unsuccessful varieties of enterprises actively applied for price reduction, included in the Shanghai medical insurance payment drug agreement purchase price. A number of pharmaceutical companies, including Novartis, Zhengda Tianqing, Shiyao Ouyi, Qilu Pharmaceuticals, have been on the list, of which Zhengda Tianqing's imatinib mesylate, Qilu Pharmaceuticals's gefitinib new pricing are lower than the price of the winning drug.
On March 4, Zhejiang Pharmaceutical Machinery Sunshine Procurement Platform issued a series of announcements saying that Lilly took the initiative to apply for a reduction in the price of pemetrexed disodium for injection. On the same day, Zhejiang Huahai Pharmaceutical also announced its initiative to apply for a reduction in the "4 7 belt procurement" in the winning varieties of irbesartan tablets, risperidone tablets price......
In the face of "menacing" "volume procurement", domestic and foreign pharmaceutical companies are lowering prices to keep their original market share. During the interview, the reporter found that the unsuccessful pharmaceutical companies also began to take the initiative to cut prices, hoping to seize the market outside the collection. Between attack and defense, the market is quietly changing.
The volume of procurement is also known as the two sessions of the representatives of the hot topic, the National Pharmaceutical Group Pharmaceutical Co., Ltd. chairman of the supervisory board of Cui Wei believes that 47 volume procurement may lead to the re-division of the drug market pattern. Ding Zhaoze, chairman of Huiyu Pharmaceutical, said that volume purchasing has created opportunities for enterprises to participate in competition to a certain extent, but it should learn from some British experience and should be divided according to common name varieties, and all specifications should be converted into the smallest unit for centralized purchasing.
　　price drop
"In recent years, the two words in the pharmaceutical industry can represent the main theme, namely, price reduction. A series of policies revolve around price reduction, such as the consistency evaluation of generic drugs, zero tariff on the import of anti-cancer drugs, and procurement with volume, etc." Cui Yan, chairman of the board of supervisors of Sinopharm Group Pharmaceutical Co., Ltd., revealed that after the integration of Sinopharm industry, there are more than a dozen industrial enterprises below. Almost all the things the management talked about last year and this year were 47 volume purchases. Everyone judged that this may cause the industry to reshuffle, which is a problem that will affect the overall situation of the enterprise.
It should be said that since the announcement of the 4+7 band procurement to promote the pilot, it has caused a lot of shock in the industry. Until now, the pilot cities have continued to expand, and the price of drugs has fallen by an average of about 50%. The pattern of the pharmaceutical industry and even the market share pattern of pharmaceutical companies are undergoing rapid changes.
4 7 volume procurement, in the pharmaceutical industry, is called the new medical insurance department for drug price control of the first move, December 6, 2018 announced this volume procurement pilot, that is, by 4 municipalities and 7 provincial capitals or cities with separate plans to participate.
Volume procurement is proposed on the basis of centralized procurement, which means that when bidding or negotiation is carried out in the process of centralized drug procurement, the purchase quantity should be made clear, so that enterprises can quote for specific drug quantities. This procurement method of clear procurement volume is called volume procurement, and it is also the goal that China's drug procurement has been striving to achieve for many years. Simply put, volume procurement can be understood as a large-scale "group purchase". The purchase volume is clear, and the low-priced bidder wins the bid. Volume procurement can play the role of volume for price through market-oriented bidding among enterprises, and reduce the price of purchased drugs.
4 7 The volume procurement model reveals its extraordinary "influence" in terms of rules ".
Anti-cancer drugs are among the most important innovative drug sequences and have always existed in the market as "high-priced drugs. In the list of "4+7 belt purchases" released in December 2018, AstraZeneca's gefitinib tablets (Iressa) were selected as a rare anti-cancer original research drug. The list of selected varieties in the collection shows that the price of the drug has dropped by 76%, from the original 2280 yuan/box to 547 yuan/box, and can be reimbursed by medical insurance.
In the view of the pharmaceutical industry, the 4 7 band procurement officially opened a new round of drug price reduction trend.
Nine days after the publication of the "47-band procurement" list, the Shaanxi Provincial Public Resources Trading Center issued a "Notice on Adjusting the Online Price Limit of Gefitinib Tablets", saying that according to the application of the enterprise, the online price limit of gefitinib tablets produced by Qilu Pharmaceutical (Hainan) Co., Ltd. was adjusted from 1585 yuan/box to 498 yuan/box. This price is 49 yuan lower than that of the same variety and standard gefitinib tablets selected by AstraZeneca.
On December 29, 2018, the Office of the Leading Group for the Collection of Pharmaceutical Consumables in Liaoning Province issued the ''Notice on the Implementation of 42 Drug Price Reduction Results''. Among them, Qilu Pharmaceutical's price linkage once again lowered the prices of 27 categories of drugs, and Qilu Pharmaceutical's gefitinib tablets It also dropped from 1562.6 yuan/box to 498 yuan/box, a decrease of 68%. It is also the largest drop in the 42 price-cutting drugs.
According to incomplete statistics from reporters, Qilu Pharmaceutical's gefitinib tablets have successively reduced prices in Shandong, Jilin, Zhejiang, Heilongjiang, Beijing, Shaanxi and other places.
4+7 belt quantity purchase, the first batch of 25 winning varieties, an average decrease of 52%, the highest reached 96%. Most of the Chinese medicines did not win the bid when purchasing the 4+7 belt in Shanghai, because some original medicines were involved and the price was too low to cover the cost.
As far as Cui Yan's expression is concerned, in this 4 7-band procurement, people who did not win the bid or abandoned the bid did not see how unhappy they were, but there was always a worry, that is, the product could not enter the hospital, the entry voucher was gone, what to do in the future? And the winning bid did not have much joy, because the price dropped very low, and they were also worried about the future profitability.
Cui believes that the relevant departments should pay attention to the living conditions and living space of pharmaceutical companies, including profit space. At present, the unified view of the domestic pharmaceutical industry is to make innovative drugs and original drugs, which all need money. If after this round of pilot procurement, pharmaceutical companies have been squeezed to varying degrees in terms of profitability, how much room do they have for innovative drugs?
According to many people such as Sinopharm, Shiyao and Hengrui Pharmaceuticals, if the 47-band procurement is too much for the profit margin, then with the withdrawal of some products from bidding, China's pharmaceutical market pattern will have a major change. As a result, China's pharmaceutical industry will also usher in the situation that some pharmaceutical companies are difficult to survive or even close down, and the industry will enter a reshuffle period.
Cui Yan suggested that the relevant departments should pay close attention to this situation. Because the introduction of a policy, first of all, you should pay attention to the whole process before, during and after the event. It is best to make a summary at the end of the first round of the 47-band procurement pilot, evaluate the gains and losses, and then steadily promote it.
　　Recommendations
Ding Zhao, chairman of Huiyu Pharmaceutical, believes that to a certain extent, 47 volume procurement also has positive factors, providing opportunities for some enterprises to get started.
Take Huiyu Pharmaceutical as an example. The company has only been established for more than 8 years. The first drug was sold in the UK through volume procurement. Perhaps for this reason, Ding Zhao's knowledge, understanding and views on volume procurement are a minority.
Ding Zhao believes that Huiyu Pharmaceuticals is the beneficiary in terms of volume procurement. If there is no centralized procurement, although the drugs meet international quality standards and have passed the consistency evaluation, it may be difficult to enter a hospital, especially a large hospital. The arrival of centralized procurement, for enterprises like Huiyu Pharmaceutical, gives them the opportunity to participate in market competition in China.
Ding Zhao believes that centralized procurement to 47-band procurement is also a good thing for China as a whole. There is no doubt that centralized procurement will definitely reduce drug prices, eliminate some unreasonable intermediate links, and save medical insurance funds for the country. The developed countries in Europe and the United States also operate in this way, but each country does it in different specific forms.
According to Ding Zhao, the United States is through PDM, Germany is through commercial insurance, and the United Kingdom is the most thorough country in the world to do volume procurement, its benefits are obvious.
For example, in the UK, the volume of procurement is divided into six regions, each region 100 per cent of the winning bid, compared with 4+7,60 to 70 per cent of the winning bid in the country. The UK also stipulates that a company's maximum market share cannot exceed 70%. In other words, a company in the UK can be in three to four regions at most. The advantage of this is to ensure the stability of drug supply for many companies. If an enterprise is unable to supply for special reasons, there are other enterprises to replace it. But the single indicator for the winning bidder is 100 percent of the winning bid.
A common situation is that no matter the United Kingdom, the United States, or China, in the face of future uncertainty, companies take the initiative to lower their posture and seize the market as the first element.
From a domestic point of view, for the enterprises that have won the bid in the "4+7 belt procurement", 11 cities will hand over 70% of the market share of the annual drug consumption to the exclusive bid winning enterprises. According to the data, the total amount of drug use in these 11 cities accounts for about 30% of the national share. How to actively seize the remaining 70% of the national market at the price of quantity purchase may become the focus of the next work.
A few days ago, Huahai Pharmaceutical announced in Zhejiang that it had voluntarily applied for a reduction in the prices of irbesartan tablets and risperidone tablets, which was exactly the winning variety of Huahai Pharmaceutical in the "47-band procurement. Take Irbesartan tablets as an example, Sanofi was the original research manufacturer and then entered the Chinese market. Domestic manufacturers mainly include Zhengda Tianqing, Hengrui Pharmaceutical, Beijing Haiyan Pharmaceutical Co., Ltd., Huahai Pharmaceutical, Guangdong Zhuhai Rundu Pharmaceutical Co., Ltd.
In terms of market share, data from the China Pharmaceutical Industry Information Center Drug Comprehensive Database (PDB) show that Sanofi's products occupy most of the domestic market share, and Hengrui Pharmaceutical's products are also highly competitive in China. Although Huahai Pharmaceutical won the bid in the "4 7 volume procurement", it is only part of the market after all. In the case of low market share, it can quickly link the whole country with the price of centralized procurement, which may form a competitive advantage for it.
And a detailed study of the motivation of enterprises to take the initiative to reduce prices, but also attributed to the policy drive. The National Medical Insurance Administration issued the "Opinions of the National Medical Security Administration on the National Organization of Centralized Drug Procurement and Use of Pilot Medical Insurance Supporting Measures" (hereinafter referred to as the "Opinions") on March 5, showing that the selected price in the "4 7" centralized procurement will be used as the medical insurance payment standard., And made price adjustment requirements for the prices of drugs that were not selected in the bidding, encouraging non-selected companies to actively reduce prices and converge to payment standards.
The Opinions also stipulate that if the bottom price of non-selected drugs in 2018 is more than 2 times the selected price, the payment standard shall be reduced by not less than 30% according to the original price in 2019, and the payment standard shall be adjusted to the selected drug price in 2020 or 2021. If the price of non-selected drugs at the end of 2018 is less than 2 times (including 2 times) the selected price and the selected price, the selected price shall be the payment standard in principle.
In the price reduction list published by Shanghai Sunshine Pharmaceutical Purchasing Network, the products of Zhengda Tianqing and Shiyao Group are all varieties that have not passed the consistency evaluation. According to the "Opinions", in the bidding for drug collection, no transition period is set for varieties that have not passed the consistency evaluation of generic drugs under the same generic name, and the payment standard in 2019 is required not to be higher than the price of the selected drugs.
"If the above-mentioned medical insurance supporting measures are followed up when the second batch of 47-band procurement pilots are pushed forward, then it will become a general trend for enterprises to actively reduce prices." A senior member of Haizheng Pharmaceuticals believes.
"The current Chinese pharmaceutical industry has entered the most difficult period of development in history. Enterprises are under internal and external pressure, on the one hand, Sino-US trade friction intensified. The internationalization of Chinese medicine is blocked. On the other hand, the domestic industry market supervision and policies, especially the 4 7 procurement policies, have not been well connected. Enterprises are facing the pressure of survival, which is not conducive to increasing investment in innovation and the healthy development of the industry. The state should carry out top-level design and build a policy environment for the sustainable and healthy development of the pharmaceutical industry." Yu Shengchen, president of Beijing Yuekang Pharmaceutical Group Co., Ltd., said that support should be given during the bidding process to encourage everyone to actively improve the quality of commonly used common drugs. The quality has improved and the price has to be appropriate. Some effective, safe and reliable drugs, hope to give support in health insurance.