Price negotiations are focused on the exclusive "second bargaining" trend.

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Recently, the news that "the state will set up a drug price negotiation committee" has spread like wildfire, and will mainly conduct price negotiations for patented drugs and exclusively produced drugs.
The idea of negotiating prices for poorly competitive drugs is not new, but it has been difficult to put into practice. At the time when the National Development and Reform Commission is advancing the reform of drug price management, the country's determination to advance the price negotiation mechanism may be unprecedented. In the long run, the price negotiation mechanism is bound to be effectively implemented, but for now, there are still no obvious escort measures for the specific negotiation basis, the implementation subject, the procurement implementation after the negotiation, and the convergence of price negotiation with drug bidding and payment of benchmark price.
At the local level, in order to comply with the trend of drug price reform, the local authorities seem to have acquiesced in the exploration of "second bargaining" in drug bidding. After the removal of the highest retail guide price, the price of drugs or enterprises will be under greater pressure.
Targeting Exclusive Products
According to relevant information, the drug price negotiation committee will be led by the Medical Reform Office of the State Council and will be responsible for formulating major issues such as negotiation varieties, negotiation implementation plans, and purchase prices. The committee will have a comprehensive office and a negotiation office, which will be placed in the National Health and Family Planning Commission.
It is understood that the negotiation committee will first negotiate the price of exclusive varieties, patented varieties and related individual pricing varieties with insufficient competition in tumor drugs, cardiovascular drugs, pediatric drugs, Chinese patent drugs and other categories. In the selection of specific varieties, provinces are required to rank according to the amount of drug purchases in the previous year and report the top 20 varieties.
The Price Negotiation Committee establishes a negotiated drug price information base and determines the price ceiling based on the winning price, historical purchase price, pharmacy retail price and foreign purchase price of various local purchases.
So far, the reporter has not yet received the relevant reply from the National Health Planning Commission on the establishment of the price negotiation committee. However, the reference to price negotiations for exclusive varieties is not new.
Recently, the National Development and Reform Commission's draft of the ''Plan for Promoting Drug Price Reform'', which has attracted great attention, has clearly proposed the establishment of multi-party participation for patented drugs (including patented drugs outside the medical insurance catalog), exclusively produced proprietary Chinese medicines and other drugs with insufficient market competition. The formation mechanism of price negotiation. It is particularly noteworthy that the National Development and Reform Commission proposed to abolish the original drug prices and establish a new drug price formation mechanism. This may mean that the price treatment of the NDRC's separate pricing of chemicals and high-quality Chinese patent medicine products will be adjusted. In the middle of this year, the National Health and Family Planning Commission's "Guiding Opinions on Improving the Centralized Procurement of Drugs in Public Hospitals" also emphasized price negotiations for patented drugs, exclusively produced drugs, and products that cannot be effectively lowered by regular bidding rules.
However, in the short term, both business people and relevant experts have a more unified view that it is difficult to succeed in price negotiation of exclusive varieties under the existing system: on the one hand, most exclusive varieties do have their unique advantages in clinical practice, are academically exclusive, and have strong bargaining power in negotiation; on the other hand, the most common system of "purchasing with quantity and exchanging price with quantity" in price negotiation has not been well implemented.
In addition, if the unified negotiation is conducted at the national level, will it still be necessary to purchase drugs through centralized bidding in various places after the negotiation? Do all places need to implement volume procurement? These issues are also unresolved.
"Second bargaining" on the table?
It is worth noting that although this round of drug price adjustment is slightly hasty, the pilot policies in various places have already responded, especially the "second bargaining" of traditional Chinese medicine hospitals in drug procurement may be formally revealed by this round of reform.
The reporter observed that the current government document requirements for the actual operation of "second bargaining" have changed. For example, in document No. 64 issued by the former Ministry of Health, medical institutions shall not conduct "secondary bargaining" when purchasing and selling drugs in accordance with the contract ". However, by June 2014, the ''Guiding Opinions on Improving the Centralized Procurement of Public Hospitals (Draft for Comment) ''issued by the Department of Pharmacy of the National Health and Family Planning Commission mentioned that under the existing provincial centralized procurement, if the pilot The transaction price of the city is lower than the provincial bid-winning price, the province's hospitals must purchase at the transaction price of the pilot city. In addition, the NDRC's price reform plan also mentions the establishment of a mechanism to save procurement costs and promote hospitals to actively lower procurement prices.
UBS Securities pointed out that the implication of this content of the above-mentioned draft for comments may indicate that the government has acquiesced in the public hospital reform pilot cities to explore their own experience. If the drug price can be reduced, then the attempt of "second bargaining" is not impossible. It is worthy of the attention of manufacturers.
Pilots of "second price negotiation" have also begun in various places. In the new round of drug bidding and procurement plans in Shanghai, Fujian, Liaoning, Sichuan and other places, hospitals are encouraged to adopt the method of "implementing volume procurement and linking volume and price". Although the "second price negotiation" is not explicitly mentioned, the industry believes that there will be no difference in essence.
A person from the Shanghai bidding authority has also recently stated in public that, in principle, under the condition of ensuring quality, the pricing power of drugs will be handed over to the market, and different hospitals are allowed to have different prices.
Geng Hongwu, general consultant of Jiuzhoutong Marketing, Niu Zhenggan, vice president of China Pharmaceutical Enterprise Management Association, and other industry professionals believe that "second bargaining" has become a future bidding trend that is difficult to reverse. Among them, low-priced drug products will be the first to try. The signs of other products being included in the trial have also appeared.
Previously, the blue book on medical reform jointly written by the Graduate School of the Chinese Academy of Social Sciences and the Social Science Literature Publishing House suggested that hospitals should be allowed to "second bargaining" and the control of the price difference rate should be abolished, so that the lower the purchase price of hospitals, the more profits they will make, and there is an incentive to reduce the purchase price of drugs. This will be an effective way to reduce drug prices, which can simultaneously achieve the goals of general reduction of drug prices, increased enthusiasm of medical institutions, recovery of commercial bribery, no need to increase the financial burden, and promotion of the reform of the centralized drug bidding system.