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Recently, the National Medical Insurance Bureau publicized the "List of Drugs Approved by the Preliminary Formal Review of the 2021 National Medical Insurance Drug Catalog Adjustment", and the deadline is August 5
Now, we will make a comparative analysis of the varieties that have passed the preliminary formal review and 2020, so as to predict the negotiations in 2021
01.
1.
The adjustment of the medical insurance catalog includes five stages: preparation, declaration, review, negotiation, and announcement of the results.
A total of 474 declared drugs have been received this year, of which 271 have passed the preliminary formal review, of which:
①160: During the period from 2016.
②13: drugs with major changes in indications or functions and indications during the period from 2016.
③6: drugs included in the "National Essential Drug List (2018 Edition)", 5 fewer than 2020;
④74 in the catalog: are exclusive negotiated drugs whose agreement will expire on December 31, 2021, and the payment standard needs to be re-determined in accordance with the agreement, 50 more than 2020
Among the 160 new generic medicines, there are 6 exclusive Chinese patent medicines, including 3 Chinese patent medicines for the prevention and treatment of new coronary pneumonia approved by the State Food and Drug Administration on March 2 this year, namely Qingfei Paidu Granules (Chinese Academy of Chinese Medical Sciences Clinical Medicine) Institute of Basic Medicine), Huashibaidu Granules (Guangdong side), Xuanfeibaidu Granules (Shandong Stepchang)
3.
There are a total of 8 PD-1/L1 drugs on the market in China (imported and 4 domestically produced), except for Roche’s T drug (atelizumab), all of which are included in this initial review list, although the previous 4 domestically produced PD- 1 All have been included in the medical insurance through the national talks with a decrease of more than 70%.
The first domestic CAR-T (Fosun Kate’s Achilles injection) with a treatment cost of over one million, the Noxinassen Sodium Injection (Bojian, for the treatment of spinal muscular atrophy) of 697,000 yuan per tube, and a wide range of The new Alzheimer's disease drug "Nine Phase One" that has received attention has all passed the formal review.
02, success rate
Beginning in 2020, the national medical insurance negotiations have been conducted once a year, and the "adjustment work plan" is basically the same.
As China’s drug regulatory authorities and the securities market continue to increase the gold content of pharmaceutical innovations, the quality of China’s newly listed drugs is also greatly improved.
03.
Decline
Since the national new drug negotiation with the purpose of volume-for-price initiated by the former National Health and Family Planning Commission in 2016, the Ministry of Human Resources and Social Security in 2017 led by the newly established National Medical Security Administration in 2018 and beyond.
Except for the lower decline in 2017, the average decline in the other several times exceeded 50%.
In 2020, 162 varieties participated in the negotiation.
Eventually 119 were successful, with an average decline of 50.
64%.
Among them, 138 new varieties were successfully negotiated.
97, an average decrease of 60%
.
Although under the background of medical insurance control fees, the pricing of newly listed products has become more rational in recent years, but under the dual influence of investors and stockholders’ pressure on commercial returns and the dual-channel policy to open up sales channels after medical insurance, this year Negotiation and bidding for new drugs will continue to be fierce
.
(Picture 4)
04, free cage for bird
In view of the affordability of the medical insurance fund, the new medical insurance fund expenditure of about 28 billion yuan per year required for the 119 medicines successfully negotiated in 2020 is made up by adjusting the structure of the medical insurance catalog itself, that is, by kicking out 29 varieties, This was achieved by renewing the contract and negotiating price reductions, increasing the medical insurance payment restrictions for some varieties, and negotiating price reductions for some large varieties in the catalog
.
Among them, the negotiations on the 14 exclusive varieties with annual sales of more than 1 billion yuan in the catalog contributed the most, with an average drop of 43.
46% (Figure 5)
.
Although a certain amount of medical insurance funds has been squeezed out through a combination of mass procurement, key monitoring and rational use of medicines, and combating fraudulent insurance and other medical insurance control fees, due to the uncertainty of the new crown epidemic, the increase in aging and the participation of new business personnel and other factors The medical insurance fund is still under pressure
.
On June 30, 2021, the “Interpretation of the 2021 National Medical Insurance Drug Catalogue Adjustment Work Plan” issued by the National Medical Insurance Administration particularly emphasized the need to insist on “there is an entry and exit, and the cage is replaced”, optimizing the structure, and improving the protection capacity.
It also indicates that the new medical insurance expenditures newly included in the medical insurance category this year will still be mainly digested by the medical insurance catalogue, and in 2020, "in the same treatment field, the price or cost is high and there is no reasonable reason for drugs" and "clinical value" The selection criteria of “inaccurate drugs that can be better replaced” will still be applied in this year’s national talks.
Special attention should be paid to the varieties that have been included in the local key monitoring and rational use of drugs.
The total amount of medical insurance expenditure that needs to be increased to be included in the medical insurance products is determined, and the income is within the limits
.
Guided by the principle of focusing on people's health and ensuring more fairness and accessibility, the annual national medical insurance negotiations will contribute to encouraging innovation in medicine, reducing the burden on patients, and improving the availability of medicines
.
