A new round of health care negotiations has come to adjust the direction of the forecast.

On the 17th, the State Health Insurance Administration issued two announcements, the 2020 National Health Insurance Drug Catalog Adjustment Work Programme and the 2020 National Health Insurance Drug Catalog Adjustment Reporting Guidelines, marking the official opening of the 2020 National Health Insurance Drug Negotiations.
In order to reduce the burden on patients, through negotiations, so that drug prices down and then paid by health insurance, this volume-for-price approach than the previous simple administrative price reduction, has indeed been praised by all parties, and achieved tangible results, from 2016 onwards, held once a year, has been held four times in a row.
This paper will make a comprehensive comparative analysis of the first four country talks from the four aspects of success rate, proportion of Chinese and foreign varieties, price reduction range and beneficiary enterprises, and provide reference for dealing with the upcoming 2020 national talks.
, the success rate of 2016's first state talks led by the former National Health and Planning Commission, a total of 5 varieties to participate in the final success of 3, the success rate of 60%.
2017 to match the adjustment of the health-care catalog, the higher price of 44 drugs out of the centralized negotiations, the final 36 success, the success rate increased to 82%.
May 2018 1 import of anti-cancer drugs to implement zero tariffs, the Prime Minister for "I am not a drug god" to give instructions, in this vigorously improve the drug especially anti-cancer drug access, in the context of the anti-cancer drugs on October 10 of that year, a total of 18 anti-cancer drugs to participate in the negotiations, the final 17 success rate reached an unprecedented 94.4%.
is still in line with the adjustment of the large catalogue, more varieties will be included in the national talks in 2019, a total of 119 varieties to participate in the negotiations, the final 70 success rate of 58.8% (Figure 1).
's success rate has been increasing because the successful varieties of negotiations have indeed achieved a significant increase in sales, enterprises have benefited, enterprises from wait-and-see to active participation - it is estimated that in 2020 the participation of state-to-state talks enterprises will be higher, the success rate will be very high.
Take AstraZenecom's Fluvis Group, which negotiated successfully in the second in 2017, as the country's varieties only gradually landed in the second half of the year, so its overall sales growth rate in 2017 was only 70%, but the growth rate in the fourth quarter of 2017 was up by 121%, and in the first and second quarters of 2018 it was as high as 182% and 210%, with companies negotiating through health insurance to achieve price-for-price effects (Figure 2).
. Sino-foreign proportion of health insurance negotiations for patients to reduce the burden, but also to encourage pharmaceutical innovation, and China's pharmaceutical innovation is still in its infancy, so in the past national talks, imported varieties into a lot.
in the first state talks in 2016, in addition to Beda Pharmaceuticals' hydrochloric acid ektini (Kemina), Fumaric acid novovedimate (Verid, GSK) and Gfeitini (Iresha, AZ) Are imported, 2017 negotiations successfully 36 varieties, 17 domestic, 19 foreign enterprises, domestic accounted for 47%, 2018 anti-cancer drug talks successful 17, only 2 seats, only 12%.
In recent years, the domestic set off the climax of pharmaceutical innovation, but also achieved significant results, many local pharmaceutical companies approved new drugs, so in the fourth national talks in 2019, domestic drugs performed well; Three (of which 8 belong to major national special projects), 37 imports, the proportion of domestic production as high as 47%, of course, in the 37 domestic including 18 Chinese medicine (Figure 3), but from the national talks can also feel the pace of China's pharmaceutical innovation and amazing achievements.
the domestic pharmaceutical innovation environment is improving day by day, the results of pharmaceutical innovation is rapid progress, so, the upcoming 2020 national talks, there will be more successful negotiations on new domestic drugs.
, one of the main purposes of the price reduction negotiations is to bring down the price, so the price reduction range of each negotiation has also become the most intuitive measure of the outcome of the negotiations.
first state talks in 2016 led to a nearly two-thirds drop in drug prices (an average drop of 59 per cent) and, invisibly, set a benchmark for the subsequent decline in negotiations, with several subsequent declines largely expected to fluctuate slightly around this decline; Forty-four per cent in 17 years and 56.7 per cent in 2018, the average decline of 70 new negotiated varieties in 2019 was 60.7 per cent, almost the same as in 2016 (Figure 4).
it remains to be seen whether this year's decline in state talks will also be around 60%.
4. Who is the winner take the 2019 state talks as an example, a total of 22 local enterprises 24 varieties of successful negotiations, including Hengrui's Malay acid pyridoxine tablets, thiopei non-gsium injections, apatini tablets and other 3 varieties of success, become the largest winner of local enterprises.
The foreign companies that benefited the most from the 2019 talks were Novarchi, with nine varieties successfully negotiated, seven of which were new and two successful in renewal, followed by Roche with eight (including three renewals), Johnson and Johnson with seven, Gilead with six (including two renewals), and AZ5 (including one for renewal) (Figure 5).
's upcoming 2020 National Health Care Drug Negotiations, which will cover a wider range of new, cost-effective drugs, will indeed improve drug access, encourage innovation, and significantly reduce the financial burden on patients.
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