Can the new round of health care negotiations achieve remarkable results without any discount?

On November 28, the State Health Insurance Bureau officially released the list of medical insurance negotiation access in 2019, including 70 new drugs, with an average price drop of 60.7%; 27 renewal drugs, with an average price drop of 26.4% On the same day, the state health insurance bureau and the Ministry of human resources and social security issued the notice on the inclusion of negotiated drugs in 2019 into the category B scope of the national directory of drugs for basic medical insurance, work injury insurance and maternity insurance (hereinafter referred to as the notice), which clearly unified the payment standards of 97 negotiated drugs In fact, at present, relevant government departments have pushed forward a series of reform measures around drug prices, including the consistency evaluation of generic drugs, volume procurement, etc In this situation, pharmaceutical enterprises can survive and have a future only if they continue to innovate, increase R & D investment and develop new products with real clinical value At the same time, only with cost advantage, can we extend the product life cycle It is understood that there are 2709 drugs included in the catalogue of drugs for national basic medical insurance, work injury insurance and maternity insurance in 2019 Compared with the 2017 version, 218 drugs were transferred in, 154 drugs were transferred out and 64 drugs were increased net In 2019, the medical insurance access negotiation is the largest one since the establishment of the National Medical Insurance Bureau Tan Ruizheng, a special observer of this newspaper and CEO of Parkson (Guangzhou) Biological Products Co., Ltd., highly affirmed the negotiation results He said that the success of the drug price negotiation will bring win-win results to medical insurance, pharmaceutical companies and patients First of all, the structure of medical insurance catalog is optimized In recent years, most of the successful drugs are new drugs with high clinical value, involving more than 10 clinical treatment fields such as cancer, rare diseases, hepatitis, diabetes and so on From the perspective of key areas, all five essential drugs were negotiated successfully, 22 anticancer drugs, 7 drugs for rare diseases, 14 drugs for chronic diseases (including diabetes, hepatitis B, rheumatoid arthritis, etc.) and 4 drugs for children were negotiated successfully Secondly, the burden of medication was reduced In this negotiation, the medical insurance department played the role of "strategic buyer" and pushed the drug price down sharply through the strategy of "price for quantity" Many world-famous "noble drugs" issued "civilian price", and the imported drugs basically gave the global lowest price, so that patients could use "noble drugs" In addition, it increased the sales of pharmaceutical enterprises The sales volume of drugs entering the medical insurance catalogue will be greatly increased, which has a great driving role in achieving the overall goal of profit Lu Chuanyong, general manager of Wuhan Harui Pharmaceutical Co., Ltd., also said that in accordance with the requirements of doing as best as you can, the negotiation established the adjustment ideas of highlighting the key points, making up the shortcomings, optimizing the structure and encouraging innovation The products included in the b-category list of medical insurance included in the negotiation are clinically necessary, safe and effective, reasonable price and other access conditions In the development direction of the pharmaceutical industry, it is of great significance to leverage the medical insurance negotiation to enter the medical insurance catalog, to leverage and stimulate drug innovation, to let more life-saving drugs enter the medical insurance, and to improve the drug security capacity of China in major diseases and important fields The negotiation method of the national health insurance bureau is to determine the expected price paid by the medical insurance first, and the enterprise will quote twice, and those who both exceed the expected price by 15% will be out Lu Chuanyong pointed out that at the beginning of the negotiation, the expected decline was confirmed and enterprises were induced to offer the most sincere price, which was conducive to achieving the expected effect Tan Ruizheng also believes that this negotiation mode reflects the wisdom of the medical insurance bureau If the quoted price of pharmaceutical enterprises exceeds 15% of the expected price twice, it is reasonable to eliminate them on the basis of coordinating the payment ability of medical insurance and the economic affordability of patients If the pharmaceutical companies adhere to their previous pricing, it is bound to limit the market capacity Of course, the upper limit given by the health insurance bureau, with its strong performance, is more about the economic value of drugs What's more, most of the drugs successfully negotiated in this negotiation are newly marketed drugs with high clinical value in recent years, many of which are newly marketed in 2018 Prior to that, the state has issued policies such as the work procedures for breakthrough therapeutic drugs and the work procedures for priority review and approval, encouraging innovative drugs to apply for review and listing in China, and stimulating domestic enterprises to develop more new drugs driven by clinical needs With the support of all kinds of policies, Lu Chuanyong believes that the pattern of "focusing on imitation" will be broken In the past, generic drugs adopted the marketing mode of "high pricing, high cost and high gross profit" similar to innovative drugs, and began to end This health care negotiation will first include the newly listed drugs with clear curative effect, which will further enlarge the marginal effect of medical insurance access and let more innovative drugs enter the market According to their own advantages and product structure characteristics, generic pharmaceutical enterprises should actively carry out consistency evaluation and compete with the original drugs The global drug market includes innovative drugs and generic drugs, and its core driving force lies in the continuous investment of innovation, Mr Tan said The renewal and iteration of innovative drugs directly drive the growth of drug market, and the development of generic drugs largely comes from the second expansion after the expiration of the patent protection of innovative drugs Because of the "large investment, high risk and long cycle" of new drug research and development, most of the domestic pharmaceutical enterprises are imitation enterprises With the continuous deepening of the medical reform, the new medical reform and drug policy are constantly launched, which makes the pharmaceutical environment of our country gradually connect with the international market The winning logic of the pharmaceutical industry has changed greatly, and innovation has become the core driving force of the domestic drug market Enterprises must comply with the changing trend of the industry, increase R & D investment, and maintain high-quality sustainable growth by building a perfect product echelon under research Without cost-effective innovative products, it is bound to be eliminated by the market, and the transformation of generic pharmaceutical enterprises is imperative The notice made it clear that the payment standards for 97 negotiated drugs should be unified and included in the category B scope of the catalogue of drugs for national basic medical insurance, work injury insurance and maternity insurance Both of the above experts pointed out that the drugs in the negotiation were included in category B of the medical insurance catalogue, mainly considering the balance between the payment of medical insurance funds and the payment of patients Class a drugs refer to 100% reimbursed drugs, class B drugs refer to drugs that need to pay a certain proportion by themselves first, and the rest belong to the scope of medical insurance payment At present, the guarantee ability of basic medical insurance in China is still limited Although the price of class B drugs has been greatly reduced after negotiation, the overall price level of class B drugs is still higher than that of class a drugs, which is fully paid by the fund, which has a great pressure on the fund, so patients need to share a part of the cost Lu Chuanyong also said that when the negotiated drugs for medical insurance are included in the category B reimbursement scope, it will bring benefits to patients and related enterprises In terms of the implementation policy of this medical insurance catalog, it is mainly to exchange price for quantity After being shortlisted for medical insurance, it can quickly cover the clinical market and promote the overall sales growth obviously With the implementation effect of the policy appearing, the generic drug marketing is weakened, which is conducive to further saving the marketing cost of enterprises, enlarging the dividend of shortlisted medical insurance catalog and the advantage of future volume purchase After the negotiated drugs of medical insurance are included in the category B reimbursement scope, can they be truly implemented in medical institutions, so that patients can enjoy dividends, and relevant pharmaceutical enterprises can get tangible returns after making profits? Tan Ruizheng said that through various measures such as improving the treatment guarantee, optimizing the payment method, simplifying the medication process, and improving the medical insurance service, he actively promoted the implementation of the national drug negotiation results as soon as possible, worked hard to get through the "last kilometer" of the negotiated drugs, and tried to make the dividends of the national medical insurance policy come true in the shortest time, so that the insured patients can buy, use, and reimbursed Let the active participation of enterprises get the expected results, and truly achieve win-win results In this negotiation, 97 unified national payment standards for drugs were determined During the validity period, if a generic drug (generic drug) is listed, the medical insurance department will adjust the payment standard of the drug according to the price level of generic drug, and may also include the generic name in the scope of centralized procurement The unification of medical insurance payment standard has been put forward in the industry for many years, but it has been stranded for various reasons Lu Chuanyong said that the difficulty of unifying the medical insurance payment standard is due to institutional reasons Before the medical insurance bureau carried out the national procurement and negotiation, the historical bidding policy kept the "super national treatment" of the original research drugs There was a large difference in the bid winning price of the same generic name, the same dosage form, the same specification of the original research drugs and generic drugs, so the unified medical insurance payment standard could not be adopted So, what are the main impacts on pharmaceutical companies after the unified medical insurance payment standard? Lu Chuanyong said that after unifying the payment standard of medical insurance and the same product and the same price, what we spell is brand and marketing The same payment standard is higher than the payment standard, and patients who are sensitive to price will choose generic drugs Patients who value brand more may choose the original research drugs at their own expense Both options make sense, leaving the patient to decide Therefore, the marketing of pharmaceutical companies is not unnecessary In addition to price competition, they need to invest resources to make efforts on the brand At the same time, Tan Ruizheng also reminded that the unified payment standard is good for pharmaceutical enterprises Don't delay the implementation of the standard because of the landing problem, and realize the expansion of sales volume as soon as possible In recent years, various departments of the state have launched a series of policies around drug prices, including the implementation of generic drug consistency evaluation, promotion of drug centralized bidding and purchase, the introduction of large amount of drugs into key monitoring, and the negotiation of medical insurance price of innovative drugs Moreover, it can be predicted that there will continue to be policies on reducing drug prices in the future In such a policy environment, only by improving quality and efficiency, reducing costs, can pharmaceutical enterprises last forever Lu Chuanyong said, first of all, manufacturers need to strengthen the research and development value, quality standardization of generic drugs, and the research and development orientation of pharmaceutical enterprises should focus on clinical value, and the original pursuit of exclusive dosage forms and specifications will lose significance As the volume purchase can make new products quickly and massively, but it can also be replaced by better varieties more quickly, which requires enterprises to have the ability to continuously push through the old and bring forth the new Secondly, enterprises need to strengthen the value of cost advantage Under the mode of volume purchase, the price of drugs will decline significantly after being continuously impacted by the latecomers Enterprises with cost advantages due to the factors of low cost and high operating efficiency of API will have obvious advantages, such as the integration of "API + Preparation" enterprises will have more competitive advantages.