Does "4 + 7" price selection change the pattern of Fujian?

Medical network, March 13 Sanming had the experience and foundation of "volume for price" before, and it is also the star city of medical reform The landing of 4 + 7 price may, to some extent, open the prelude of "4 + 7" linkage ▍ 4 + 7 price, linkage Sanming Recently, the official account of Sanming medical insurance, sponsored by the Sanming City medical security administration and the municipal medical insurance fund management center, announced that the results of the "centralized purchasing of 4+7" in the state organization began to fall in Sanming According to the news, on February 25, clopidogrel bisulfate tablets (trade name: Taijia) produced by Shenzhen xinlitai Pharmaceutical Co., Ltd officially entered the Sanming alliance pharmaceutical machinery joint price limit purchase catalogue with the "4 + 7" winning price, becoming the first "4 + 7" winning variety in Sanming City It is understood that the supply price of clopidogrel bisulfate tablets is 22.26 yuan / box (75mg * 7 tablets) and 26.40 yuan / box (25mg * 20 tablets), which is expected to save nearly 7 million yuan of drug costs in one year In addition, Sanming medical security administration will further improve relevant supporting measures and continue to promote the implementation of other "4 + 7" selected varieties in Sanming City As the first batch of comprehensive medical reform pilot areas established in Fujian Province, a large number of medical reform samples have emerged, and Sanming City, as one of the star cities, is widely concerned by the outside world Sanming medical reform has also been focused on drug prices, for example, on the basis of provincial bidding procurement, it adopts the unified price limit procurement of the whole city, and strictly implements the "one product, two regulations", "two ticket system" and "president responsibility system of drug procurement" It is reported that, in the end, the purchase price of 69 kinds of drugs was lower than the provincial bidding price by more than 50%, among which the drug with the largest decline was reduced from 256 yuan to 7.8 yuan In addition, Sanming explored cross regional joint price Limited procurement, and "price for quantity" in the form of joint packaging and volume reporting: Sanming City established the "Sanming alliance", whose members are distributed in 14 provinces, covering 21 prefecture level cities, 31 counties, and the population of cities and counties is 101.32 million For a long time, when the relevant departments encourage the non central selection regions to collect 4 + 7 central selection prices, they all emphasize the importance of "linkage between mode and price" Before that, online transfer Fujian Province organized and held a symposium to follow up the national centralized purchase and use work It was necessary to take 60% of annual drug consumption as the purchase volume, so that the 4 + 7 winning products would be preferentially purchased online, and to a certain extent, it realized the requirement of "with the volume, the price can be linked" Sanming had the experience and foundation of "volume for price" before, and it is also the star city of medical reform The landing of 4 + 7 price may have opened the prelude of "4 + 7" linkage to some extent ▍ the original research is more favored by hospitals, do you want to change the pattern of Fujian? In the first ten days of each month, Fujian will publish the top 20 list of drug sales last month For a long time, foreign original research drugs firmly occupy the majority of the list According to the observation of Cyprian blue, in the whole year of 2018, Pfizer's cefoperazone sodium and Sulbactam Sodium for injection and atorvastatin calcium firmly occupied the first place, among which, cefoperazone sodium and Sulbactam Sodium for injection were the first in March, and atorvastatin calcium was the first in the rest 11 months The data company sorted out the top 20 drugs purchased from January to August through Qiwei wukangce, and imported over half of the original research drugs, accounting for 70% of the total The ranking of other domestic drugs is lower and the fluctuation is relatively large Only Lepu's clopidogrel bisulfate tablets basically remain in the top 10, which is superior to the original product of Sanofi, Plavix From the above, hospitals in Fujian prefer foreign-funded original research drugs And will Fujian's linkage belt purchase have a certain impact on the existing pattern? According to the selection results of the 4 + 7 Band purchase, atorvastatin calcium tablets, amlodipine besylate tablets, clopidogrel bisulfate tablets, imatinib mesylate tablets and other varieties are regular customers in the top 20 sales list of Fujian Province Taking atorvastatin calcium tablets as an example, according to the data of minenet, the market scale of atorvastatin calcium tablets in China is nearly 11.9 billion, and the growth rate slows down (photo source: minenet) in 2017, the top three market shares of atorvastatin calcium tablets were Pfizer, Beijing Jialin and Tianfang pharmaceutical, of which Pfizer accounted for 56.3%, Beijing Jialin and Tianfang pharmaceutical accounted for 22.91% and 16.54% respectively (photo source: minenet) in Fujian Province, Pfizer occupies the main market share of atorvastatin calcium tablets, ranking first in sales volume all the year round The winning enterprise of atorvastatin with volume purchase is Beijing Jialin, with the specification of 20mg, Beijing Jialin is 0.94 yuan / capsule, and Pfizer is 7.48 yuan / capsule In the supporting measures for volume purchase issued by the medical insurance bureau, the document clearly states that: the 4 + 7 centralized purchase price selected as the payment standard for medical insurance, and some patients who exceed the price shall be responsible for their own expenses; if the price of non selected varieties is more than twice the price selected, 30% of the original price shall be reduced as the payment standard; moreover, the state clearly determines that the price selected shall be adjusted to the payment standard in 2020 or 2021 That is to say, with the gradual adjustment of the country in place, Pfizer's atorvastatin calcium tablets will be gradually adjusted to the median price of 0.94 yuan as the payment standard, and the proportion of patients' self payment will gradually increase - 6.54 yuan / pill The atorvastatin calcium tablet is also a chronic disease drug Patients need to use it for a long time, and they will be more sensitive to the price Once the purchase price with volume is popularized in Fujian, the market pattern of atorvastatin calcium tablet may change ▍ price war, ignited Obviously, nationwide, price reduction is the trend Enterprises, whether willing or not, will be involved in the war of price reduction On March 4, Zhejiang Province issued a notice: Lilly actively applied to reduce the price of pemetrexed disodium for injection; on the same day, Zhejiang Huahai actively reduced the price of its 4 + 7 winning varieties of irbesartan tablets and risperidone tablets At the same time, Qilu Pharmaceutical (Hainan) Co., Ltd took the initiative to apply for lowering the price of its generic consistency evaluation product, gefitinib tablets, which was adjusted from 1585 yuan / box to 498 yuan / box, even lower than AstraZeneca's bid price In fact, it is not only gefitinib, but also imatinib, dexmedetomidine hydrochloride and pemetrexed disodium for injection that have not been selected in non pilot cities with prices lower than 4 + 7 Obviously, in the 4 + 7 non selected enterprises have cut prices to seize the market outside the pilot city Huahai and xinlitai, as the selected enterprises, participate in the market share competition of non pilot cities in the way of linkage price.