Drug price reduction has become the focus of policy, promoting overall control of drug costs

Source: CPHI 2014-8-26 with the deepening of medical reform, this year is the most frequent year for medical policy For the pharmaceutical industry, there are advantages such as "Three Guarantees in one", "serious illness insurance pilot", "new low-cost drug policy", etc., but in front of the guidance of drug reduction, this year's decline in the profit margin of pharmaceutical enterprises has become a trend Now every Friday, pharmaceutical companies are a little nervous and busy, because the pharmaceutical management department likes to release policies on Friday This is not true Last Friday, Zhejiang and Sichuan released a draft for Soliciting Opinions on 2014 drug bidding, and Liaoning Chaoyang issued a notice of second price negotiation With the deepening of medical reform, this year is the most frequent year for medical policy For the pharmaceutical industry, there are advantages such as "Three Guarantees in one", "serious illness insurance pilot", "new low-cost drug policy", etc., but in front of the guidance of drug reduction, this year's decline in the profit margin of pharmaceutical enterprises has become a trend Drug price reduction has become the focus of policy, which is different from the previous Fujian bidding policy, which is widely criticized for its low price Last Friday, Zhejiang's bidding solicitation draft changed a lot, and a new term cost-effective is introduced At the same time, in its two envelope mode, the ratio of quality to price is 6:4, which embodies the principle of quality first, but price reduction is necessary In the draft for comments of Sichuan Province, for basic drugs, the lowest price will be selected as the bid winner after the quality is shortlisted, and for non basic drugs, the second lowest price of the bid winner in the surrounding 5 provinces and cities will be selected as the limit price of network, and the bid winner will be determined after negotiation with medical institutions It also points to drug price reduction Also on Friday, Liaoning Chaoyang issued a second bargaining notice The second price negotiation of drugs refers to that after the winning bidder is determined in the first level bidding at the provincial level, that is, after the winning price is determined, the region still needs to negotiate with the drug enterprises in the specific procurement, that is, the price will drop one more piece This practice has been tried for a long time in Zhejiang Province, and has been used for reference by some regions in Chaoyang, Beijing and Shanghai of Liaoning Province Sanming, Fujian Province, requires a further 30% drop in drug prices, pushing this practice to the extreme If Sanming's practice is widely implemented, the ex factory price of drugs will be reduced, and the profits of drug companies will naturally be greatly reduced Zhejiang and Sichuan's bidding plans have different impacts on various pharmaceutical enterprises First, the exclusive varieties require price reduction, but the price is still under the control of pharmaceutical enterprises Second, the high-quality brands and pharmaceutical enterprises passing the new version of GMP, because there are bonus points, they do not need to compete the price completely, and the profit margin is higher simply; Third, in the competition for conventional varieties, the Zhejiang plan stipulates "one lowest price, two highest scores" and "cancel the sales scale score of enterprises", which means that large pharmaceutical enterprises do not necessarily have an advantage; fourth, in the Zhejiang plan, the injection of traditional Chinese medicine in basic drugs is required to be reduced by as much as 20%, and the price reduction of antibiotics is up to 15% This is obviously not good for traditional Chinese medicine enterprises and pharmaceutical enterprises whose main products are antibiotics In fact, there are many links in the drug price chain, the first is the price, the second is the dosage of drugs, and the third is the composition of different drugs (including innovative drugs, original research drugs, generic drugs, etc.) in the whole market Drug price control is only one part of the control Drug cost control should be considered from two aspects of supply and demand The supplier should consider drug enterprises and circulation system, while the demander is hospital, doctor, drug quantity and patient This year, in addition to requiring drug companies to reduce drug prices, the pharmaceutical administration is also trying to control drug costs from the demander From June to August, Anhui, Sichuan, Jiangxi and other places clearly proposed to explore the payment by disease in the medical reform plan; on August 18, Anhui health and Family Planning Commission issued the notice on strengthening the management of intravenous infusion in medical institutions, which identified 53 types of common frequently occurring diseases without infusion treatment in outpatient and emergency departments This is the first province to clearly put forward the management regulations and specific requirements and measures for intravenous infusion according to the requirements of the health and Family Planning Commission Anhui has always been the forerunner of medical reform, known as the wind vane of medical reform, other provinces have a high probability of following suit According to the policy of paying for diseases, the hospital will take the initiative to control the drug cost, so it will choose more drugs with low price and good curative effect, which is good for domestic pharmaceutical enterprises However, the policy of restricting infusion is obviously unfavorable to the enterprises of big infusion and traditional Chinese medicine injection, and beneficial to oral liquid Low price drug policies vary from place to place over the weekend, with media reports that in September the national health and Family Planning Commission will supervise the implementation of low price drugs in various places Low price drug policy is regarded as the biggest positive for drug companies this year, but judging from the current actions around, this judgment is still too early The low-cost drugs defined in the Zhejiang bidding plan include two parts: one is the varieties of base drugs and low-cost drugs, that is, base low-cost drugs; the other is the varieties overlapped with the original low-cost drugs catalogue in Zhejiang, and the second batch of bidding for the remaining low-cost drugs At the same time, Zhejiang only reviews the technical bid of low-cost drugs with historical price as the reference price, with a maximum of 8 companies, and stipulates that if the purchase price is 30% or more higher than the reference price, the transaction shall be suspended Therefore, it is difficult for low-cost drugs to reach the standards set by the national development and Reform Commission in Zhejiang Sichuan's regulations are relatively simple: commonly used low-cost drugs: purchase drugs on the Internet at any time within the limit price of 3 yuan / 5 yuan according to the daily average cost standard, provided, of course, that you win the bid first Looking at the pharmaceutical policies since this year, it is an inevitable trend that the profit margin of pharmaceutical enterprises will decline In addition to the exclusive heavyweight, high-quality and well controlled pharmaceutical enterprises, most pharmaceutical enterprises may not increase revenue this year, while the large infusion, traditional Chinese medicine injection and other enterprises may still have a significant decline in revenue