For PD-1 and health care negotiations part of the Junshi Bio Million Letter Back to the Shanghai Stock Exchange

Junshi Bio was established at the end of 2012, in 2015 listed a new three-board, three years later to Hong Kong listing, becoming the first "new three-board and H" stock enterpriseAt the end of 2018, ResiBio's Triprei single-fight was approved as the country's first domestic PD-1, with a low price, but failed to negotiate in 2019Currently, the listing of the Science and Technology Board is currently being declaredWhy did thehealth care negotiationsfail?Before the health-care negotiations, Junshi's PD-1 price was almost the lowest in the countryAs for the offer in the health care negotiations, Junshi Bio said to consider three points:one is that the price reduction into health insurance is not conducive to the current approved adaptation certificate patient increaseAccording to Frost Sullivan's report, in 2019, the number of new melanoma patients in China, who meet the license approved by Junshi, is about 2,400, so Junshi believes that the price drop is limited to the availability of patients and the increase in the penetration of the company's productssecond is Junshi believes that market-oriented independent pricing to obtain a certain amount of cash flow and income to help enterprises to better carry out continuous research and development investmentthird is the current round of medical insurance negotiations of similar drugs competition pressure is not strong, and Junshi approved the same indications of K drug annual treatment costs in more than 300,000because of the different number of patients, the health insurance fund for different adaptation certificate of the expected expenditure, the health insurance fund's affordability is also different, therefore, Junshi bio believes that the health insurance bureau of the various adaptation certificate negotiation target price determination is mainly affected by the disease background and the current state of national economic developmentat the same time, the National Health Insurance Administration because there is no open negotiation floor price measurement indicators and parameters, so it is difficult to grasp the relevant situationIn addition, Junshi said, "after taking into account the drug economics, the impact of health insurance on product prices and sales, patient accessibility and the future development of the enterprise, the company provides the lowest price can afford at this stage, but still not accepted by the National Health Insurance Administration." "
" is the cabbage price"for the decline of the Letter a PD-1, China Galaxy Securities Research report pointed out that its negotiating floor price is by reference to The Real's Triprei single-resistant drug program, on the surface shows that the price of SindiLi single resistance fell very large, the apparent decline reached 64%, in fact, this is Cinda's pricing strategy and drug-giving strategy victory before the health-care negotiations, Junshi's Treprien single-handedly for the domestic PD-1 price depression The first adaptation certificate approved by Triprei single resistance is melanoma, the actual one-year drug burden of patients under the charity drug giveaway method is about 100,000 yuan, Cinda after the price reduction, in addition to the medical insurance adaptation card patients, with little difference, and no longer have charity medicine Citic Construction Investment Securities research report also believes that Cinda this price decline in the acceptable range, especially for Cinda's brand publicity and saving spending on the hospital is very favorable, with the completion of the current new capacity construction, this entry into the health insurance will have a certain positive impact on Xindili single anti-sales At the beginning and end of 2019, Junshi and Cinda set the annual cost of PD-1 at 100,000, which is undoubtedly a pressure on the latter " is the price of cabbage, want to enter the price to accept, there is no choice Wang Lai, vice president of Baiji Shenzhou, told E Pharmaceutical Manager before the year ago, "We will participate in the negotiations after that, and the PD-1 price is expected to go down." "The PD-1 of Baiji Shenzhou will be approved by the end of 2019 and, if successful, will be able to participate in the next round of health-care negotiations, and Baiji Shenzhou has indicated its active participation." Citic Jiantou believes that because the current Sindili single anti-resistant adaptation certificate only second-line Hodgkin lymphoma, entering health insurance will not have too much impact on other PD-1/PD-L1 products market competition, the overall PD-1/PD-L1 market remains optimistic to reduce the price? before the health insurance negotiations, Junshi's pricing is lower than similar products, in the cost of about one-third of K drugs, and Baiji Shenzhou, Cinda is not much different as the first approved PD-1 in the country, how did such a price come about? Junshi Bio says its pricing first takes into account the availability and affordability of Chinese patients and the cost of the product In addition, although the price is much lower than imported products, but with Baiji Shenzhou, Cinda, Hengrui after the annual treatment costs are not much different, the price is comparable but after the health care negotiations, will Junshi choose to reduce the price? Junshi said that from a global perspective, the Chinese market's Low PD-1 product pricing has limited the scope for price reductions in such products, at the same time, the cost of product development is higher In the third quarter of 2016 to 2019, Junshi has invested more than 1 billion yuan in Research and Development of PD-1 products, which also limits the level of price reduction to some extent make the policy adjustment of the drug-giving policy the first move by PD-1 manufacturers that are not currently covered by health insurance In December last year, Moshadon adjusted the policy of giving medicine to Paboli Pearl Monoantia (K-drug), lowered the threshold for drug-giving, increased the proportion of free-giving drugs, and reduced the cost from 287,000 yuan to 215,000 yuan in nine months In January this year, BMS's Navuliu mono-anti (O-drug) offering program was adjusted from the original "6 plus 7" to "first 3 plus 3, follow-up 3 plus 4 cycle", after adjustment, the patient's self-payment ratio decreased by 50% Hengrui Pharmaceutical's current drug-giving program for "buy 2 give 2, buy 4 give a year", the power of the drug is also greater March 2, Baiji Shenzhou announced the price of its PD-1 drug Terellizumab aid program, according to the official plan, long-term use of Terelli-Zthanian injection treatment patients only need to pay the cost of 5 courses to obtain a full year of drug treatment, the annual minimum cost of treatment is about 1069 million yuan but it is worth noting that AstraZeneca's PD-L1, which is listed this year, has not been significantly affected by the price reduction, and that its pricing level is basically the same as that of imported products How does deal with the PD-1 market under Medicare? Junshi believes that because Sindili single resistance into the medical insurance adaptation certificate and Junshi is different, so its market share impact is relatively limited, and in other adaptation certificates, Junshi is still "the world's lowest price." However, in the future, if there are products in the larger adaptation certificate first into health insurance, may have a negative impact on Junshi also suggested that the inclusion of drugs in the medical insurance catalog is conducive to doctors and patients on the awareness of drugs and efficacy of confidence, drug visibility is expected to further enhance, conducive to marketing In terms of hospital access, the inclusion of drugs in health insurance may also be more convenient in hospital access process, which is conducive to drug companies to expand their hospital coverage Therefore, Junshi may face certain competitive risks in marketing and hospital access in addition, if other competitors significantly reduce prices, Junshi will face increased market competition, may further reduce prices, thereby affecting the size of sales and profitability in response to the possible impact of the health care negotiations, Junshi said it would take four measures to improve penetration, (1) to strengthen the company's sales team By the end of February 2020, the total number of the company's sales team has reached 424, of which the sales department has arrived at 359 people, a total of 472 people are planned to recruit in 2020 Further expand hospital coverage, (2) to strengthen product marketing In major academic journals and conferences actively publish the latest clinical research results of Treprii monoantigen, strengthen the collection and aggregation of clinical research data, real-world use data, the use and efficacy of drugs, the prevention of adverse reactions and other key information to doctors and patients , increase academic promotion efforts; At present, there are 44 clinical trials of lung cancer for PD-1 in China (Phase III 32), 22 clinical trials of liver cancer (Phase 3 13), 66 clinical trials of urinary skin cancer (Phase 3), and 10 clinical trials of nasopharyngeal cancer (Phase 3) Junreal melanoma, nasopharyngeal cancer, urinary skin cancer, liver cancer, breast cancer and other adaptation certificate progress in the top four, (4) to speed up the development of other research and development pipeline products it is worth noting that many industry insiders have publicly predicted that Hengrui's PD-1 "will definitely run out", and behind this is the different commercialization capabilities of various enterprises For innovative pharmaceutical companies, marketing and sales capabilities are a bigger challenge and competitive focus Mersadong's K-drug in china's annual sales revenue of more than 2 billion yuan, not only leading the overseas market, in the domestic for the newly listed innovative drugs performance is also amazing commercialization of PD-1, Baiji said it plans to expand its business team from 700 to 1,000, covering 800 to 1,000 hospitals Cinda, on the other hand, has reduced a lot of market access with the help of national health insurance citic capital, , believes that as the number of Adaptation Certificates covered by each PD-1 increases, the price competition for the same adaptation certificate will become more intense At the same time, PD-1 single resistance as a whole is still in the rapid release stage, in this case, the coverage progress of the large adaptation certificate will become the core factor of competition in the next year Lung cancer, liver cancer, stomach cancer and other "big cancer" is a few domestic PD-1 are vigorously promoted the adaptation certificate, Cinda, Junshi, Hengrui, Baiji Shenzhou are mostly laid out, and the progress is faster the next two years, a positive battle in areas such as lung cancer is inevitable, and there is some differentiation in the market's smaller adaptation certificates In the face of future competitive situation, in addition to finding clinical advantages, overseas markets and how to improve research and development efficiency, reduce research and development costs should also be considered by local innovative pharmaceutical companies original title: Junshi Bio Million Letter to the Shanghai Stock Exchange, revealing what secrets of PD-1 and health care negotiations?