Hepatitis C drug into health insurance: no floor price competitive negotiations Pharmaceutical companies say "very tired"

Recalling the competitive negotiations on health care in mid-November, Luo Yongqing, global vice president of Gilead Sciences and general manager of China, said that "four products talked for two days" and was tiredafter half a month of negotiations and follow-up consultations, the 2019 National List of Basic Medical Insurance, Work Injury Insurance and Maternity Insurance Drugs was finally released on 28 November and will be officially implemented on 1 January 2020it is understood that this year's health care negotiations involved a total of 150 drugs, including 119 new negotiated drugs and 31 renewal negotiationdrugsOf these, 70 new drugs were negotiated into the health insurance catalogue, and the three hepatitis C drugs that entered the list for the first time were of particular concernAfter this round of adjustment, the 2019 edition of the catalog contains a total of 2709 drugsin this negotiation, Gilead has a total of four new drug negotiations, including two hepatitis C special drugs - Lidi Paeveso phosphorous buwe (commodity name: Xia Fanning) and Sophobuvevepartavir (commodity name: propylene sand)The two drugs and Elbawegrarewe of MerthyrTyon (commodity name: Pida) are the only three hepatitis C drugs to enter the health insurance category, while the price of the drug fell by an average of more than 85% after entering the health insurance catalog, and the cost of each course of treatment fell from more than 50,000 yuan to 10,000 yuanXia Fanning and Peda are hepatitis C 1b-type therapeutic drugs, through competitive negotiations into the catalogUnlike the previous one-to-one traditional negotiation method, competitive negotiation is a new way of negotiation by the Health Insurance Bureau on hepatitis C 1b treatment drugs, that is, no minimum price, each enterprise offers their own quotations, according to the quotation from low to high to determine the selected varietiesLuo Yongqing told the Economic Observer reporter, the hepatitis C special effects drug competitive negotiations is a "game", because the psychological price of the two sides are not the same, and the negotiations between the c-pharma for up to two hourscompetitive negotiations
Fujian Province, the head of the joint procurement center of pharmaceutical equipment, Lin Qi participated in the negotiations on hepatitis C 1b treatment drugs, he revealed the negotiation process: after expert review, voting selection, with the enterprise to confirm the intention of negotiations, Geely, Mersadong, Aberwi and Goli Pharmaceuticals (01672HK) The four enterprises of 6 kinds of drugs into the final negotiations, the health insurance bureau of 6 drugs first for clinical efficacy assessment and scoring, and then by the enterprise package quotation, the negotiation team according to the rules of the enterprise quotation on-site conversion, to determine the outcome of the negotiationLuo Yongqing told the Economic Observer that the company reported not the price of the drug itself, but the price of packages, including pre-screening, and that the negotiations between Gilead's propion sand sand spree had been going on for more than two hoursAccording to the rules of negotiation, the negotiation time for a product is half an hour"competitive negotiation" provides for the preferred low bidder to win the bid, if the offer is the same, then the clinical evaluation of high-scoring candidates selectedThis also means that the negotiation team not only needs to make an analytical judgment on the data declared by the enterprise, but also to compare the data declared and make a decisiondata measurement is particularly importantIn August this year, the National Health Insurance Administration announced the number of drugs to be negotiated, and in early September organized clinical experts to conduct clinical demonstration of drugs, as a reference for drug price measurement, while organizing drug economics experts and medical insurance fund measurement experts to conduct parallel measurementsBased on earlier estimates, the health-care agency negotiated with two sets of data: one for drug economics, including the lowest international price, and one for data on the amount of money that drugs might affect the amount of medics fundedLuo Yongqing admitted that the reason for the negotiations up to 2 hours is "not a consensus, each other's floor price is not the same", the two sides do not know the psychological price of the other side, "some manufacturers talkaboutd five or six minutes out, because the price 'off target', no talkability, fall within 15% of the floor price has room to talk, two quotations off target out." Xiong Xianjun, director of the medical service management department of theState Medical Security Administration, said at a press conference at the previous press conference that, given the widespread efficacy of the six hepatitis C drugs, the therapeutic effect is comparable and expensive (treatment costs are more than 50,000 yuan), relying on pharmacoeconomic calculations and regular access negotiations to guide enterprises to reduce prices to a reasonable range, the Health Insurance Bureau creatively introduced competitive negotiations, explicitly allowing only two drugs with the lowest total cost of treatment to enter the list, and promised not to include new drugs within 2 yearsGilead's Xia Fanning and Mershadon's choice of the final negotiations, and AbbVie and Goliath Pharmaceuticals' product negotiations failedthe 2019 health care negotiations involving 150 new drugs, with a success rate of about 65%In this regard, Luo Yongqing believes that for innovative drugs, "into health insurance is not a way to Huashan", no access also have other ways to find solutions within reach, such as commercial insuranceIs competitive negotiationsthe best approach? Luo Yongqing said there is a lot of thinking, "I believe that the National Health Insurance Administration in the competitive negotiations to make careful consideration, because of the characteristics of hepatitis C, especially the special nature of hepatitis C GT1b", so the use of competitive negotiationsfor TNCs, a prerequisite for a successful negotiation is to gain headquarters approval, otherwise good negotiation skills are uselessLuo Yongqing revealed that Gilead China has done all aspects of consideration, pre-judgment of various circumstances, wrote a detailed report, and finally was recognized by the headquarters"Only two direct antiviral drugs in the 2019 National Health Insurance Catalog have been approved for the treatment of hepatitis C, gene 1b," said Luo Wanli, senior vice president and president of China,'s MercadoElbawegrarevir tablets are one of them, representing the Chinese government's recognition of the importance of the drug in the field of hepatitis C treatmentWang Fusheng, director of the National Center for Infectious Diseases, said at a press conference that hepatitis C is a chronic disease that seriously endangers people's health, Wang Fusheng, director of the National Center for Infectious Diseases, said at a press conference to bring special drugs into the Medical Center of the People's Liberation Army General Hospital In China, chronic HCV infection occurs in about 7.6 million to 10 million people, and the natural course of disease usually manifests in patients who do not have timely treatment is typical of three stages: chronic hepatitis, cirrhosis and liver or liver failure the international traditional treatment of hepatitis C is with interferon treatment, but interferon needs injection, patient compliance is poor, oral Direct Anti-CVIRUS drugs are more convenient 2018, a number of hepatitis C innovative drugs were approved in China: in April, Mercavereast's oral direct antiviral drug Elbavegrarevir was approved for the market; -6 All genotype hepatitis C; in June, danorewe (commodity name: Gonovi) developed by the domestic pharmaceutical company Gourko Pharmaceuticals approved, and in November, Gilead's "Ji II" Lidieweso phosphorus buwe tablets were approved "There are several characteristics of the drug now: convenient to take, short course of treatment, safe and effective, high cure rate, reasonable price (after entering health insurance) The convenience of taking is mainly reflected in the complete oral drugs, do not need injections, the course of treatment is mainly 12 weeks treatment time, drug safety and patient tolerance are very good, no obvious adverse reactions, the key is the clinical cure rate is close to 100%," Wang Fusheng said, there is a problem is that the cost of drug treatment is higher, 4 years ago in the United States treatment costs 1000 dollars a day, and before the medical insurance in China a course of treatment costs are also 30,000-70,000 yuan the market for hepatitis C drugs is a "cure" market, with the patient's cure rate gradually decreasing Gilead, a hepatitis C giant, has launched four hepatitis C drugs since it went on sale in 2013, with sales of nearly $20 billion in 2016 With patients cured, sales are expected to be about $3 billion in 2019 into health care also means a sharp reduction in prices, Luo Yongqing said, the government's goal is very clear, is to benefit the people, enterprises to consider whether the price of the health insurance bureau is profit, so the health insurance is the product to make patients accessible, government health insurance can bear, enterprise research and development sustainable three points of balance "Headquarters has expectations of sales in China, we have listed in China 'Ji generation' 'Ji second generation' 'ji third generation', there is definitely a need for commercial returns", the introduction of health insurance is "in exchange for volume, so that sales are not too far off than expected." before this adjustment, there was only one treatment in the medical insurance catalogue using interferon, with a treatment time of 1 year and a cure rate of about 50% After the introduction of 3 new drugs, DAA (oral direct anti-Hepatitis C virus drug) hepatitis C drug use time of about 12 weeks, cure rate of 98% however, the three hepatitis C drugs of the medical insurance payment standard (the enterprise and the National Health Insurance Administration jointly agreed on the standard of medical insurance payment, is the sum of the fund payments and individual patient severance payments) did not disclose, the enterprise and the National Health Insurance Administration reached a payment standard confidentiality agreement this, Xiong Xianjun said: "In order to help guide enterprises to significantly reduce prices, try to introduce price confidentiality practices, the transaction price of some drugs promised officially not open to the public." After the catalogue lands on January 1 next year (2020), the vast number of insured people will have a personal feeling "
medicare is the first step in improving drug accessibility, but there is still a process to get into the hospital after health insurance Luo Yongqing hopes that the government can coordinate with all parties, enterprises to strengthen the disease science education, to ensure the fastest speed of supply.