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China's innovative drugs five years after the market annual sales, an average of only 50 million yuan - 150 million yuan, and research and development investment may reach hundreds of millions of yuan.
Recently, the Liaoning Provincial Health planning committee issued the "Liaoning Province public medical institutions medicine, medical supplies and medical equipment procurement management and assessment rules" (hereinafter referred to as the rules) pointed out: through national negotiations, fixed-point production and other means and the province's cities, provincial medical associations to negotiate the procurement price, public medical institutions may not organize any form of "secondary bargaining."
With the complete abolition of drug additions, pharmaceutical companies in the major hospitals when many are facing secondary bargaining, including even selected in the national health insurance negotiations list of 36 special drugs, although in the provinces have been implemented online procurement, but specific to the hospital procurement, pharmaceutical companies still face "secondary bargaining." Some people in the industry pointed out that this is closely related to the state's request in recent years for hospitals to control the proportion of drugs, medical insurance charges and so on.
on the issue of secondary bargaining, at the just-concluded 2nd China Pharmaceutical Innovation and Investment Conference, a number of pharmaceutical company leaders told the 21st Century Economic Report that the second bargaining will seriously affect the research and development and innovation of enterprises. A pharmaceutical company chairman pointed out directly that if the bidding and procurement, health care negotiations, secondary bargaining and other links can not be straightened out, the enthusiasm of enterprises may be affected.Innovating drugs encountered secondary bargaining
On November 3, the Liaoning Provincial Health and Planning Commission issued the above-mentioned rules, which made detailed requirements for the proportion of basic drug use, two-vote system, shortage of drugs, auxiliary drug use, etc. of public medical institutions in Liaoning Province, including "secondary bargaining" and special instructions.
so-called secondary bargaining refers to medical institutions in the provincial drug tender results on the basis of the winning drugs into the hospital procurement, the price of another kill. For this form, the National Health and Planning Commission has also repeatedly expressed opposition.
E.e. in July 2010, when the Ministry of Health issued the "Health Regulations and Wealth No. 64" document "On the issuance of medical institutions centralized procurement of drugs work norms notice", Article 36 requires that medical institutions in accordance with the contract for the purchase and sale of drugs, may not carry out "secondary bargaining." Strict examination of drug purchase invoices to prevent off-target procurement, price-breaking procurement or procurement of drugs from non-prescribed channels.
, however, there are still various forms of "secondary bargaining" in provincial tenders. In the reform practice of perfecting the centralized procurement of drugs in public hospitals, the vast majority of public hospital drug procurement in the pilot cities of comprehensive medical reform failed to carry out simultaneous procurement on the provincial platform in accordance with the requirements of the state, but adopted a lag action strategy based on the results of centralized drug procurement transactions at the provincial level in the name of "volume procurement" and "secondary bargaining".
According to incomplete statistics, At present, Fujian, Zhejiang, Anhui, Shaanxi, Henan, Hubei, Chongqing, Shanghai, Hunan, Ningxia and other provinces and cities are piloting "secondary bargaining", many places to reduce drug prices will become the norm. Ningbo City, Zhejiang Province, which recently announced the completion of the joint price limit purchase of Chinese medicine, has reduced the price by an average of 15.5% on the basis of the winning bid price in the province.
So before a province procurement body and pharmaceutical companies after the "secondary bargaining", the enterprise quotation was cut to 1.5 to 4 fold, such as the enterprise hanging network quotation 22 yuan, hospital quotation 6.381 yuan;
and included in the national drug price negotiations of drugs, although the Health and Planning Commission has issued a text stressing that 36 negotiated access varieties, the implementation of the implementation of national negotiating prices, the implementation of direct network procurement, no longer separate organization of negotiations to negotiate prices, but also encountered various forms of "secondary bargaining" at the local level.
At the above-mentioned meeting, Beda Pharmaceuticals Chairman and CEO Ding Liming, for example, said that Kemina as a "major new drug creation" of important results, has been included in health insurance through price reductions, but when entering provincial and municipal hospitals, but also encountered a second bargain, hospitals generally require rebates, respectively, 3%, 5%, 10%, 20%.Pricing at the value of drugs
an industry analyst told the 21st Century Economic Report that more and more companies are experiencing secondary bargaining, one of the important reasons being that hospitals strictly control the proportion of drugs and the amount of drugs used. At the end of October 2015, the Health Planning Commission, together with various ministries, issued a number of opinions on controlling the unreasonable growth of medical expenses in public hospitals, ingesting that the proportion of drug revenue in public hospitals as a proportion of medical income has decreased year by year, and that the proportion of medicines in public hospitals in pilot cities (excluding Chinese medicine tablets) will drop to about 30% overall by 2017.
hospitals are under pressure to adjust their national policies, control the proportion of drugs, eliminate drug subsidies, and have government subsidies in place. Public hospitals will eliminate drug charges across the country, and the hospital's profit model will change subversively. However, financial subsidies at all levels are not in place, resulting in most hospitals can not well absorb this part of the loss of profits.
ding listed in the view that the second bargain to the sale of domestic innovative drugs has brought great difficulties.
In fact, innovative drugs to enter the health insurance directory is not easy, an industry insider admitted that the public hospital drug catalog only 3000, in the Ministry of Human and Social Affairs to implement the total advance, the Health and Planning Commission strictly control the proportion of drugs and the amount of drugs in the background, the inclusion of a new drug, which means that there is one to be kicked out, but this decision is more difficult.
and a drug to enter more hospitals is not easy, such as the above-mentioned Kemina market for many years, the product only entered 250 public hospitals, of which 150 hospitals, accounting for only 27% of the country's secondary or above medical institutions.
if innovative drugs enter health insurance and then face a second bargain, in the eyes of many pharmaceutical company leaders, will affect the future of enterprise research and development, innovation. Liu Templebo, chairman of Greenlee Pharmaceutical Group, believes that if the bidding and procurement, health care negotiations, secondary bargaining and other links can not be straightened out, the enthusiasm of enterprises may be affected.
Previously, the Chinese Pharmaceutical Association, the China Pharmaceutical Enterprise Management Association, the Chinese Pharmaceutical Association and other joint McKinsey analysis shows that China's innovative drugs five years after the market annual sales, an average of only 50 million yuan to 150 million yuan, and innovative drug research and development investment may reach hundreds of millions of yuan, which highlights the bleak reality of innovative drugs from another angle.
A total of 24 new drugs, including vaccines, were only available during the 12th Five-Year Plan period, meaning that most of the innovative drugs have not been on the market for more than five years, and the cost of research and development has not yet been recovered;
, Sun He, vice president of Tiansli, expressed the hope that domestic drug pricing could be considered based on the value of the drug, not the price. "How companies get their money back in the market is a challenge, promoting innovation on the one hand and pricing it on the other, which may more or less limit the development of true innovation capabilities."
understood that in order to implement the "opinion on deepening the reform of the review and approval system to encourage innovation in pharmaceutical medical devices", the corresponding policies may be adjusted. At the level of bidding and procurement of innovative drugs, some industry experts suggest that the National Health and Planning Commission can work with the provinces to organize the market, together on the price and access to negotiate, reach a unified price, achieve a national price, do not need another tender, such as product maturity, recovery of the cost of pre-research and development investment, and then into the normal bidding process. (21st Century Economic Report)