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The roll does not win, lying and lying uneven
.
This may be the heart of
many PD-1 companies.
.
This may be the heart of
many PD-1 companies.
For PD-1, in order to achieve a double increase in hospital admission speed and sales volume, medical insurance negotiations are a "gamble" that is small and broad, and companies must deal with
it.
, the impact of the reduction must be considered; If you do not advance, you will not be able to carry out effective promotion
.
In this regard, "big coffee" such as K medicine and O medicine have long looked down on "medical insurance life and death"
.
.
In the countdown to 2022 medical insurance negotiations, who will spend on the "star darling" of the pharmaceutical market and PD-1 in the 200 billion market by stirring up the pharmaceutical market on its own?
PD-1/PD-L1 drugs:
PD-1/PD-L1 drugs:Seven domestic drugs participated in this negotiation
Seven domestic drugs participated in this negotiationAt present, there are 15 PD-1/PD-L1 drugs on the market in China, 11 of which are produced in China and 4 are imported
.
.
Fierce competition has kept PD-1/PD-L1 drugs on the cusp
.
This year, a total of 7 PD-1/PD-L1 drugs passed the preliminary formal review of the medical insurance catalog, accounting for less than 50% of
the marketed products.
Among them, 4 imported PD-1/PD-L1 drugs are eligible to participate in this medical insurance negotiation, but are not on
the list that passed the preliminary form review.
the list that passed the preliminary form review.
There is a precedent
for imported drugs to refuse to reduce prices into medical insurance.
As the world's most famous PD-1, Merck K drug (pembrolizumab) has not been included in medical insurance, and the annual cost of charitable drug donation is about 325,000 yuan
.
Similar to K drugs, O drugs, these "big coffee" seem to have long looked down on "medical insurance life and death"
.
.
The reason is that most of these imported drugs have strong economic strength and a strong sales network, and can often rely on academic promotion and other links to offset the impact
of price reductions.
Among the domestic PD-1/PD-L1 class drugs, there are 4 that have previously been in the catalog, including Hengrui Pharmaceutical, BeiGene, Innovent Biologics, and Junshi Biologics;
and the newly approved Akeso PD-1/CTLA-4 dual antibody, Henlius PD-1 monoclonal antibody, and Corning Jerry/Sidi / Simcere PD-L1 monoclonal antibody
.
Those who did not participate in the medical insurance negotiations were Akeso/Zhongsheng Pharma PD-1 monoclonal antibody, CStone PD-L1 monoclonal antibody, Yuheng Biologics PD-1 monoclonal antibody, and Lepu Biologics PD-1
Monoclonal antibodies
.
.
Among them, 3 products of Akeso/CSP, CStone Pharmaceutical, and Yuheng Biologics are eligible to participate in this medical insurance negotiation (as of June 30, 2022
), but not in the list that has passed the preliminary formal review, and Lepu's PD-1 monoclonal antibody is not eligible to participate in this medical insurance negotiation
because it was approved for marketing later than June 30, 2022.
For local innovative pharmaceutical companies with newly established sales teams and weak families, post-marketing research requires money and academic promotion funds, and there is not enough profit support, and whether to enter medical insurance negotiations has become a dilemma
.
, the impact of the reduction must be considered; If you do not advance, you will not be able to carry out effective promotion
.
.
Table 1 PD-1/PD-L1 drugs
Sorting out the status of medical insurance negotiations in 2022
Source: Health Insurance Bureau, CDE, Essence Securities Research Center
Further analysis, among the four PD-1 monoclonal antibodies in the catalog added and renewed in this round of national medical insurance negotiations, Hengrui's carrelizumab will have 8 indications involved, Innovent's sindilimab will have 6 indications involved, BeiGene's tirelizumab will have 9 indications involved, and Junshi Biologics' teripalimab will have 4 indications involved
.
In the context of highly overlapping indications, medical insurance negotiations in the PD-1/PD-L1 field may face more fierce competition
this year.
Table 2 Domestic PD-1/PD-L1 biological drugs
Analysis of approval and entry into medical insurance
Source: Health Insurance Bureau, CDE, Essence Securities Research Center
PD-1/PD-L1 drugs:
PD-1/PD-L1 drugs:Price reduction forecast analysis
Price reduction forecast analysisJudging from the average price reduction of drugs related to medical insurance negotiations in the past, through medical insurance negotiations, the average price of drugs newly entered into the medical insurance catalogue needs to be reduced by about 50-60%;
At present, products that are already in the medical insurance catalog:
The annual treatment cost of Hengrui Pharmaceutical's carrelizumab and BeiGene's tislelizumab is about 5.
2-53,000 yuan, and the annual treatment cost of Innovent Cindilimab is about 3.
9
million yuan, the annual treatment fee of Junshi Biotech teripulimab is about 34,000 yuan
.
Therefore, several other domestic new medical insurance PD-1/PD-L1 monoclonal antibodies, the probability of annual treatment cost quotation range between 30,000-50,000 yuan, compared with the initial price (not considering charity drugs and other discounts), the reduction will be more than 80%.
In particular, as the world's first approved PD-1-based bispecific antibody drug based on PD-1, Akeso's PD-1/CTLA-4 bispecific antibody drug may be relatively limited by virtue of the uniqueness of its product and clinical value
.
In addition, according to the current simple renewal rules, the price reduction rate of innovative drugs after new indications will be between
0%~44%.
However, due to the high overlap of indications, existing products may refresh the lower limit
of quotation.
With a high probability, in the field of popular indications, the annual fee of domestic PD-1 may fall below 30,000.
PD-1/PD-L1 drugs:
PD-1/PD-L1 drugs:Is it wise to negotiate Medicare?
Is it wise to negotiate Medicare?The first major advantage of innovative drugs participating in negotiations into the medical insurance catalogue is that it is expected to improve the problem of access difficulties, achieve rapid penetration covering hospitals and pharmacies, and accelerate the commercialization process
of innovative drugs.
.
In terms of entering the hospital drug list, after the drug enters the medical insurance, it is expected to lower the admission threshold and accelerate the admission efficiency; In terms of entering pharmacies, after drugs enter medical insurance, it is expected to accelerate their entry into pharmacies through the "dual-channel" management mechanism of drugs negotiated by national medical insurance, and achieve accelerated volume
.
The second major benefit is to accelerate sales growth, and innovative drugs are expected to accelerate after
entering the medical insurance catalog.
entering the medical insurance catalog.
Taking BeiGene's tislelizumab (Bazelian) as an example, after it officially entered the medical insurance on March 1, 2021, its sales growth was very obvious, reaching 767 million in 2021, with a growth rate of 1316.
6%.
In particular, on January 1, 2022, after the three new indications of Bazean were included in medical insurance, covering lung cancer and liver cancer patients, its growth momentum was further enhanced
.
Fig.
1 Sales scale of tislelizumab in national hospitals
Image source: Zhongkang CHIS
But it cannot be ignored that "price for volume" has a price
.
.
On the one hand, the average price of drugs entering the medical insurance catalogue needs to be reduced by about 50~60%, and it may be difficult
for some products to exchange price for volume.
On the other hand, the life cycle of many innovative drug sales has also been greatly compressed, especially products with overly concentrated R&D targets, and fierce competition
from similar products.
For some products, even if you want to exchange price for quantity, it may be very difficult
.
Therefore, there are also solutions
to maintain high-price strategies such as K drugs and O drugs.
to maintain high-price strategies such as K drugs and O drugs.
From the perspective of specific products, potential products with a large range of use and wide application scenarios are expected to cross the "medical insurance barrier" and achieve price and volume flight.
For drugs with a small scope of use and small dosage, it may not be such a wise choice to enter medical insurance, and the rational use of pharmacoeconomic calculations and the formulation of corresponding commercialization strategies may be more mainstream
.
"Ultra-low prices are not good for anyone", the state is adjusting, and enterprises also need to adjust
.
.
No matter how the payment strategy changes, the key to making differentiated clinically urgently needed new drugs and good drugs is the key
for pharmaceutical companies to grasp the initiative in negotiation.
