People to middle-aged pharmaceutical sales were cut to cry local version of the volume of procurement than the national version more ruthless

TextsJianwen Wu Weilocal version of the volume of procurement, it seems to be more powerful than the national version of the cut pricePharmaceutical companies may be prepared for more brutal challengesThe future return to normal state of the pharmaceutical industry, should be to do research and development of innovative pharmaceutical companies singing the main role, a large number of production of generic drugs to make sales profits of pharmaceutical companies, after the price of water drying, if not transformation only face eliminationbecause of the outbreak temporarily interrupted the local version of the volume of procurement, is recently in various places to restartThe latest, is the national DRGs pilot pioneer Zhejiang Jinhua, June 1 released the city's second batch of volume procurement meeting information, involving the number of drugs 287, compared with the first batch of 22 at the end of November last year, the size of the expansion of 12 timeslocal version of the band purchase, it seems to be more aggressive than the national version of the cut priceA live video of the negotiations, which has been circulating in recent days, is impressive"hopefully to consider our temporary difficulties ..There are people like me in the company who are middle-aged"
, according to the Changjiang Daily, January 9, 2020, Wuhan City, the first batch of drug-taking procurement of insulin special bargaining site, after some negotiations, a female representative from the enterprise, wipe shone with tears and tears to speakthis episode is easily reminiscent of the "soul cut" of the NHS experts two months agoThe health-care sector, as a super-payer, is behind the huge market of the entire province and city and even the whole country, tears are unconvincingthe result of this round of mining negotiations in Wuhan, in addition to insulin, 39 of the 44 drugs were successful, with a maximum price reduction of 93%Eighteen imported varieties were selected, compared with the lowest prices in the country, the average decrease was 20.15 percent, and the maximum price reduction of raw drugs was 43.45 percentthis is just the beginningIn addition to wiping away tears, pharmaceutical representatives may be prepared for more brutal challengesfollowing two band purchases by the National Health Insurance Administration in November 2018 and September 2019, local tape purchases for medicines outside the national procurement catalogue have also startedWuhan is one of the pioneers, originally expected to produce a "demonstration effect" in the country, but because of the new crown outbreak was forced to interruptrecalls that since the establishment of the National Health Insurance Administration in 2018, the national volume procurement and health care catalog negotiations have been vigorously advanced, and pharmaceutical companies, pharmaceutical representatives and other stakeholders in the drug sales chain are also coming to realize that the state is serious about lowering drug pricesThe butterfly effect, which results in it, will eventually reconstruct the pattern of the pharmaceutical industrya pharmaceutical representative recalled that in 2018, "4 plus 7" belt procurement pilot, "at that time is still a new thing, coupled with the overlap with the Guangzhou Pharmaceutical Fair, the participation of the manufacturers generally not high enthusiasm, especially foreign enterprises." "
after witnessing a lot of collection, witnessed 7 cents a piece of ammonia chlorate flat, 1.68 yuan a box of Atovastatin, he had to believe that "the future of national mining and provincial collection will become the norm." "
and before that, even if the boots of the policy one by one, used to profit from high-priced drugs pharmaceutical companies and the medical representatives accustomed to giving rebates to doctors, have been lucky to think that the relevant policies are just a gust of wind, blowing over, everything will return to the beginningFor the previous related policies, the pharmaceutical industry always seems to be "the army will block, water to cover.", for example, the "two-vote system" for drug procurement, introduced in 2017, in the circulation of drugs from pharmaceutical companies to hospitals, has been invoiced up to twiceUsually the drug from the pharmaceutical factory sold to the first-level dealer to open an invoice, the dealer sold to the hospital and then open eday, and each variety of the first-level dealers may not exceed 2before the "two-vote system", it is common to have seven votes and eight votes, that is to say, after the drug leaves the factory, it takes six or seven turnovers to reach the hospital, in the process of change of hands, naturally can not avoid layer-by-layer price increases"In the middle are 'leather bag companies', in fact, is to help the drug factory to launder money, and finally to the drug agency and doctors" A health care expert said so"two-vote system" after the implementation, there are not so many middlemen, pharmaceutical companies immediately found a response - the sale of the company's gross profit to the manufacturer, these needs to be spent "kickback fee" as the cost of the drug factory sales, to resolve the policy invisibly until the introduction of "4 plus 7" band procurement, pharmaceutical companies finally began to get a little nervous: in order to gain market share, you have to really significantly reduce prices now, the first few rounds of collection is only the National Health Insurance Bureau made a demonstration, after the local health insurance departments have followed up, the local version of the collection of tenders and negotiations is a good play "It's like a war with a group of troops, and now the guerrillas are coming, it's just a sea of health insurance wars everywhere." The above-mentioned experts describe it this way and drug companies are negotiating with a local health-care board, they are actually facing the same national market Because if the price is announced on the sunshine platform, there is bound to be a linkage effect This is like the WTO's "most-favoured-nation effect", when a country receives MFN treatment, other countries will follow suit and demand equal treatment The demands on drug prices are the same everywhere expert analysis, from this point of view, the national level for local belt procurement is welcome, because the overall can further depress drug prices On the other hand, the National Health Insurance Administration also does not have so much time and energy to complete more drug negotiations, the local health care departments completed the local negotiations, the formation of a national linkage effect, it has reached the same effect as the national negotiations , as the former pharmaceutical company representative hunched, the future of national mining and provincial collection will become the norm, and even for pharmaceutical companies and pharmaceutical companies, the bigger storm is still ahead in the special negotiations on insulin in Wuhan City, which was attended by the representatives of the tearful pharmaceutical company, the model of purchasing volume was agreed upon according to the gradient of the price reduction range, which was different from the main condition sized with the national band procurement gradually to the lowest price as the winning bid Specifically, the Wuhan model is in accordance with the price reduction range is different, to give different procurement volume, the larger the price reduction, you can get more procurement volume in this negotiation, the total procurement of insulin drugs was 1.7057 million, the total amount of about 130 million yuan According to the Wuhan Pharmaceutical Joint Procurement Office issued on January 3, "on the Wuhan City insulin drug tape bargaining notice", the participating companies include Novo Nordisk, Lilly Suzhou Pharmaceuticals, Tonghua Dongbao Pharmaceuticals (600867.SH), Federal Pharmaceuticals (037933.HK), Yuheng Pharmaceuticals (002437 SZ, Sanofi (Beijing) Pharmaceuticals, Ganli Pharmaceuticals and other nine are divided into seven groups for bargaining negotiations specific bargaining rules are: the same group of enterprise products only one specification (water number), to December 1, 2019 the lowest price (excluding Guangdong, Chongqing) as the basis, the price is lower than the national minimum price of 5%, the product in 2018 Wuhan region procurement volume of 70% as agreed purchase volume; When the same group of enterprise product rules (flow number) is 2, the quotation is lower than the national minimum price of 5% (weighted reduction) and 10%, respectively, 70% and 90% of the agreed purchase volume If the decrease and weighted decrease does not reach 5%, the enterprise's products in 2018 Wuhan region procurement volume of more than 50% as an alternative amount, the specific quantity by the experts according to the decline on-site agreed Wuhan model strengthens the relationship between the quantity price and expands the competition among pharmaceutical companies, which also caused a lot of controversy at that time In Beijing Dingchen Pharmaceutical Management Consulting Center in the view that the Wuhan model, the ultimate benefit will be foreign enterprises, "to reduce the absolute value of the price and price reduction in the way to "distribute" market share, domestic enterprises will never exceed foreign enterprises "
in addition to the innovation of pricing methods, the local collection process, but also broke the rules of the same-time consistency evaluation of generic drug entry into the volume of procurement, opened the first time that has not been evaluated first collection November 2019, Jiangxi Province issued a notice on the implementation of the procurement and use of drug belt in Jiangxi Province, announced that the quality and efficacy consistency of the evaluation of generic drugs corresponding to the general name drugs, the selection of some of the clinical use of large, high procurement amount and more competitive drugs, the organization to implement the volume procurement Subsequently, Fujian, Hebei and other provinces and cities followed suit to some extent, the entry threshold for participating in the volume of procurement is lowered, but also intensified the competition between pharmaceutical companies Not rated but the amount of large, procurement amount, more mature varieties also have nowhere to hide, was forced into the local version of the volume of procurement layout from the drug category, the local version of the band quantity procurement is the national version of the supplement Antibacterial drugs, traditional Chinese medicine, injections, etc have been included as a special one by one in the scope of belt mining Take antibacterial drugs as an example, expert analysis said, as a number of departments can use the drug, equivalent to a million gold oil, the application of a wide range of people, after a bit of effect, coupled with small risk factor, not easy to produce side effects, can be called the best "kickback drug." So the wide variety of antibiotics, is the drug rebate stake in the hardest hit areas in addition to the national version of the band procurement, the local version has become a touch of more categories of grip What we can note is that not only drugs, local volume procurement has gradually expanded to injectables, devices, consumables and other broader medical fields volume procurement is not a new concept eight jian wen in the "China's drug reform past" has reviewed in detail: in order to increase the price negotiation capacity of hospitals and pharmaceutical companies, reduce drug prices, drug collection since 2000 officially opened a nationwide pilot The main body of the initial collection is the hospital, that is, allowing a single hospital to organize the collection of their own, the transaction price is also the decision of the hospital and the pharmaceutical company 2005, the National Development and Reform Commission waved a big discount stick, directly depressed the terminal of the retail price of drugs, price cuts led to drug companies with little profit, and hospitals do not purchase these drugs There was a new word called "price-cutting death" that year, but where a drug is collected or limited in price, it will disappear from hospital procurement Drug companies do not sell, hospitals do not enter, patients can not eat many drug companies will "cut prices to death" drugs, change dosage form or add some ingredients, get new drug batch numbers, make-up, and high prices into hospitals The price of the drug, which has been lowered by the collection, has risen back in this way the final result is that the drug reform decade, which began in 2000, drug collection is implemented year after year, but the transaction price of collection is higher than one year 2001, the hospital withdrew from the stage of collection, replaced by the municipal government at the local level, and then the provincial government, as a third-party force to the front desk, leading the organization of drug collection But be aware that it is the hospital that decides what medicine to use, and the ultimate payer is the hospital In that year, although hospitals and pharmaceutical companies signed purchase and sale contracts under the government's coercion, they often did not execute, or the implementation was not in place Today's "belt procurement" said that the year has also been repeatedly mentioned, but most of the empty talk but drug collection has to move forward Sanming medical reform is a successful case - let the medical insurance on the front desk, direct negotiations with pharmaceutical companies, will be down the huge drug price space, and then back-feeding public hospitals, thereby enhancing the enthusiasm of health care workers, and have the internal motivation to improve medical services, reduce medical expenses Six years after the reform, sanming City's health insurance fund went from a loss to a balance of 2 billion yuan is precisely because of this successful attempt, with the mission of reducing drug prices set up the National Health Insurance Bureau, directly with the first round of procurement of the first pilot, into four municipalities and seven provincial capital cities such a large extent so far, the old problem of high drug prices has been partially solved But this is only the beginning in the view of the aforementioned medical reform experts, most of the domestic production of generic drugs do not have high value Ping An Securities report also pointed out that China's generic drug industry concentration is low, the approval pile is serious 2018, There are 4,441 pharmaceutical enterprises in China, far more than in developed countries such as the United States, with overcapacity Top10 companies in the sample hospital market account edonly at only 21.5 percent of sales, a lower proportion when imported patented drugs are excluded take 289 oral solid formulations (i.e "289 varieties") in the 2012 base drug catalogue as an example, the total number of approvals was as high as 17740, of which the number of compound sulfonamide metformin tablets (an antibacterial anti-inflammatory drug) amounted to 895 and the pharmaceutical industry's ideal state should be that pharmaceutical companies invest heavily in valuable innovation research and development, in the patent period of new drugs to obtain high returns, rather than should be sold at low prices on the drug continue to eat away at profits in other words, the future return to normal state of the pharmaceutical industry, should be to do research and development of innovative pharmaceutical companies singing the main role, the mass production of generic drugs to make sales profits of pharmaceutical companies, after the price of water drying, if not transformation only face elimination.