Song Ruixuan, president of the China Drug Promotion Association, said: New drugs can not only focus on health insurance, generic drugs do not fry too quickly

By the end of December 2020, the negotiating bid will be hammered down.
this is the most critical part of the adjustment of the national health care drug catalog.
171 drugs were approved for sale between 1 January 2015 and 17 August 2020, according to a previously published list of drugs that have been reviewed in a formal form.
In order to encourage innovation, the National Health Insurance Drug Catalog will be adjusted in 2020 for the first time to implement enterprise-owned declaration, no longer by experts to select which drugs can be eligible for first instance, and the deadline for the approval of innovative drugs to market further relaxed.
while it remains to be known whether companies will be able to negotiate prices for new drugs listed on the health insurance market, the move to relax the entry threshold has raised expectations for all innovative drug companies.
, the pharmaceutical industry has become the focus of investment due to the outbreak of neo-crown pneumonia.
as of September 20, there were 271 clinical trials related to drugs to fight neocoopon pneumonia alone.
, health care charges, drug reform, China-U.S. decoupling, etc., have also become the industry's development of "uncertainty factors."
china's innovative drugs go well in the next decade? Caijing reporters interviewed Song Ruixuan, executive chairman of the China Association for the Promotion of Pharmaceutical Innovation, on related issues.
Only focus on health insurance is not the "finance": the national health insurance drug catalog into the annual dynamic adjustment, to innovative drugs into the catalog to provide a large number of opportunities, while reducing prices in that, how to see the advantages and losses?Song Ruixuan: The reform of the national medical insurance system has been adjusted very fast in recent years, and it is becoming more and more reasonable.
from the past few years to two years, now once a year, there is a lot of progress.
this year's health-care catalog adjustment rules also have an innovation: eligible enterprises can declare their own, for enterprises to have more active choice, which is a huge step forward.
health insurance management model is on the road from "administrative management" to "scientific management".
the goal of china's health care reform is to meet clinical needs, and drug research and development is also the pursuit of clinical value, so the direction of the two is the same.
health insurance is to spend money for the people to buy good medicine, so the higher the quality of drugs, the richer the innovative drugs, the greater the value of health insurance.
, however, there is room for improvement in directory adjustment rules, especially for a new class of drugs.
these innovative drugs often fill gaps in clinical treatment directly or can effectively replace existing clinical drugs.
the reform of the national drug review and approval system, a fast approval channel has been set up for innovative drugs to improve the efficiency of drug approval, with the aim of making innovative drugs available to patients as much as possible.
Therefore, we hope that the future of a class of innovative drugs access to the national health insurance directory model, not a regular adjustment once a year, but dynamic adjustment, that is, approved for listing at the same time to open up the opportunity to enter the health insurance directory negotiations, so that patients as soon as possible to use good drugs, new drugs, to meet clinical needs, to achieve seamless docking.
, China is currently approved each year a class of about 10 innovative drugs, if coupled with improved innovative drugs will be more than 20, the pressure on health insurance funds is not great.
, and many of them are already in the health insurance reimbursement directory, domestic new drugs into the catalog will only increase competition, lower drug prices, reduce the pressure on health insurance funds.
: The National Health Insurance Administration says it expects this year's success rate to be lower than in previous years because of the increase in the number of innovative drugs and the fact that drug companies may not be able to accept negotiated prices for health insurance.
: Innovative drugs are a high-tech-intensive industry, long research and development cycle, high risk, high cost, so the price is also high.
In turn, if the pricing of innovative drugs is too low, pharmaceutical companies will not be able to recover research and development costs, will eventually lead to no one willing to research and development, investors are not willing to invest, the end result is money can not buy drugs, so it is necessary to create a positive cycle of innovative drug pricing.
drugs, which are closely related to life and health, contain two attributes, one is social attribute and one is commodity attribute, the key is to master the balance between the two.
Commodity attributes must be respected, to emphasize profitability, on the other hand, drugs and human life and health related, it has a strong ethical and social attributes, since social attributes need social co-governance, by the government, society, enterprises and individuals to share the burden, need to establish a reasonable payment system and structure, pay attention to the proportion of patients, not just rely on reducing the factory price of enterprises.
, of course, basic national health insurance is not inaction in terms of innovative payments, and funding is limited, so there are a number of ways to control risk.
For example, the internationally accepted risk-sharing approach, such as a new drug that is expensive, now predicts that 10,000 boxes will be sold a year after entering health insurance, and the state's basic health insurance and businesses are negotiating a price to enter the health-care catalog.
if the actual sales exceed the agreed amount, the company will return a portion of the money to health insurance, or the company will lower the price.
, health care and businesses work together to find a balanced approach, which is common internationally.
I think that in order to make medicines affordable to ordinary people, it may be possible to get short-term effects by simply lowering drug prices by taking low prices, or by competing at the bottom price, but in the long run it is still possible for patients to suffer."
, we need to look at health care objectively.
China's health insurance is basic medical insurance, fund affordability is a ceiling, health insurance fund pool is so large, if all pay for innovative drugs, then a large number of generic drugs, chronic disease drugs how to do? The thinking of health insurance payment is the bottom line thinking, so it is unfair to simply blame the health care sector for not including more new drugs, and the whole society should help the health care sector find a way to distract from the pressure.
basic health insurance to be measured out, first of all, "clear the warehouse", so that really useful drugs into the health insurance catalog.
that the clinical effect is not obvious and the clinical value is not outstanding still exists in the medical insurance catalogue, which leads to the serious waste of medical insurance funds.
this problem is not only driven by the health care sector alone, but also requires the drug regulatory department to conduct a re-evaluation of the clinical effects of the drug.
The question that the government and the industry as a whole are now thinking about is not forcing basic health insurance to pay for too much innovative drugs, but how it can open up more payment methods, such as commercial insurance, which middle-income earners can afford to reduce the burden of basic health insurance.
We hope that health care can drive innovation, which is a responsibility of government agencies to respond to the national innovation-driven strategy, but health care can only do what it can."
: One view is that China's health-care commercial insurance is growing slowly, in part because basic health insurance covers too many areas to leave enough room for commercial insurance?Song Ruixuan: It makes sense, but this understanding is not comprehensive.
principle of basic national medical insurance is broad coverage and basic insurance.
coverage, the closer people are to health care.
health insurance is like a parent at home, the more you manage, the slower your child grows.
in fact, there are many difficulties and problems that can be shared by socialized, market-oriented subjects, there is no need to press on health insurance.
health insurance should return to basic health care, giving room for commercial insurance.
of course, as far as commercial insurance for health care is concerned, there is still a need for government-led leadership at this stage, and the key is to operate in accordance with market rules.
: How can the Government guide the development of commercial insurance?Song Ruixuan: For example, the encouragement of tax policy.
If an individual buys commercial insurance, like the Australian government, the government takes a 30 per cent annual tax rebate, and businesses can also have tax breaks if they buy commercial insurance for their employees and should settle before tax.
There are many such experiences to learn from, the need for the government to effectively let enterprises or institutions, in the wages can be paid as a benefit to employees, then the attractiveness and stability of employees is higher.
public hospitals are the main spending scenario for universal health care, should health authorities encourage commercial insurance to enter public hospitals? Then the government's financial department, whether should do to guide funds to participate in commercial insurance, these are all the government can do, the government is the most powerful force in social management.
In the case of market space, commercial insurance itself must also practice hard work, into a hospital treatment of the third-party evaluation mechanism, to know whether the doctor's prescription is reasonable, if the doctor casually open a large prescription, you can cancel the business insurance reimbursement eligibility, on the contrary, there is a reward.
Our commercial insurance is still in its infancy, using only medical care or medical insurance as a profitable tool, which is not sustainable, as a tool for social management and the promotion of social value, in the process can be profitable and sustainable."
, China's innovative drug development needs to be supported by basic health insurance, commercial insurance, charitable assistance, and a multi-level insurance system for individual payments.
to maintain a reasonable profit margin for medicines Caijing: In the existing payment environment, the soil for the development of innovative drugs is good enough?Song Ruixuan: China's innovative medicine spring has arrived, in the fertile soil of spring still need more fertilization, more dressing, let it grow a larger tree, is now this link.
As a pharmaceutical innovation promotion association, we call for innovative drugs, but also must be very rational analysis, we are currently targeting the basic health care is realistic, to rationally set what it should bear.
there are some innovative drugs, such as "orphan drugs", if the state does not adopt special policies, then doomed to no market space, enterprises have no income why do?Now pharmaceutical innovation is a very hot field, it is China's progress let everyone see hope, but also hope to see the next 10 years, China-based multinational pharmaceutical companies, can contribute to global human health.
Caijing: Previously, 700,000 yuan a rare disease "spinal muscular dystrophy medication" caused public debate.
: Speculation about the price of any drug is meaningless, society should have a rational voice.
to look rationally at what the price of the same drug is on the international market, and then what percentage of the individual pays.
if its average cost is high, the underpriced drug disappears.
doesn't make sense if the price is too high, there's a $2 million prescription drug in the U.S., and who's going to spend $2 million on that medicine? No actual transactions occurred.
now the relevant state departments are studying the reimbursement path of rare disease drugs, including the source of funds.
health-care sector now has its own system, trying to help with rare diseases, and it's impossible to cover all the costs right now, and it's bound to be tiered step by step.
social security system is a concentrated reflection of the country's ability to govern.
problem is to use a social security framework, such as national health insurance, commercial insurance, personal payments, corporate profits, to control individual drug payments to a reasonable range, rather than simply reduce prices.
: Is there a business insurance company now involved in the market for rare disease payments?Song Ruixuan: At present, I do not have this information, there are insurance companies in the study, many people are concerned about this area.
but requires supporting policies, which is a matter of coordination at the national level.
: The number of innovative drug companies participating in the national health care catalog adjustment negotiations this year may be more, fierce competition, but also to maintain a reasonable profit margin of drugs?Song Ruixuan: Since it is market competition, then the market plays a decisive role in the allocation of resources, who can control costs, who can obtain profits in the existing price system, who can survive.
can't be too anxious about generic drugs Caijing: At present, China's pharmaceutical companies' revenue mainly comes from the generics business, and the impact of the national drug belt procurement on generic drugs is obvious, will it affect innovative drugs?Song Ruixuan: China is still a generic combination, mainly imitation drug market structure.
including companies known for their innovative drugs, even those in the hundreds of billions of dollars of listed companies, more than 80 percent of its profits come from generics, so don't rush on generics now.
is still in the exploration stage, this exploration is not over.
Because the volume of procurement itself is as a commercial act, but we take the volume of procurement of Party A and Party B, the status is not the same, one is very strong, that is, this is a buyer's market, the buyer decided the price, because the buyer does not buy, the seller can not find the market.
market forces must be to promote high-quality generic drugs, to good money to eliminate bad currency.
now put generic drugs in a pool of bidding, in the same variety, the same quality level, of course, the low price should be preferred, but the question is whether the low price is low to reasonable?In this process, the most worrying thing for me is not to make the price below a reasonable cost.
once the price is lower than a reasonable cost, it may lead to quality risk, and the other is the risk of market supply cut-off, which is not the pursuit of volume procurement.
I think no matter what kind of product, as long as it is lower than a reasonable cost can not let it win the bid, this is like our "green song race", to get rid of a maximum score, remove a minimum score, the mechanism set can not let everyone try to target the lowest score, but rational to quote.
Caijing: So, through the current volume of procurement has found a reasonable price for drugs?Song Ruixuan: I think it is touching, but I still stress that I am very worried about the low price winning bid.
, especially in local pilots, some drugs that do not pass the consistent evaluation are put together to compete, and if they are not at a quality level, the phenomenon of the expulsion of good currency will occur.
think it's debatable and cautious.
Caijing: Since the volume of procurement is in an exploration period, it will continue to adjust, how should enterprises adapt to this change?Song Ruixuan: If this policy is to more and more mature direction, instability is not necessarily a bad thing.
Caijing: Should drugs be the bottom line of national procurement through consistent evaluation?Song Ruixuan: Of course, the bottom line, because drugs should be on a standard, the same drug how