The results of the medical insurance negotiation were announced, and the prices of ADCs and small molecule inhibitors were announced for the first time.

On January 1, 2022, the new version of the National Medical Insurance Drug Catalog was officially implemented
.

With the results of the medical insurance negotiation on the Internet, the medical insurance prices of a number of innovative drugs were exposed, involving PD-1, BTK, PARP, EGFR, ALK, HER2-ADC and other tumor drugs, as well as tacitcept, 971, cyclopofol, etc.

With the shortening of the adjustment time of the medical insurance catalogue, the speed of innovative drugs entering the medical insurance catalogue is getting faster and faster.
In some disease treatment fields, the trend of domestic substitution of imports is gradually emerging; The price has been reduced, and some sky-high-priced drugs have also been reduced to civilian drugs, and the accessibility of patients has been further improved.
.
.

The first talk about drugs has dropped by more than 60%

The first talk about drugs has dropped by more than 60%

Slight price reduction for renewal varieties

Slight price reduction for renewal varieties

In 2021, a total of 117 drugs participated in the medical insurance negotiation, 94 of which were successfully negotiated, with an overall success rate of 80.
34% and an average decrease of 61.
7%
.

Based on the negotiation results of the past 6 years, the decline rate of the varieties negotiated for the first time tends to be stable and remains in the range of 40-60%

According to the statistics of the pharmaceutical team of Huachuang Securities, in this medical insurance negotiation, the anti-tumor drugs included in the medical insurance catalog for the first time dropped by an average of 62.
9%; most of the declines of the renewed varieties were in the range of 5%-20%, and the bottom of the drug price expectations has gradually become clear
.

The limit price of domestic new drugs is estimated according to the size of the indications: 10,000-30,000 yuan/year for super large targets (PD-1); 30,000-50,000 yuan/year for large targets (EGFR, VEGFR, CDK4/6); 5-50,000 yuan/year for medium-sized targets 100,000/year (PARP, ALK, BTK, HER-2); orphan drug 100,000-300,000/year (HDAC)
.

In this medical insurance negotiation, the average decrease of drugs in other therapeutic areas included in the medical insurance catalog for the first time was 63.
8%; the average decrease of the renewed varieties was 25.
5%
.

According to the statistics of Essence Securities, from the perspective of 30 key innovative drugs such as PD-1, small molecule inhibitors, and ADC drugs, in addition to camrelizumab, ibrutinib, olaparib, almetinib, and Oxy In this medical insurance negotiation, no new indications have been added to the medical insurance catalog.
After maintaining the 2021 medical insurance prices, the remaining 25 innovative drugs with price changes dropped by an average of 52%
.

Domestic small molecule inhibitors are actively entering the market

Domestic small molecule inhibitors are actively entering the market

Alys, Betta, and Hengrui first talk about a large drop in drugs

Alys, Betta, and Hengrui first talk about a large drop in drugs

In addition to Internet celebrity PD-1, etc.
, the negotiation results of small molecule inhibitors under Hengrui, BeiGene, Nuocheng Jianhua, Betta, and Ellis have also attracted much attention in the industry this year.
Many small molecules participated in the negotiation for the first time.
Inhibitor products have also successfully entered
.

In terms of average annual treatment costs, the average annual treatment costs of anti-tumor drugs such as BTK inhibitors, PARP inhibitors, third-generation EGFR inhibitors, first-generation EGFR inhibitors, and ALK inhibitors are 125,000 yuan
.

Among them, the more concerned BTK inhibitors, PARP inhibitors, third-generation EGFR inhibitors, and ALK-TKI specific negotiation results are as follows:

BTK inhibitors: The three approved indications of AbbVie/Johnson & Johnson's ibrutinib have all entered the medical insurance catalog, and are still within the validity period of the agreement, and the previous price is still maintained
.

Nuocheng Jianhua's orelabrutinib entered the negotiation for the first time, with a decrease of 51%; BeiGene's zanubrutinib, a new indication for adult Waldenstrom's macroglobulinemia, also successfully negotiated, with a decrease of 14%
.

The current medical insurance treatment annual reference values ​​of BeiGene's zanubrutinib and Nuochengjianhua's orelabrutinib are 122,000 and 128,000 respectively, and the prices tend to be at the same level

PARP inhibitors: The main products are AstraZeneca's olaparib, Zai Lab's niraparib, BeiGene's pamiparib, and Hengrui's fluzoparib
.

Olaparib added BRCA-mutated prostate cancer indications to participate in the national negotiation, but the negotiation was unsuccessful.
Its reference to the treatment cost in the previous year was 147,000; niraparib added ovarian cancer, fallopian tube cancer, and primary peritoneal cancer first-line The maintenance treatment participated in the negotiation, and the negotiation was successful in the end.
Nirapari reduced the price by about 24% with the new indications this time, and the annual treatment cost is expected to be 165,000 yuan
.

Baiji Shenzhou's pamiparib and Hengrui Medicine's fluzoparib entered into negotiations for the first time, with a drop of 54% and 43% respectively.
The current reference value of the current medical insurance treatment annual fee is 116,000 yuan
.

The third-generation EGFR-TKI: the current competitive landscape is 2 domestic and 1 imported varieties - Hansen Pharmaceutical's Ametinib is still within the validity period, and the previous price is still maintained, with a reference annual fee of 127,000 yuan; Metinib entered the negotiation for the first time, with a decrease of 79%, and the reference annual fee was 85,000 yuan; AstraZeneca's osimertinib, a new indication for the adjuvant treatment of EGFR-sensitive mutation non-small cell lung cancer, participated in the negotiation, but the negotiation was unsuccessful.
The previous price is still maintained, and the reference annual fee is 67,000 yuan
.

ALK-TKI: Betta Pharmaceutical's Ensatinib participated in the medical insurance negotiation for the first time, with a decrease of 70%, and the reference annual fee was about 138,000; Roche's alectinib participated in the renewal negotiation, with a decrease of 7%, with a reference to the annual fee is about 182,000
.

Pfizer's crizotinib and Novartis' ceritinib are still within their expiry dates and have not lowered their prices

It is worth noting that the efficacy data of the domestic variety ensatinib is better than that of the first-generation ALK inhibitor crizotinib and comparable to the imported second-generation ALK inhibitor alectinib
.

In addition, multi-target TKIs: Zejing Pharmaceutical’s Donafenib fell by 69%, with a reference annual fee of 31,000; Chi-Med’s surufatinib fell by 52%, with a reference annual fee of 87,000
.

TPO-R: Hengrui Medicine’s first negotiated entry into the first negotiation of Hetrombopag ethanolamine also achieved a 69% drop

It can be seen that new domestic small molecule inhibitor drugs are actively entering the market, accelerating import substitution
.

Some brokers have predicted that if they enter the medical insurance catalogue this time, the domestic varieties will further expand the market.

Get medical insurance quickly

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Rongchang Bio's 2 new drugs dropped by about 70%

Rongchang Bio's 2 new drugs dropped by about 70%

The 2021 version of the medical insurance catalogue was announced.
Among the ADC drugs, Rongchang Bio's vedicetumab (trade name: Aidixi) successfully entered the market, while Takeda's velbuximab (trade name: Anxali) did not enter
.

Among the 3 ADC drugs that have been marketed in China, Roche's trastuzumab (trade name: Hercele) and vedicetumab both target HER2
.

However, the approved indications of trastuzumab in China are mainly in the field of breast cancer
.

In January 2020, the first indication was approved - adjuvant therapy for patients with HER2-positive early breast cancer with residual invasive lesions after receiving taxanes combined with tratocilizumab-based neoadjuvant therapy; In June 2021, another indication was approved—monotherapy for patients with HER2-positive, unresectable locally advanced or metastatic breast cancer treated with taxanes and trastuzumab

Among them, the annualized cost of trastuzumab emmet is still close to 600,000 after considering the charity donation
.

Rongchang Bio's Vidicitumumab will be launched in June 2021, and the annualized cost of gastric cancer indications after the donation is about 340,000

Currently, only Hengrui Medicine's apatinib and vedicetumab have been approved for third-line treatment indications for locally advanced or metastatic gastric cancer
.

Rongchang Bio's Vidicitumumab 60mg dropped from 13,500 yuan to 3,800 yuan, a decrease of 71.
85%
.
According to the price after the medical insurance negotiation, assuming that the patient’s weight is 60Kg, and referring to the median progression-free survival (mPFS) of Rongchang Bio’s third-line treatment of gastric cancer with vedicetumab Proportion) to pay an annual fee of about 41,000 yuan
.

Another innovative drug of Rongchang Bio, Taitacept (trade name: Taiai), was launched in March 2021.
After medical insurance negotiation, the price of Taitacept 80mg dropped from 2586 yuan to 818.
8 yuan, a decrease of 68.
34%
.
The current annual medical insurance treatment fee is 79,000 yuan
.

Taitacept's main competitor is GlaxoSmithKline's belimumab (trade name: Beliton)
.
Belimumab is the world's first biotargeted agent approved for the treatment of systemic lupus erythematosus (SLE).
In July 2019, GlaxoSmithKline's belimumab was officially approved in China
.
In 2020, Belimumab is priced at 1976 yuan/120mg
.
After the medical insurance negotiation that year, it was reduced to 755 yuan/120mg
.
The recommended dosing regimen is 10 mg/kg every 2 weeks for the first 3 doses and every 4 weeks thereafter
.
Based on this calculation, the annual drug cost of Belimumab after being insured is about 41,500 yuan
.
In the 2021 medical insurance negotiation, Belimumab will cut the price by another 7%
.

other

other

Regarding the price of other closely watched drugs, such as the price of domestic PD-1, we have made a report recently (see: "The latest price of domestic PD-1 is exposed! Medical insurance reshuffle, track cooling, Junshi, Cinda .
.
.
")
.

In addition, Biogen's spinal muscular atrophy (SMA) treatment drug Nosinagen Sodium Injection (Spinraza) 5 ml 12 micrograms each dropped from 53,680 yuan to 33,000 yuan, a drop of nearly 40% before and after; Green Valley Pharmaceutical's Ganlu The price of special sodium capsule (Ninth Phase One) 0.
15 has dropped from 895 yuan to 296.
1 yuan, a decrease of 66.
92%, and the current annual medical insurance treatment fee is about 15,000 yuan; Xingqi ophthalmic cyclosporine eye drops (Ⅱ) 0.
4ml : The price of 0.
2mg (0.
05%) has been reduced from 799 yuan to 165 yuan, a decrease of 79.
35%.
The current annual medical insurance treatment fee is about 2,000 yuan.
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Attachment: 2021 National Medical Insurance Catalogue Product Price and Drop Details

Drawing: rainbow, slowly

Note: The chart is manually entered, if there is any error, please welcome errata
.

Reference materials: corporate announcements, recruitment platforms, Huachuang Research, Essence Securities,
etc.
In this article, the annual fee and the doses with reference to body weight are assumed to be patients with a body weight of 60kg
.