The sales volume of drug price negotiation varieties soared, with the highest growth rate exceeding 3000%! Auxiliary drugs out of the game, the whole line down! The shuffle of state led pharmaceutical enterprises began

Source: on the one hand, on April 17, 2018, more advantageous therapeutic varieties and high price therapeutic drugs for major diseases were gradually included in the medical insurance catalogue to realize price for volume exchange On the other hand, the restrictions on adjuvant drugs are becoming more and more strict The market pattern has begun to change If you don't want to die, you have to change According to the PDB database, more than 680 key city hospitals in 24 regions of the country were selected as sample hospitals In 2017, the total sales volume of sample hospitals reached 22.23 billion yuan, an increase of 1.58% year on year In fact, since 2014, the sales growth rate of sample hospitals has been declining, with the year-on-year growth rates of 11.53%, 12.53%, 6.45% and 7.49% respectively in 2013-2016 On the other hand, according to IMS data, in the fourth quarter of 2017, the drug sales at the hospital end showed a negative growth, which was mainly related to factors such as bidding price reduction, the proportion of actively controlled drugs at the hospital end, the growth rate of drug fees, hierarchical diagnosis and treatment, etc On the one hand, with the gradual progress of medical reform, through drug price negotiation, more advantageous therapeutic varieties and high-priced therapeutic drugs for major diseases are gradually included in the medical insurance catalog to achieve price for quantity On the other hand, the restrictions on auxiliary drugs are becoming more and more strict Provinces have issued policies to restrict auxiliary drugs In addition to limiting the indications for reimbursement, some adjuvants have been removed from the Medicare catalog 1 as of December 25, 2017, 31 provinces, autonomous regions and municipalities directly under the central government have announced that 36 negotiated drugs have been included in the category B directory of medical insurance, and most of the specific implementation time starts from September 1, 2017 Among them, 12 provinces such as Heilongjiang and Jiangsu directly purchase online, and Shaanxi and Xinjiang limit price purchase Since the third quarter of 2017, drugs included in the medical insurance catalog through negotiation have been purchased according to the new bidding price According to the results, the volume in the fourth quarter of 2017 is obvious, and the terminal price is close to the negotiation price Due to the different implementation progress of medical insurance in various provinces and cities, the sales volume of negotiated varieties is expected to maintain a high growth in 2018 In terms of sales volume, 2017 In the fourth quarter of the year, the varieties of domestic enterprises participating in the negotiation increased by a large margin, with the growth of apatinib of Hengrui medicine, alisartan ester of xinlitai, ginkgolide of Kongyuan medicine, molinnidazole of Haosen, and ginkgolide of Baiyu pharmaceutical all exceeding 300%; in terms of sales volume, apatinib of Hengrui medicine, alisartan ester of xinlitai, and conbercept of Kanghong pharmaceutical The year-on-year growth of Ginkgolides in Kangyuan Pharmaceutical Co., Ltd was over 25%, and that of other varieties was relatively slow Source: PDB database, Tianfeng Securities Research Institute In terms of imported products, in the fourth quarter of 2017, the sales volume of AstraZeneca's fluvectorum, Roche's bevacizumab, jianzan's fluvectorum, Novo Nordisk's lilaluptide, shire pharmaceutical's lanthanum carbonate chewing, new base organism's lenalidomide, Janssen's abitron and bortezomib all increased by more than 200% year on year Data source: PDB database, from the perspective of sales volume of Tianfeng Securities Research Institute, except for the decrease of 14.69% in the sales volume of paroxetine enteric coated slow release of GSK, the sales volume of other varieties increased significantly year on year In the fourth quarter of 2017, sales of some varieties, such as AstraZeneca's fluvistrone, jianzan's carbonation siram, mosadong's posaconazole, Novo Nordisk's lilalutide, shire pharmaceutical's lanthanum carbonate chewing, Neogene's lenalidomide and Janssen's abitrone, increased by more than 70% on the same basis It can be predicted that in the future, innovative drugs and more therapeutic varieties can be included in the medical insurance timely through the dynamic adjustment mechanism of the medical insurance catalog After the newly established health insurance bureau goes online, the super department with pricing right, purchasing right and payment right will also intensify negotiations, and the price reduction is likely to be greater For pharmaceutical enterprises, it is worth noting that the current policy of the state is very clear, that is to let those therapeutic products enter the medical insurance through drug price negotiation and other ways, so as to reduce the burden on the people Therefore, there will be all kinds of support for these kinds of medical insurance entered through drug price negotiation to benefit enterprises, which is the guidance of the state Next, with the tariff reduction of imported anti-cancer drugs, the national level will start new drug price negotiations, and more products will be included in the medical insurance through negotiations However, after the previous two rounds of negotiations, the national level has a relative grasp of product prices Therefore, under various policies such as tax reduction, the following negotiations will have a more say in the price reduction In addition, after the reform of most systems, the State Medical Security Bureau, which has both the money and the right, has really started to determine the Department of the life and death of the enterprise's products The price for quantity will no longer present various constraints, so as to protect the rights and interests of the entrants from all levels, so as to guide more product price reduction Purpose At present, a number of provinces and cities have accounted for the negotiated varieties separately, which are not included in the hospital drug proportion assessment Therefore, from the national level, we should not only vigorously promote drug price negotiation, but also make the enterprises involved in drug price negotiation profitable, so we will provide various favorable guarantees for the implementation of the policy The difference between the decline of more than 50% of traditional Chinese medicine injection and the obvious volume of negotiated varieties is that the auxiliary drugs and traditional Chinese medicine injection continue to bear pressure In the 2017 new version of the medical insurance catalog, the use of traditional Chinese medicine injections is strictly limited, which can only be used under specific conditions, and all of them are limited to secondary and above medical institutions For traditional Chinese medicine injections, which used to be mainly sold in primary hospitals, the impact on sales can be imagined According to the Research Report of Ping An Securities, the proportion of nervous system drugs continued to increase from 2012 to 2016, and began to decline significantly in 2017 In the first half of 2017, the sales volume of monosialotetrahexosylganglioside, oxiracetam, calf blood protein extract, Ginkgo biloba extract and other large-scale varieties decreased much more than the whole category of nervous system drugs, and the impact of auxiliary drug restrictions began to appear In addition, the growth rate of strictly controlled traditional Chinese medicine injection Market is obviously weak According to the data of Ping An Securities, the market scale of traditional Chinese medicine injection industry in 2016 was 89.08 billion yuan, with a growth rate of less than 1% In terms of products of related companies, in the fourth quarter of 2017, the sales volume of Ginkgo biloba extract of treasure island and Shenwei pharmaceutical dropped by more than 50% year-on-year, Shenmai injection of Shenwei pharmaceutical, Shenqi Fuzheng injection of Lizhu group dropped by more than 30% year-on-year, and danshenchuangongzine injection of Kangenbei dropped by more than 25% Affected by the policy, the sales scale of traditional Chinese medicine injection in secondary and above hospitals will continue to be under pressure in 2018 Source: PDB database, Tianfeng Securities Research Institute, in accordance with the guidance on comprehensive reform pilot of urban public hospitals issued by the general office of the State Council, proposes to strive to reduce the proportion of public hospitals in pilot cities (excluding Chinese herbal pieces) to 30% left and right by 2017 Another goal is to comprehensively push forward the comprehensive pilot reform of urban public hospitals in 2017, which also means that all public hospitals across the country need to reduce the proportion of drugs to less than 30% Therefore, in the terminal of hospital medication, auxiliary medication has become the first damaged side of the drug proportion limit Since last year, provinces have introduced policies to limit the use of complementary drugs Jiangsu Province should appropriately increase the proportion of self payment for the drugs that play the role of auxiliary treatment or are easy to be abused, open the level of payment proportion with other class B drugs, and establish a dynamic adjustment mechanism Fujian Medical Insurance Office also set the medical insurance settlement price of common varieties of auxiliary drugs such as Salvia miltiorrhiza, Xueshuantong and Xuesaitong as only 50% of the maximum sales price of their medical insurance Henan Province issued a catalogue of 48 auxiliary drugs, including hundreds of varieties, covering 18 cities and 9 counties, including Zhengzhou City, 21 provincial hospitals including the First Affiliated Hospital of Zhengzhou University At present, the top 20 drugs in China are concentrated in the fields of anti infection, adjuvant drugs, infusion and so on, which is greatly different from the global drug market structure Therefore, the products with high clinical value will have greater market space in the future For enterprises, with the change of market, the product strategy will also change, otherwise it will be eliminated In fact, the country has laid the foundation for the future development of the pharmaceutical industry through various policies Although on the surface, the policy of controlling the proportion of drugs and the two vote system runs counter to the principle of market economy, in fact, it is a backward mechanism, that is, the strategy of "vacating the cage and changing the birds" Through the backward mechanism, the hospital can adjust its medication structure, guide the patients with real clinical value, and let those "magic drugs" out Now it is just the beginning Next, we will There are more actions to sort out the products that have no clinical value 2018 will be the year when all policies are fully implemented, and the Medical Security Bureau will make full efforts to open fire As a year, the industry reshuffle is officially launched this year.