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Domestic insulin companies are more difficult
than all parties think with the help of national procurement and release.
01 Insulin national mining for half a year
01 Insulin national mining for half a yearThe "price for volume" of domestic enterprises did not meet expectations
The "price for volume" of domestic enterprises did not meet expectationsThe results of the sixth batch of insulin special national procurement were issued on November 30 last year, and basically landed nationwide in June this year
.
However, in half a year, many domestic insulin companies "can't sit still"
.
Relevant people reported to Cyboran that up to now, the agreed purchase volume of hospitals with foreign companies has been overcompleted, and other enterprises have not done well, especially domestic enterprises, and some have basically not moved - domestic enterprises have relatively large opinions and are giving feedback from all parties
.
Fortunately, the complaint has also attracted attention
.
In response to the opinions of enterprises, on October 21, the National Health Insurance Administration has held a meeting with enterprises, and a relevant person told
Cyboran.
Cyboran noted that some provinces have issued notices on the implementation of the results of the national selection of insulin, and the rhetoric is also very direct
.
The Hunan Medical Insurance Bureau pointed out in the notice:
The special collection and procurement of insulin landed, but the procurement volume showed a two-level differentiation trend
.
Foreign companies have exceeded the quota, and the completion rate of domestic enterprises is even less than 20%, which is far
from what was originally expected.
"Previously, we expected the purchase volume to be good, and maybe even exceed the quota early, even at normal procurement volume, it should now be 40-50%
.
" An insider from a domestic pharmaceutical company that entered the collective procurement revealed
to Cyboran.
.
It is worth noting that on the eve of the landing of the special national procurement of insulin, the National Medical Insurance Administration has issued a notice to improve the special centralized procurement and use of supporting measures for insulin, and in the earlier stage of collective procurement rules, whether the replacement of products can be completed smoothly has also been considered
by the National Medical Insurance Administration.
Clearly, policymakers have thought of the possible domestic substitution dilemma
.
It's just that the problem still arises
.
.
It's just that the problem still arises
.
Why is the implementation so far from the expectations of domestic enterprises in the early stage, an industry veteran said that the core problem is still the implementation of the implementation - hospitals, there is no motivation, and there is the implementation of medical insurance and the management of patient services in a series of enterprises
.
It believes that hospitals "don't care" whether they use domestic or imported, including patients
.
Because the personal payment part is too low, generally at 10%-20%, the price gap between imported and domestic production is not large
.
As for the lack of motivation in hospitals, the main reason is that the incentive mechanism is not in place, according to which it is understood that this is the situation of
many hospitals.
The special domestic replacement of insulin, after 6 months of gestation, is still too early
.
Or the domestic substitution of biological drugs and chemical drugs, it is indeed a different logic and difficulty
.
According to the above-mentioned senior analysis, the insulin market believes in the "terminal wins" theory
.
The low price of insulin is difficult to bear the high cost of injection device circulation, which is also the advantage
of the high-threshold commercial system established by foreign companies in this field.
Some people also say that the inconsistency of injection pens is a major "blocking point"
that makes it difficult to replace insulin in China soon.
The inflection point of price for volume has not yet arrived, and the domestic insulin faucets that won the bid for 6 insulin products are also facing this impact
.
The aforementioned industry veterans believe that centralized procurement has a great impact on the revenue of domestic insulin companies, because many companies have reduced prices by at least 40%-60%, and this pricing itself is not in line with the market expectations
of enterprises.
In this case, the purchase volume needs to be doubled to meet the financial expectations
.
However, in the view of domestic insulin companies, although the performance has suffered short-term pains, they still hope to quickly increase their market share by taking advantage of the high bid of centralized procurement, laying the foundation
for subsequent sales growth and rapid entry of new products into the market in the future.
Relevant people from several domestic companies revealed to Cyboran that some of them have found relevant departments for meetings to discuss countermeasures, and then "began to find provincial medical insurance bureaus one after another, hoping to issue a document like Hunan to supervise"
.
02 The completion rate of procurement volume is low
02 The completion rate of procurement volume is lowCompanies: "We are also wondering"
Companies: "We are also wondering"The Hunan Provincial Medical Insurance Bureau issued a document emphasizing that "the medical insurance departments of various states and cities should earnestly perform their regulatory responsibilities, increase monitoring and scheduling, urge medical institutions to strictly follow the agreement and reasonable procurement, and ensure that the agreed procurement volume is completed on schedule"
.
In response to the recent release of the completion rate of insulin agreed procurement in Hunan Province, an industry insider said, "The implementation of insulin can be seen that these products involved are newly listed products, the market foundation is poor, the market has not formed the habit of using these products, and cannot fully reflect the advantages of centralized procurement and low price selection, but with the in-depth understanding of the centralized procurement policy, more patients will be more willing to use high-quality and low-cost insulin
.
" “
"After the price reduction of three generations, I am more willing to use three generations of insulin," and when asked whether the hospital would allocate the amount of insulin to department doctors in the next few months, the person said, "In order to avoid the safety risks
caused by a large range of patients replacing drugs.
" It is hoped that all relevant pharmaceutical institutions will reasonably adjust their procurement plans according to the agreed procurement volume, and do a good job in orderly substitution between different brands of insulin"
.
"
From the perspective of the completion rate of the agreed procurement volume, the documents released by Hunan show that the completion rate of individual products is even less than 20%, and the procurement progress is seriously lagging behind
.
The above-mentioned persons also expressed concern
that pharmaceutical institutions could not complete the agreed procurement volume during the bidding period.
A person who does endocrine consumables said, "I talked to doctors some time ago, according to the current purchase volume, it is estimated that December will be uniformly distributed to individual doctors, and the bonus
will be deducted if it is not completed.
" "These are things that our companies don't want to see, a number of business people said
.
The aforementioned relevant people also said that in order to successfully complete the agreed procurement volume of domestic insulin, it is expected that there will be a specific plan in the future, but it also depends on the implementation of
relevant departments.
As for the specific rules that may be introduced, behind this is a mathematical problem, the collection of procurement reports and the current implementation of the provinces should be comprehensively compared, look at the overall completion, and then issue the detailed rules, because there are other factors
in it.
It is expected that there will be several sets of plans in the future, gradually introduced according to the implementation of the plan, of course, the strength of the program will be gradually strengthened, according to its understanding, the overall idea to ensure the implementation of the results of the special collection of insulin is to strengthen management, the whole country is a chess game
.
However, the purchase volume does not meet expectations, and it depends on the situation
.
"Grade hospitals will be better, after all, there is no shortage of new patients
, and primary hospitals generally continue the prescriptions of higher-level hospitals, and there are not enough new patients, and the procurement completion rate of primary hospitals has lowered the overall situation," added a person in the endocrine consumables market
.
03 Pharmaceutical companies:
03 Pharmaceutical companies:Some lay off employees, some recruit
Some lay off employees, some recruitOn November 30 last year, shortly after the results of the insulin special national selection were officially announced, Novo Nordisk and Sanofi reported layoffs
.
On November 30, Eli Lilly announced that all six insulin products participating in the collective procurement won the bid.
Half a year later, just yesterday (November 9), Eli Lilly held an internal conference call to notify the layoffs and asked employees to wait for news
.
A person close to Lilly said that the above news is "true", "The adjustment is mainly the line of Lilly diabetes products,
They are responsible
for insulin and GLP-1.
The main reason is that in September this year, Eli Lilly has been in short supply for a long time in the country of dulaglutide is out of stock, as for when it will be broken, it is still uncertain; Now insulin, it is estimated that it will not feed too many people"
.
"Personnel adjustments exist, mainly insulin, GLP-1, and compensation for relevant personnel has been arranged, and it is not convenient to disclose
the number of layoffs.
" Lilly said
.
Regarding why this decision was made, the above-mentioned people said that the market is changing rapidly, too much uncertainty, under the comprehensive influence of the epidemic, centralized procurement and other factors, this adjustment is based on the changes in the entire market, the overall market this year is more turbulent, there are also some problems in supply, overall, it is a phased adjustment
that has to be made due to force majeure.
On the other hand, domestic insulin companies have been recruiting in advance
.
.
A few days ago, Gan&Lee Pharmaceutical expanded its team after collection, and an insider of Gan&Lee Pharmaceutical said that the expanded team is mainly used for the business of
grassroots and grade hospitals.
The sixth batch of insulin special centralized procurement adopts the principle of non-elimination, foreign companies and domestic enterprises also reduce prices, for foreign companies, price reduction can keep the "half of the rivers and mountains" laid down before, after all, the amount will not be greatly affected; However, for domestic insulin companies, "the amount released by the price reduction is difficult to equalize the loss caused by the price reduction"
.
They had to take more markets
.
.
04 Domestic replacement of insulin
04 Domestic replacement of insulinWhere is the "blockage"?
Where is the "blockage"?Judging from the current problems reflected by many parties, the domestic replacement of insulin, a biological drug, is more difficult
than that of chemical drugs.
A number of industry insiders analyzed that injection pen replacement is a "blocking point"
.
"Insulin replacement also involves some consumables - injection pens - doctors need to communicate
with patients.
Why the procurement volume of foreign companies is well completed is because there are many old patients before, and the amount can be rolled up here in old patients, and domestic insulin companies want to replace, on the one hand, to open up some new patients and new markets; On the other hand, when some manufacturers promote insulin, they will give away some injection pens, although one injection pen also costs two or three hundred"
.
Some insiders believe that insulin collection does reduce the price and benefit patients, but the inconsistency of injection pens is a big problem
.
.
"Some companies' injection pens are very similar, but after installation, because the insulin outer packaging is a glass bottle, the injection pen does not match, and the bottle may crack.
Therefore, although the shape of insulin produced by each manufacturer is the same, and the internal products produced by the manufacturer can also be universal, it is not possible to change the manufacturer
.
”
In addition to the problem that the injection pen cannot be universal, the above-mentioned people who do endocrine consumables revealed to Cyborn Blue that the purchase of domestic insulin is not up to expectations, and there are differences
in promotion models.
"The price of domestic manufacturers' products has dropped very low, but there is no team to sell and maintain, such as Xinjiang, Gansu, Qinghai and other areas, there may be two or three people in a province, but insulin does need a professional academic promotion team
.
" At present, I have learned that there are special teams like Ganli, Tonghua Dongbao, and the Federation; East Sunshine is the person who did other product lines before pushing; These enterprises in Hefei are all handed over to the entire province and city to attract investment, but after all, there is still a difference between investment promotion and the promotion of professionals within the company," the above person added
.
As for the problem of hospital report management, the hospital reported that many times patients are reluctant to change
.
.
At present, in the hospital, various manufacturers of insulin, but the doctor specifically proposed to let the patient replace, "the patient will feel that the previous product is effective, your hospital also has this product, why change, is your doctor have any gray income" A doctor is more confused
about this.
A director of the endocrinology department of Beijing Grade 3A Hospital said: "The national intake of insulin in our hospital has only recently been implemented, and there are no requirements
for doctors to use it for the time being.
”
How to do an orderly replacement of different brands of insulin with the same purchasing group requires enterprises, hospitals, and medical insurance to negotiate a more detailed plan
.
05 Future biosimilar collection
05 Future biosimilar collectionWill it be affected?
Will it be affected?In response to the problem that the insulin procurement volume of domestic enterprises is not as expected, some people in the industry are already worried that it will affect the subsequent centralized procurement
of biological drugs.
It said that although domestic insulin is not cheap, the overall attitude of domestic enterprises to participate in centralized procurement is relatively good, and the price
has been reduced a lot.
This involves the spirit of the contract, if the amount of agreement is not completed, how to continue collective procurement in the future? How to do centralized procurement in the field of biologics in the future?
Whether the current hospital can complete the procurement volume is critical
.
Domestic enterprises choose to reflect the problem intensively now, the core reason is that in the first quarter of next year, from February to March, the next "cycle year" will be reported, if the hospital procurement situation cannot be actively changed and adjusted from now on, I am afraid that next year's report will have a "bigger" problem
.
At present, a number of domestic insulin companies have reported corresponding problems, and subsequent provinces will also pay attention to this problem, and there will be a meeting next week to discuss the plan
.
The above-mentioned people believe that the implementation of the special centralized procurement of insulin is a problem
that has to be faced.
When it comes to the complexity of biologics, it believes that insulin is the most complex, followed by PD-1, so if the implementation of insulin special centralized procurement is not as expected, it may also affect subsequent biological drug collection
.
Finally, he said that in fact, many companies are not afraid of reducing prices more, but they are afraid that the amount is not enough, after all, it is a price for volume
.
This may also require detailed adjustments
to the rules by the relevant authorities.
