Three key points of life and death of drugs in national negotiation

Source: sabilan / Lin Ling 2015-7-22 recent financial media reports that exclusive and patented drugs other than proprietary Chinese medicine will be negotiated by the state, and proprietary Chinese medicine will be in the charge of the province Why do Chinese and Western medicine divide and govern? Who will be the biggest beneficiary? What reasonable factors should the government pay attention to in the actual operation of the industry sales and development, and treat them scientifically and fairly? Why not include Chinese patent medicine? There are two factors inevitably involved, one is the safety factor, including the safety of traditional Chinese medicine injection, the recent purchase of raw materials such as Ginkgo biloba preparation and the problem of safety production not in accordance with the declared process specification In addition, according to the report of Hong Kong Phoenix Weekly, the statistics of 16 large hospitals in China show that 20% of cases of drug-induced liver injury are caused by Chinese herbal medicine Data from three large specialized hospitals show that more than half of the cases of drug-induced liver disease are related to traditional Chinese medicine, while the most important cause of acute liver failure is also traditional Chinese medicine It is necessary to call on the public and the government to attach great importance to the fact that Chinese herbal medicine is becoming the pathogenic factor of liver disease, rather than the traditional Chinese medicine which is known as non-toxic and harmless Secondly, the price of raw materials fluctuates, and the extraction process is priced at will, so the price is hard to say clearly The high price of drugs caused by price factors is very common Some cardiovascular and anti-inflammatory traditional Chinese medicine injections have been at the top of the drug sales list in various provinces for a long time The market will throw out countless question marks by dividing Chinese and Western medicine into two policies It is a more stable practice for the country to gradually launch the price negotiation list of each batch Is national negotiation good or bad? It is not difficult to see from the detailed rules of Article 70 that the national guiding document blurs the boundary between basic drugs and non-basic drugs, breaks the previous pricing rule that basic drugs do not distinguish the quality level, and takes the lowest price of the whole country only the hero of low price theory Scientific grouping, each group no more than 2 winners are joint venture medicine, patent medicine and original research medicine However, Hunan standard also blurs the boundary between the two, resulting in the fact that the non base drugs are tight and the base drugs are loose Undoubtedly, this is also the result of the operation behind many powerful enterprises National negotiations have their advantages They are centralized and unified, and they can be settled at one time There is no need to wait for three years for each provincial round of bidding as before In recent two years, due to the impact of the pharmaceutical environment and the change of institutional personnel, the progress of network hanging has become more sluggish In the past two years, few non base new standard areas have been implemented, which has seriously affected the sales of new products Once again, foreign-funded enterprises and large varieties of powerful government affairs have been fully developed and reflected The results will also polarize Good is better, bad is worse How to make strict and fair negotiation rules is more critical Factors to be concerned at the government level 1 Are all patents and exclusive products included in the national negotiations, or are existing products with large sales volume or national health insurance catalog products directly managed by the state? In the first half of the year, officials introduced that the national negotiations were aimed at high-priced products that did not enter the medical insurance market Some serious illness medical insurance products, mainly joint-venture drugs, were listed in exchange for lower prices It is precisely because of the limited sales volume of products at their own expense stage, which can not amortize the high R & D, production and marketing costs, so they can only maintain high price sales, while after entering the medical insurance, the government, enterprises and the public will win more if they exchange profits for large-scale sales In the past, medical insurance and price departments all over the country have taken the lead in these two tasks However, after the drug price was liberalized or the Internet was eager to promote the price linkage, it failed to respect and consider the sales law and pricing law of the products, resulting in the uneven happiness and bitterness of the medical insurance area and the non-medical insurance area, the price of the medical insurance area did not adjust the enterprise lottery, and the non-medical insurance area could not maintain the enterprise survival with reference to the low price of the medical insurance area This report is for all products Is there enough energy to understand each product when the country directly leads and deals with price negotiation for the first time? Whether the rules are scientific and reasonable, open and transparent determines whether the enterprise products can survive, and many enterprises rely on one or two fist products If an unreasonable price is given, the death penalty will be imposed on products and enterprises We need to be careful and responsible for the industry and enterprises 2 Is price negotiation gentle or severe? Or full of imagination? The R & D cost of exclusive products and patented products is tens of millions or even hundreds of millions, and the enterprise GMP transformation investment is over 100 million The number of various burdens and expenses is not counted This is what the country needs to consider when setting the expected goal of price negotiation for the survival and development of the industry and enterprises At the same time, we should not bring down industries and enterprises indefinitely The price of each product is reduced by 5%, and the annual drug cost saved by the national pharmaceutical market for the country and the people is up to 100 billion The pharmaceutical industry has been actively cooperating with the state to reduce the drug price, but whether the reduced price is transmitted to patients, or because the medical reform is only structural adjustment rather than essential radical cure, resulting in a larger black hole in medical institutions, resulting in soaring medical costs? What's the point of lowering the drug price like that? Volume purchase may bring two results One is that the enterprise makes profits, but there is no sales volume guarantee When the price reduced products enter the market, they are abandoned and neglected by medical institutions, which is not enough for enterprises to support sales teams and find distribution customers One is that monopolistic shortlisting leads to widespread use, just like the aristocratic medicine into the basic medicine for everyone, even if the price of the product is still high, the former injured the industry and enterprises, and the latter burdened the patients and the state Whether the national price negotiation is based on different rules and large artificial operation space, or on products with large sales volume with the same decline rate as Zhejiang Province, though controversial, is clear Even if the price is the lowest in China, but all products are low, no favoritism, medical institutions will not be choosy, will not let enterprises not win the bid is dead, low-cost bid is dead Every product with large sales volume needs to go through the operation of the medical insurance link How does the medical insurance department take over the price negotiation board? Whether it is light or heavy, whether it is rare or just law enforcement attracts people's attention It can be expected that the negotiation rules should be more rational and fair in theory At the same time, it is also suggested that the government should change its management thinking and style, listen to the voice of the market, provide conditions for enterprises and industries to support development, and provide professional guidance and services, rather than blindly crack down on and enforce requirements Reasonable suggestions and feedbacks from industries and enterprises also need the attention and support of the government 3 Is the reference basis scientific and reasonable? 1) Should the theory of "only the lowest price in China" be perfected? More and more regions have thrown out the national price linkage and taken the national lowest price as the price limit rule Guangdong, Shandong, Sichuan and other provinces are more professional and rational, taking the lowest average price of 3-5 provinces is more reasonable Fujian is also the result of winning the bid collected within two years The low price bid winning record that the enterprise has not had the supply record shall be reasonably eliminated In the past, there were hundreds of products in various enterprises There were only one or two bidding personnel, and the quotation time was only one or two days It is inevitable that there are some mistakes in such a high-intensity intensive quotation Some enterprises do not have the ability of specialized sales, and there are not a few who encounter malicious bids The enterprise can't void the bid, the sales can't, and the whole bid period is empty there If it is not reasonable to take this as the normal selling price of an enterprise, the enterprise should be given a reasonable opportunity to correct 2) Medical insurance and non-medical insurance products are treated separately As mentioned above, medical insurance is another core access condition for product sales After having the starting conditions, the sales volume of medical insurance products far exceeds that of self paid products At the stage of self payment, enterprises should be given the right of independent pricing, which is convenient for enterprises to survive in the stage of low sales After entering the stage of medical insurance, the government will limit the price 3) Only when the sales volume of mature products and immature products are differentiated, can they be able to reduce the price The larger the sales volume, the better the cost control, and the longer the sales time, the thinner the expense amortization The R & D cost of new listed products is tens of millions, and the marketing cost is millions If we add the cost of investment and factory building, we can't beat it If the enterprise does not have any sales volume, it directly requires the enterprise to reduce the price, and the new products can only be all out 4) Is price important or is efficacy, safety, comprehensive treatment cost and cost performance more important? Some products are cheap, but the side effects are large, or the dosage is great, and the stage treatment cost is much higher than the new dosage forms of slow controlled release products and the next generation of drugs Although the price of some products is higher, the curative effect is irreplaceable It needs to be treated comprehensively and scientifically 5) Reasonable view on international drug price There are three factors that cause the high price of joint ventures and imported products, one is tariff and commercial tax, the other is the high operating cost in China, even if the products have not been put into the market, the employees' wages have to be paid as they are, and the cost of academic promotion is even greater; the third is that the sales volume of new products is limited and the investment is huge, which is different from the market stage of other countries and regions with mature sales volume, and the drug habit is different Different, cost amortization and conversion ratio are different, and pricing cannot be the same This is the same reason that the price of imported milk is generally lower than that of domestic milk, and the cost of living in Beijing and Shanghai is higher than that in London and New York The operation cost of social economy is totally different The cost of high-tech and high investment pharmaceutical industry is only higher than that of food industry Through national negotiation, we can reasonably reduce the price difference, but we can't ignore the law of sales and the law of economy How to speed up the bidding and medical insurance start-up process in a scientific, reasonable and fair way, improve the marketing efficiency and results of enterprises, leave a reasonable development space for the pharmaceutical industry and enterprises, at the same time, truly benefit the people, not only to put the tears of enterprises into the deep pockets of medical institutions, resulting in higher medical costs, but also the downstream Pharmaceutical industry Only by giving enterprises a normal and reasonable space for development and fair and reasonable treatment, and gathering the hearts of the industry and the general public to move backward and forward, can we really reverse the real problem of overspending of medical insurance costs.