Western bid price linkage! Pass the consistency evaluation and meet the price test again

  On May 8, Qinghai provincial drug and medical consumables centralized purchase network released the announcement on carrying out online purchase of some drugs in public hospitals in Qinghai Province (Qinghai announcement for short) In the annex, the notice on doing well in drug supply guarantee through the consistency evaluation of quality and efficacy of generic drugs proposed that: drugs and deemed Tongtong through the consistency evaluation of quality and efficacy of generic drugs When participating in the centralized procurement of provincial drugs, the drugs with consistency evaluation shall be treated as the original research drugs 15 specifications of cefuroxime ester tablets, gefitinib tablets, irbesartan hydrochlorothiazide tablets, irbesartan tablets, lisinopril tablets, tenofovir dipivoxil fumarate tablets, rosuvastatin calcium tablets, escitalopram oxalate tablets and amlodipine besylate tablets are included in the online procurement Name list Reality dilemma: the provincial online purchasing policy is still in the process of price competition, which is the next city after Shanghai, Jiangsu, Ningxia, Shaanxi, Jilin and other places, through the consistency evaluation of generic drug quality and efficacy However, different from the excitement of seeing the implementation of consistency evaluation policy in the early industry, the recent enterprises' multiple consistency evaluation through the encounter of varieties in the actual recruitment and acquisition, so that the release of the new policy did not cause the market optimistic expectation According to the Qinghai announcement, the health and family planning administrative departments at all levels in the province should strengthen the supervision of drug purchase, use and price implementation of medical institutions to ensure standardized operation; the provincial health and Family Planning Commission regularly announced the actual purchase price of medical institutions and the bid winning price of western provinces during the purchase period, which should be referred to and dynamically adjusted by medical institutions "With the price linkage in western provinces, it's hard to ensure that the varieties that pass the consistency evaluation may be squeezed out by the low-cost" fake medicine " Industry insiders told reporters that although the state and the provinces have successively issued policies to ensure that the varieties passing the consistency evaluation are regarded as the original research treatment, the recent bidding and centralized procurement still hasn't changed the "rules of the game" of winning the bid only at a low price, and the enterprises have invested a huge cost to carry out the consistency evaluation of generic drugs, but the actual bidding and procurement can only compete with the price of "Shanzhai drugs" In January of this year, Shanghai Sunshine pharmaceutical purchase network issued the notice of Shanghai Municipality on direct online purchase of generic drugs through conformity assessment of quality and efficacy, which first mentioned that if the conformity assessment varieties are not included in the volume purchase and negotiation in Shanghai, they can be directly online purchased Subsequently, Jiangsu, Inner Mongolia, Ningxia, Shaanxi and other provinces issued policies to define different "price limit requirements" Shanghai According to the regulations of sunshine pharmaceutical purchase network, through consistency evaluation of varieties, the purchase price of the same varieties of the enterprise in 15 provinces and cities including Beijing, Tianjin, Jiangsu, Zhejiang, Guangdong, Chongqing, Anhui, Fujian, Jiangxi, Shandong, Henan, Hebei, Liaoning, Hubei and Hunan shall be filled in at the same time of hanging up the network Generally, the price negotiation result shall not be higher than the price of the original research drug or reference preparation 70% of grid Shanxi's policy requires enterprises to promise that the sales price of the product in Shanxi Province is not higher than that in other provinces; the preferential policies of Jiangsu, Shaanxi and Ningxia are similar, and it is required to pass the consistency evaluation in the centralized procurement cycle, but the varieties that are not shortlisted in the centralized procurement can be directly included in the scope of record procurement, or apply for online price negotiation (Procurement) under certain conditions; Inner Mongolia pharmaceutical purchase network issued a notice on February 12 this year, stipulating that Qilu Pharmaceutical (Hainan) Co., Ltd shall include the "0.25g of gefitinib tablets" as the registered procurement drug through the conformity evaluation of generic drugs into the direct online procurement category How does "priority" and "encouragement" really come into being? 　　 Qinghai announcement also proposed that: for the drugs passing the consistency evaluation, all medical institutions should include them in the list of substitutable drugs with the original research drugs, and give priority to purchase and use If the same domestic varieties fail to pass the consistency evaluation, the actual purchase price should not be higher than the ones passing the consistency evaluation Qualified medical institutions are encouraged to carry out the products passing the consistency evaluation To promote the rational use of consistency evaluation varieties "Priority" and "encouragement" are actually just suggestions, which can be seen in the landing policies of many provinces, but they do not have institutional compulsion " The above insiders further pointed out that, Bidding and purchasing still need to respect the drug choice of medical institutions, but this choice is often affected by many factors Under the premise of "one product, two regulations", the second price negotiation, price difference space, drug habit, profit margin and so on are all factors to be considered, while the original research drug has a higher profit margin margin, and "Shanzhai drug" has an obvious advantage of low price control, but the consistency evaluation variety is not high However, some varieties sell better through the consistency evaluation of generic drugs 　　 On April 26, Foshan Municipal Bureau of human resources and social security issued a notice, announcing the feedback on the implementation plan for centralized drug procurement of public medical institutions in Foshan City (Draft for comments), in which, in response to the enterprise's proposal of "adding the incentive policy of" giving priority to the procurement and clinical selection of drug varieties that pass the consistency evaluation ", Foshan City clearly did not adopt the opinion, "We should respect the clinical choice of medical institutions" Under the pressure of strict control of medical expenses and on the basis of ensuring medical safety, it is undoubtedly the value choice for medical institutions to weigh costs and benefits At present, there are 29 generic drug conformity evaluation specifications, among which there are only 10 varieties in 289 catalogue Compared with the large number of thousands of clinical drugs, the completion of the current generic drug conformity evaluation is not enough to make medical institutions reverse the clinical thinking and interest demands of traditional drug selection, and in the short term, it is impossible to really fall the institutional guarantee of the generic drug conformity evaluation varieties into the system In fact, the current situation of "bad money drives out good money" still needs to be changed When we fight for low price, we should focus on quality, when we fight for quality, we should focus on price Now, the varieties that have passed the consistency evaluation of generic drugs are undoubtedly in a state of special historical embarrassment Although the policy clearly stipulates that "if there are more than three manufacturers that have passed the consistency evaluation for the same kind of drugs, no more varieties that have failed the consistency evaluation will be selected in terms of centralized purchase of drugs." But for the varieties that have passed the consistency evaluation of generic drugs, whether they can survive the huge market gap between the cost input and the revenue of centralized purchase in the early stage of evaluation is really worth thinking of the whole industry List of approved generic drugs for conformity assessment of quality and efficacy