What are the benefits of drug price reduction and quality reduction and patient burden reduction?

Recently, a number of drugs have been reduced in price, including metformin, katopril, prostataine and other drugs.
August 24th, the results of the largest batch of centralized procurement of drugs organized by the state organization (hereinafter referred to as collection) were announced, with an average price reduction of 53% for 191 brand products from 55 drugs.
Since December 2018, when the centralized procurement of drugs by the State organization was piloted in 11 cities such as Beijing and Tianjin (hereinafter referred to as the "4-plus-7" pilot), the number of drug varieties purchased has reached more than 100, with more than 300 different brand products, involving more than 200 selected enterprises.
To the surprise of the vast number of insured patients, each collection lets some high-priced but large quantities of good drugs, large-name drugs significantly reduced prices, the average drop of more than half, greatly reducing the burden of medication, such as lung cancer patients first-line drug original drug Gifeitini (Irrisha), diabetic patients first-line drug Acapo sugar (Bytang), hepatitis B patients treatment drug Entikawe and so on.
third-party evaluation shows that the quality and efficacy of the selected product has been generally recognized and accepted by doctors and patients.
for the pharmaceutical industry, although suffering, but thereby improve the industry ecology, promote sound development.
, there will be more kinds of drugs into the collection, better protect the people's demand for drugs, and promote the construction of a healthy China.
Each batch of collected drugs are reduced by more than half of the centralized procurement of national organizations with a huge amount of drugs, to the huge advantage of super group purchase, in exchange for high-quality low-cost drugs in Xiamen City, Fujian Province, 76-year-old Mr. Hong suffered from diabetes for more than 20 years, while suffering from high blood pressure.
more than 10 years ago, Mr. Hong began to take Bai Tang, a month to 3 boxes of the amount, each box 90 yuan, a year down to spend about 3300 yuan, the burden of drug costs a little heavy.
recently, Mr. Hong went to the hospital to open medicine found that the drug is cheap, a year only need to spend about 330 yuan, is the original cost of 1/10.
"I asked the doctor if he had done the wrong thing, and I couldn't believe it.
thanks to the country's good policies, helping us with diabetes save money, but also with big-name drugs.
, " said Mr. Hong.
not only for chronically ill patients, but also for some seriously ill patients.
, from Tieling, Liaoning Province, is a lung cancer bone metastasis patient who has been taking giffetinib in recent years.
the first half of 2019, seeing that the box of Jifeitini in Shenyang fell to 547 yuan, more than 1,700 yuan cheaper than Tieling City, he went to Shenyang City to buy medicine.
the end of 2019, Tieling has also cut prices.
he calculated, according to the monthly consumption of 3 boxes, and then reimbursement 56%, spend less than 5000 yuan per month, a year drug costs reduced by 60,000 yuan.
this august, Mr. Wu, a Shanghai resident, went to Tongren Hospital, affiliated with Shanghai Jiaoxuan University Medical College, to open a box of acetic acid acetic acid tablets for the treatment of malignant tumors.
he was pleasantly surprised to find that the original price of 16,268 yuan of medicine, now as long as 2800 yuan, price reduction of more than 80%, medical insurance reimbursement, personal burden of 1100 yuan.
is a reform dividend from the centralized procurement of drugs organized by the State, benefiting countless families of patients.
2018, after a pilot, the state organized various provinces to form alliances, entrusted joint procurement offices, and carried out cross-regional alliance centralized volume procurement.
each region has assembled the amount of medicines used in local public hospitals, and the selected drugs will be given 50 to 80 percent of the market usage, with advance payments from health insurance.
in the case of consistent evaluation of quality certification, the national organization of centralized procurement of drugs with a huge amount of usage, to the huge advantages of super group purchase, in exchange for high-quality low-cost products.
data show that the selected drugs are popular in clinical practice, and the agreed dosing is high.
the one-year period of the "4 plus 7" pilot, the average completion of the agreed procurement volume of 25 selected drugs 2.4 times, the procurement volume of the selected drugs accounted for 78% of the procurement volume of the same kind of drugs.
shanghai is one of the pilot cities of "4 plus 7" and the first region to do volume procurement.
Li Ling is the pharmacist of Tongren Hospital, affiliated with Shanghai Jiao university medical school, and the vice chairman of the Pharmaceutical Professional Committee of Shanghai Pharmaceutical Society Hospital.
she told reporters that Shanghai to implement the national procurement policy is doing a good job, such as leaving "out of the air hole", you can choose the chinese medicine, you can also choose the non-Chinese medicine.
hospital publicity is done in place, implementation in place, even if the original research drugs into generic drugs, patient acceptance is relatively high.
also uses near-infrared spectroscopy for each batch of drugs to ensure excellent quality.
the implementation of the disease, only a few clinical adverse reactions have been reported, and the recognition is high.
No longer "low price is to take" high-quality requirements of the entry threshold means that even if the price of the drug selected is low, quality is guaranteed to each tablet of 0.15 yuan of benzodiamin chloride tablets, each tablet of 0.034 yuan of paracetamol tablets, each tablet of 0.014 yuan of Catoprile tablets, each tablet of 0.015 yuan of hydrochloric acid metformin tablets ... Some of the selected drugs as low as 1 dime, 1 cent, the quality is reliable? Is this collection back to the old way of "low price is taking"? Zhai Bo, director of the price extraction department of the Shanghai Municipal Health Insurance Bureau, said that in the "4 plus 7" pilot, not many generic drug companies through consistent evaluation, coupled with the procurement pilot scope is not large, in order to reflect the scale effect of the band, so only the lowest-priced drugs to obtain the winning qualification.
But from the beginning of the national expansion of collection, variety rules increased, procurement volume expanded to the whole country, according to the market competition pattern to determine the maximum number of selected enterprises, in the third batch of collection, the maximum number of selected enterprises of a variety expanded to eight.
participating in the collection of drugs is a consistent evaluation of generic drugs, high quality level, in this case the winning bid is different from the previous do not distinguish between the quality level of the "low price is taken."
the entry threshold for high-quality requirements also means that quality is guaranteed even if the price of the drug selected is low.
reporter interviewed some of the original use of the original drug later in the selection of generic patients.
in Shanghai Wuliqiao Community Health Service Center general clinic, taking Bai Tangping for more than 10 years, Mr. Lin is taking medicine.
last month, Mr. Lin changed his collection of selected medicines.
" at first afraid of the effect is not good, first opened a box, a try is good, on the choice.
, " said Mr. Lin.
Huang Lei, director of the Wuliqiao Community Health Service Center, said that there are currently 26 kinds of national collection of drugs used in hospitals, benzodialycine chloride, akapo sugar as high blood pressure, diabetes patients commonly used drugs, although no longer the original drug, but every day can prescribe more than 200 boxes.
" these drugs dosing large, the decline is also large, after the drug change effect is good, welcomed by patients.
" on April 20 this year is the first day of the second batch of collected drugs, many patients on the same day specifically to the hospital to buy drugs.
For some drugs down to "ultra-low prices", expert analysis, some small enterprises in the use of "ultra-low prices" to win the odds, because not dead, can survive, but if there is no new varieties to follow up, it is still difficult to survive.
contrast, large enterprises are becoming more rational, they have good cost control, quality assurance, product line is stable, as the market is optimized, they will win the market.
have suggested that such a low price, corporate profit margins are too small, will affect innovation.
companies say generics do not involve research and development costs, so they are relatively low.
in many countries, generics are small and over-marketed.
to reduce prices for the market, enterprises have their own strategic considerations.
for companies, generics and innovative drugs are two systems, and it is impossible to make money from selling generics to develop innovative drugs.
international experience, the financing of innovative drugs is rarely filled by generic profits, more by capital markets such as venture capital, stock market and other channels of financing.
in the third batch, Jiangsu Haussen Pharmaceuticals has 6 products to participate in the bidding, 5 products selected.
in three batches, Howson's many products were selected with significant price cuts, but did not affect the pace of innovation.
company responsible person said that the collection rules are more and more perfect, the hospital in place, the actual amount is much greater than the amount reported, giving enterprises a lot of confidence.
enterprises actively transition to innovative enterprises, there are currently several 1.1-class innovative drugs in the fields of sugar reduction, cancer, blood and other fields waiting to be listed.
"Patent cliff" appeared with the volume of the original research drugs after the patent period can not maintain high prices, prices dropped significantly, patients can afford big-name drugs in these rounds of collection, some high-priced original research drugs encountered a series of "patent cliffs", some people called the original research drugs in the collection of "retreat".
, however, it is not.
"patent cliff" of the original drug was first seen in December 2018 in the "4 plus 7" pilot.
, the original drug Gifeitinib reported a global low of 547 yuan, a 76% drop from the original price.
in the industry, this is not just a price reduction, but the opening of the original research drug "patent cliff" of the new drug price era.
"patent cliff" refers to the original drug patent expired, due to the emergence of generic drugs led to a sharp drop in prices.
, many patented drugs expire, imitation drugs have been slow to appear.
Even if it appears because there is no consistent evaluation of quality certification, in the tender can not confirm the quality level of generic drugs, with volume procurement has not really been implemented, so after the patent period of the original research drugs still maintain high drug prices, and occupy a larger market share.
generic drugs can not replace the original research drugs, patients with a high drug burden.
the "4 plus 7" pilot, the situation had completely changed.
the third generation of non-small cell lung cancer targeted drugs have been listed, the first generic drugs have also been listed, as the first generation of products Gifeitinib will soon be eliminated from the market.
In a large number of generic drugs have passed the consistent evaluation, the state began to organize the volume of centralized procurement of drugs, the price of the original drug Gifeitinib "big dive" to deal with market competition wise choice, has become the first time in the history of China's pharmaceutical "patent cliff."
the second batch of drugs in January this year, the original research drug "patent cliff" re-emerged.
the original drug for diabetes, Akapo sugar price reduction of more than 90%, treatment of rheumatoid arthritis of the original drug meloxicon tablets, the price reduction of more than 80%, the price per tablet from 2 yuan to 0.18 yuan.
in the third batch of centralized procurement of national organization drugs, involving more original research drugs.
, although only 3 original research drugs selected, but with the previous collection, the original research drug enterprises are actively involved, not "retreat."
said: "The general price of the original drug is higher, the collection of quantity in exchange for price, the need for a substantial reduction in the price of drugs."
in the collection of drugs at home and abroad, generic drug selection is a normal phenomenon, the original drug selection is the exception.
" from the point of view of the original pharmaceutical enterprises, the choice is closely related to the enterprise's own development strategy.
is the occupation of the selected market, or the occupation of non-selected market usage, will give the major domestic and foreign markets what impact, and so on, these need to be considered.
Hu Shanlian, a professor at Fudan University's School of Public Health, said that pharmaceutical companies that can slash prices are mainly due to the high cost of circulation, and most of these winning companies control the source of raw materials, so they can achieve significant price reductions.
some of the original drug prices in order to a new generation of products can quickly occupy the market.
" shows the future direction of innovation, will bring new weather to the entire pharmaceutical industry.
" data show that from the "4 plus 7" pilot areas, the proportion of people using the original drug and through consistent evaluation of generic drugs from about 50% to more than 90%, the quality of patients significantly improved.
"With gold sales" disappeared with the volume of collection to promote affordable generic drugs to replace high-priced original research drugs, patients love to use low-cost drugs re-resurrected, enterprises pay attention to product quality, no longer use rebates to promote sales volume collection not only to promote generic drugs to replace the original research drugs, while forcing enterprises to change the unreasonable "gold sales" model, to guide enterprises to focus on product quality, rather than a large amount of energy on sales, thereby changing the industry ecology.
past, some drugs exist "with gold sales" phenomenon.
drug to the agent at the bottom price, relying on layers of rebates to sell out, the price can often be several times higher than the factory price or even more than a dozen times, forming a false price.
" before the centralized bidding of drugs did not take volume, although the drug won the bid, but into the hospital there is a threshold, still using the 'gold sales' model.
of production and production so that enterprises have expectations, understand that there is a market, you can consider the cost, market, development strategy and other factors to quote.
the unreasonable 'gold sales' model, help to improve the industry ecology, promote the healthy development of the industry.
, " said Wu Ming, assistant director of the medical department of Peking University and professor of health economics.
the "gold sales" model change, in the second batch, some of the past patients love to use low-cost drugs to "resurrection", back to the market.
For example, the anti-heat analgesic drug acetaminophen, the winning price of 0.03 to 0.07 yuan / tablet, slightly higher than the historical 0.02 yuan / tablet of the lowest sales price, so that low-cost drugs have a certain profit, and access to the market, as well as toothache drug methotrexazole, antibiotics standing drug amoxilin and so on.
these low-cost drugs are not costly to produce and are highly competitive.
the past due to circulation mode reasons, can not afford the "gold sales" cost, low-cost drugs are difficult to open the market, high-priced drugs "reverse elimination", patients difficult to buy drugs at low prices.
this is the well-known drug "price reduction death" phenomenon in the past.
the centralized procurement and use of drugs organized by the state, through the volume of procurement, to ensure the use of enterprises no longer need to sell public relations, low-cost drugs can be "resurrected" back to the market.
some quality-oriented enterprises to win the market through collection.
in the third batch of collection, Sichuan Huiyu Pharmaceutical injection with aza cytosine to each 260 yuan selected.
it is the first generic drug, which has previously been marketed in Europe.
through the collection, this product does not need to set up a sales team can enter the hospital, to achieve small profits and more sales.
"We focus on product quality, products come out quickly through the consistent evaluation."
now through the collection can enter the hospital, which is also with the volume of procurement to the market.