Chinanews client, Beijing, November 4th (Reporter Zhang Ni) In November 2018, the fifth meeting of the Central Comprehensive Deepening Reform Committee reviewed and approved the "National Organization of Centralized Drug Procurement Pilot Program."

Subsequently, China began to carry out pilot quantities of procurement in 4 municipalities and 7 sub-provincial cities across the country, referred to as "4+7".

　　Nowadays, the national centralized drug procurement has been carried out for 3 years. What is the effect?

Has the cost of medicine for the common people dropped?

Data map photo by Han Zhangyun

Five batches of centralized procurement covers 218 drugs with an average price reduction of 54%

　　In 2018, with the "4+7" kicking off, the improvement of drug quality and price reduction became the main theme.

　　According to the "Blue Book on the Progress and Effectiveness of China’s Medical Insurance Drug Administration Reform" issued by the Chinese Pharmaceutical Association and the China Medical Insurance Research Association on the 3rd in Beijing, at present, five batches of centralized drug procurement organized by the state have been successfully carried out, covering a total of 218 drugs. The price was reduced by 54%, and the price of selected drugs dropped from more than 2-3 times the international price to a comparable level.

　　Statistics show that as of September 2021, since the reform of centralized procurement, cumulative savings have been about 250 billion yuan.

　　From the perspective of drug categories, the national organization of drug collection has covered mainstream drugs for chronic diseases and common diseases such as hypertension, diabetes, hyperlipidemia, and chronic hepatitis B.

　　Among them, 21 kinds of hypertension drugs, accounting for more than 50% of the market size of antihypertensive drugs, the most widely used amlodipine besylate tablets are reduced by 79%, and the annual treatment cost has been reduced from 300 yuan to 60 yuan.

　　There are 15 types of diabetes medications, and the amount involved accounts for more than 60% of the oral hypoglycemic drug market. After centralized collection, the average price is reduced by 69%, and the most widely used metformin hydrochloride tablet is reduced by 53%.

　　The hepatitis B treatment drug Tenofovir, the pre-collection price was 10.61 yuan/tablet, and the annual treatment cost was 3800 yuan. After the collection, the price dropped to an average of 0.38 yuan/tablet, a decrease of 96%, and the one-year treatment cost dropped to 137 yuan.

The average annual treatment cost of the first-line drugs Entecavir and Tenofovir Disoproxil decreased from RMB 5,500 and RMB 6,000 to around RMB 70 and RMB 150 respectively.

　　According to Jia Jidong, director of the Liver Disease Center of Beijing Friendship Hospital Affiliated to Capital Medical University, with the increasingly complete medical insurance catalogue and lower drug prices, the selection of liver disease drugs in my country has become more reasonable, and the diagnosis and treatment rate has been improved, thereby reducing the occurrence of liver cirrhosis and liver cancer. Achieved the guarantee goal of a better strategy.

Data map: Photo by Yu Danfei, automatic medicine dispenser

Increased availability of life-saving medicine

　　In 2018, the movie "I am not the god of medicine" increased the attention of the outside world to high-priced anti-cancer drugs.

Now, through a series of reform measures, the accessibility of anticancer drugs is also increasing.

　　Take the tumor treatment drug gefitinib as an example. The pre-collection price is 132 yuan/tablet, and the annual treatment cost is as high as 47,000 yuan. After the collection, the price drops to an average of 41.8 yuan/tablet, a decrease of 69%, and the annual treatment fee It was controlled at about 15,000 yuan. After the medical insurance reimbursement, the individual patient only bears about 6,000 yuan, which greatly reduces the burden.

　　In addition, the national drug access negotiations have also improved the level of drug use by patients.

For the 17 anticancer drugs that were successfully negotiated in 2018, in the first quarter of 2021, the amount of drugs increased by 25.8 times and the amount of drugs increased by 8.8 times compared with the pre-negotiation period.

　　The Blue Book shows that from the first quarter of 2015 to the first quarter of 2021, the proportion of anti-tumor drugs in medical insurance drugs has shown an upward trend, from 7.0% in the first quarter of 2015 to 13.9% in the first quarter of 2021.

　　The amount, dosage and year-on-year growth rate of the anti-tumor drug sub-categories have all increased significantly, driven by the negotiated drugs.

Patients' accessibility and affordability of anti-tumor drugs have been greatly improved.

　　Leng Jiahua, director of the Medical Insurance Service of Peking University Cancer Hospital, analyzed, “With the establishment of the National Medical Insurance Bureau and the establishment and gradual improvement of the dynamic adjustment mechanism of the medical insurance drug catalogue, the innovative drugs required for cancer diagnosis and treatment are expensive and use irregularly. , The problem of limited market supply has been greatly improved, the introduction of a large number of good medicines for first aid, the optimization of the catalog structure, and the improvement of the medical ecology."

Data map: The patient uses the face recognition system to make an appointment with an expert number under the guidance of the patient.

Photo by Wang Guangzhao

The original research drug no longer enjoys super national treatment

　　The national organization of centralized drug procurement has also brought about a substantial improvement in the quality of drugs used by the masses.

　　Mass purchase puts the original research drug and the same quality generic drug on the same platform for fair competition, and the result of the competition is directly linked to the sales volume.

Under the centralized procurement model, original research drugs no longer enjoy super national treatment, which promotes the substitution of high-quality generic drugs for original research drugs, and greatly improves the availability of drugs for the masses.

　　The blue book released this time shows that the proportion of the original research drugs used in the first batch of centralized drugs has dropped from 22% to 11%; among them, the proportion of the original research drugs of atorvastatin calcium tablets, which are used in a large amount, is in the "4+7" pilot. From 50% to 25% in regions, and from 37% to 11% in other regions.

　　From the perspective of drug efficacy, generic drugs have not disappointed either.

　　Zhang Lan, director of the Department of Pharmacy of Xuanwu Hospital of Capital Medical University, according to real-world research, among the "4+7" procurement of successful bidding drugs, 14 generic drugs that passed the consistency evaluation are clinically equivalent to the original drugs. Ensure that the people enjoy high-quality and affordable medicines.

　　Nowadays, in order to enjoy the reform dividend and seize the market, generic drug companies are continuously increasing their investment in consistency evaluation.

　　Data from the Blue Book shows that as of the end of September 2021, 537 generic name varieties and 2,696 products have passed the consistency evaluation.

　　The analysis believes that the centralized procurement reform has further increased the concentration of the pharmaceutical production industry, and the leading pharmaceutical companies have shifted their development focus to the development of first- and difficult-to-copy drugs, which has improved the quality of drugs.

　　And behind a series of measures, every ordinary patient will ultimately benefit.

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