The Office of the Joint Purchasing of National Drugs has recently released the "Announcement of the Results of the National Centralized Drug Purchasing", marking the end of the seventh batch of centralized drug procurement organized by the state.
According to the information of the National Medical Security Administration, 60 kinds of drugs were successfully purchased in this centralized procurement, and the average price of the selected drugs was reduced by 48%. According to the agreed purchase volume, it is estimated that the annual cost saving is 18.5 billion yuan.
Different from the adjustment and negotiation of the medical insurance catalogue, the national drug centralized procurement is independently quoted by the enterprise, and there is another set of operation methods for bidding for the same variety.
What is the difference between the national drug collection and the past?
What impact will it have on the development of the pharmaceutical industry?
In response to these issues, the reporter interviewed relevant people.
Expand the scope of--
Involving 31 treatment categories, the average price is reduced by 48%, and the public's sense of gain continues to increase
Centralized drug procurement is to collect the actual clinical needs of medical institutions in exchange for pharmaceutical companies to provide drugs at lower prices.
Therefore, the variety of each collection and the purchase amount of each variety will be adjusted according to clinical needs.
This collection involves 31 treatment categories, including drugs for common and chronic diseases such as hypertension, diabetes, anti-infection, and digestive tract diseases, as well as drugs for major diseases such as lung cancer, liver cancer, kidney cancer, and bowel cancer.
According to the pre-purchase price, the amount involved in the 7 batches of 294 drugs accounted for about 35% of the annual purchases of chemical and biological drugs by public medical institutions.
This means that centralized procurement with volume has become an important mode of drug procurement in public hospitals.
Gu Hai, director of the Center for Health Policy and Management Research at Nanjing University, told reporters that the first five batches of centralized procurement involved a total of 218 kinds of chemical drugs, covering common diseases such as hypertension, coronary heart disease, diabetes, anti-allergy, anti-infection, digestive tract disease, and anti-tumor. Medicines for diseases, chronic diseases, major diseases, and rare diseases; the sixth batch of centralized drugs was expanded from chemical drugs to biological drugs for the first time, and 16 second and third-generation insulins were included in the scope of centralized procurement; the first six batches of centralized procurement of digestive tract metabolism, anti- Infection, nervous system, cardiovascular system, and anti-tumor drugs were included more.
This time, the expansion will continue on the original basis, and the benefit of the masses will be wider.
Compared with the average price reduction of 53% in the first six batches of national centralized procurement, the average price of the drugs to be selected this time has been reduced by 48%, which is "more moderate" in the eyes of some people.
In this regard, the relevant person in charge of the National Medical Insurance Bureau believes that the reasons come from three aspects: first, in recent years, the medical insurance department has strengthened price governance, and overall, the prices of drugs in various provinces are more transparent; second, provincial-level procurement with volume is in progress , some varieties of this centralized procurement have been included in the local centralized procurement, and the price level has dropped before the national centralized procurement; third, after multiple rounds of centralized procurement, the competition among enterprises is more rational.
Although the price reduction is slightly flat, the sense of gain of the masses will not be discounted in the future.
Not only did the centralized procurement include more new drugs, but the prices of some drugs dropped significantly.
Taking the first-line targeted drug lenvatinib capsules for liver cancer as an example, the average price per capsule has dropped from 108 yuan to 18 yuan, and one treatment cycle can save 8,100 yuan.
In the field of blood pressure lowering, slow and controlled release dosage forms were included for the first time. The price of nifedipine controlled-release tablets was reduced by 58%, and the price of metoprolol sustained-release tablets was reduced by 53%. The drug burden of hypertensive patients was significantly reduced.
The antiviral drug oseltamivir dropped from an average of 4.5 yuan to 1 yuan per tablet.
In addition, four original research drugs, including tigecycline from Pfizer in the United States, micafungin from Astellas in Japan, ebastine from Emero from Spain, and iopamidol from Bracco Xinyi from Italy When selected, the average price is reduced by 67%.
This time, an average of 5.4 companies were selected for each drug variety, further enhancing the diversification and stability of supply.
According to the arrangement of the National Medical Insurance Bureau, patients are expected to use the selected drugs in November this year.
Rule update -
Establish a "one province, two supply" model, strengthen contract performance responsibilities, and prevent private bargaining
After 6 centralized acquisitions, the centralized acquisition rules have also been slightly adjusted, the consideration is more thoughtful, and the operability is stronger.
Chang Feng, Dean of the School of International Pharmaceutical Business, China Pharmaceutical University, summed up the upgrade of the centralized procurement rules into five highlights, including a more scientific volume ratio, "one province double supply" to ensure supply, "inter-product fuse" to reduce price difference, and approval management Scope of defense standards, policy coordination continued to deepen.
From the perspective of a more scientific proportion of the amount of antibiotics, the proportion of antibiotics in the national centralized procurement is 10% lower than that of ordinary drugs, and the proportion of special-grade antibiotics is further reduced, which can inhibit the abuse of antibiotics to a certain extent, reflecting medical insurance and health care. Health and other departmental policies are coordinated.
In this rule upgrade, the more concerned is the establishment of the "one province, two supply" model.
In recent years, there have been frequent incidents of supply-cutting incidents from winning bidders for centralized procurement.
For example, in August 2021, North China Pharmaceutical selected ibuprofen sustained-release capsules from the third batch of centralized procurement in Shandong, which had a relatively bad social impact.
"Clinical drug use must ensure continuity. Once the enterprise cuts off the supply, it will affect the patient's treatment. This must be solved in the national centralized procurement." Gu Hai told reporters that "one province and two supply" not only strengthens the enterprise's responsibility to fulfill the contract, but also "Double insurance" is provided for patients - even if the main supplier cuts off the supply, the sub-supplier can take over immediately.
Chang Feng believes that "one province and two supply" provides a safer and more direct means to meet market demand, and can also effectively reduce the administrative cost of choosing alternative companies in various regions.
On July 12, at the bidding site for cefminox sodium injection, 4 pharmaceutical companies were directly out of the market due to the fact that the price was 1.8 times higher than the lowest price and there were many companies with low bids.
The new rule for centralized procurement, "fuses between products", is to compare the price differences of different varieties at the same level, which increases the difficulty and uncertainty in the consideration of quotations by enterprises to a certain extent, and more effectively restricts a few companies of the same variety from privately. bargain.
Relevant departments have noticed that the malicious and random transfer of valid registration approval documents may bypass the rules of bounded affiliated enterprises and form a bid-rigging phenomenon. Therefore, the centralized procurement rules will broaden the connotation of "affiliated enterprises" to prevent some enterprises in the process of centralized procurement. Drill holes.
Competition intensifies—
There are more competitors for a single variety, and companies expect the centralized procurement policy to remain stable
On July 12, Nanjing was extremely hot.
More than an hour before the start of the National Drug Centralized Procurement Declaration Information Disclosure Conference, more than half of the seats in the venue are full.
The waiter walked up to each participant, handed out mineral water, and two buns.
At this time, the reporter did not understand the deep meaning of this operation, and it was only after the meeting that the meeting continued uninterruptedly until 1:00 noon that they realized that everyone really did not have time to eat lunch.
"I don't have a clue at all." The reporter asked several business representatives and got the same answer.
The total sales of the drugs collected this time in public medical institutions last year was about 70 billion yuan. Which company would be willing to lose such a market?
However, there are 295 participating enterprises, more competitors for a single variety, and more than 10 manufacturers for 14 varieties. Therefore, how to make quotations tests the strength and wisdom of enterprises.
"Oseltamivir Phosphate Capsules, 75 mg multiplied by 30 capsules/box, Guangdong Dongguang Pharmaceutical Co., Ltd., 29.97 yuan." Quotation, notaries and supervisors are arranged on both sides to supervise the whole process.
488 products from 295 companies participated in the bidding. The repetition of this procedure made it very boring for laymen.
But the scene has been very quiet, the company representatives are highly focused, keep recording and calculating, and there is tension in the air.
"Can I send it to the Moments?" Just after the quotation was over, the result had not been announced yet. The representative of a company was already happy - according to the announced quotation, he knew it!
This time, 327 products from 217 companies were eligible to be selected.
Among them, 6 products from 6 international pharmaceutical companies were selected, 321 products from 211 domestic pharmaceutical companies were selected, and 73% of the bidding companies were selected.
The competition is fierce, and the election is worth celebrating. After the results were announced that day, many listed companies announced the good news of the election.
However, even if elected, some people are happy and some are worried.
"If you don't participate in the centralized procurement, you will be dead. If you participate, the profit has been falling." A representative of a small-scale pharmaceutical company "poured bitter water" to the reporter.
However, the representative of Hunan Huana Pharmaceutical Co., Ltd., who selected mycophenolate mofetil capsules at the lowest price, was full of confidence.
"We were also selected last time, and the supply has been stable. We are confident to do better!"
"Before centralized procurement, we had to deal with more than 100,000 pharmacies in thousands of hospitals. After centralized procurement, customers are more concentrated, and we have the energy to focus on R&D and production." A representative of a domestic leading pharmaceutical company told reporters that at present, There are nearly 5,000 domestic pharmaceutical manufacturers, and centralized procurement is a process of survival of the fittest, which can guide the industry to increase its concentration and move towards higher-quality development.
Talking about the future, the representative said: "We expect centralized procurement to maintain policy stability, so that companies can plan their development with a longer-term perspective."
"The purpose of centralized procurement is not to blindly reduce prices, but to achieve a win-win situation for medical insurance funds, pharmaceutical companies and patients." An industry insider said that drug prices will not drop indefinitely, and centralized procurement will squeeze the "moisture" of inflated drug prices. After the release, drug prices will eventually become reasonable, and enterprises will also obtain reasonable profits and expectations.
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