On-site negotiations on national medical insurance in 2022 will start on January 5.
In this medical insurance negotiation, there will be a number of high-value new drugs for tumors and new drugs for rare diseases, etc., which will be "negotiated" for the first time.
In terms of price, Ma Shuai, an analyst at Essence Securities, analyzed that according to the current simple contract renewal rules, the price drop of innovative drugs after new indications may drop within 44%, compared with the average drop of 50% to 60% that may be renegotiated, Its decline has narrowed.
A variety of blockbuster tumor drugs and rare disease drugs participated in the competition
According to the list of drugs that passed the preliminary review of the "National Talk", this "soul bargain" will involve 343 varieties, 145 of which are in the catalog and 198 new varieties that are not in the catalog. Among them, a number of blockbuster new drugs such as the first domestic double antibody, domestic CAR-T with an annual treatment cost of millions, and the rare disease Castleman's disease "life-saving drug" were "discussed" for the first time.
As the first domestically produced bispecific antibody and the world's first PD-1-based bispecific antibody approved for marketing, Akeso's cardonirimab has attracted much attention.
According to the State Food and Drug Administration, Cardonirimab was approved for marketing in my country on June 29, 2022, for patients with recurrent or metastatic cervical cancer who have previously failed platinum-based chemotherapy.
The current price of the drug is 13,220 yuan/125 mg/bottle. In addition to actively preparing for the medical insurance negotiation, according to Akeso Bio, "Akeso Bio is actively participating in various national and local medical security systems, and adopting patient Relief plan, the annual treatment cost is not more than 198,000 yuan."
In addition to cardonilimab, the People's Daily health client reporter sorted out the public information from the National Medical Insurance Administration and major pharmaceutical companies. In terms of PD-1/PD-L1 drugs, there are 6 domestic drugs participating in this negotiation, respectively. It is the new indication negotiation of PD-1 monoclonal antibody of 4 companies including Hengrui Medicine, BeiGene, Innovent Biology and Junshi Biological that are already in the medical insurance, while Henlius PD-1 monoclonal antibody and Corning Jerry The three products, including the PD-L1 monoclonal antibody of /Sidedi/Simcere Pharmaceuticals, participated in the medical insurance negotiation for the first time.
In the field of rare disease drugs, the reporter combed and found that in this year's preliminary review list, there are 19 rare disease drugs, and the coverage of diseases has been further expanded.
In addition to Spinal Muscular Atrophy (SMA) Oral Drug Resperan Oral Solution Powder, the first Castleman’s disease treatment drug Stuximab, Lanarizumab Injection for preventing hereditary angioedema, Type 1 Gaucher disease treatment drugs such as velaglucerase A for injection and other high-value drugs for rare diseases are among them.
In the 2021 medical insurance negotiations, the spinal muscular atrophy (SMA) treatment drug Nosinagen Sodium Injection was reduced from 700,000/needle to 33,000/needle, and the "soul bargaining" made the rare disease SMA attract widespread attention. It is also regarded as a "zero" breakthrough in medical insurance negotiations for high-value rare disease drugs.
Whether rare disease drugs will continue the negotiation route of "soul bargaining" is one of the biggest suspense in this year's medical insurance negotiations.
It is worth noting that the "sky-high priced anticancer drug" CAR-T Ruiji Orensai Injection also appeared in the "preliminary review list" of this national talk for the first time.
Ruiji Orensai Injection was approved for marketing on September 3, 2021. It is the second CAR-T product in China, priced at 1.29 million per vial, and is used to treat relapse in adult patients after second-line or above systemic treatment Or refractory large B-cell lymphoma and treatment of adult refractory or relapsed follicular lymphoma within 24 months after second-line or more systemic therapy.
The overall price adjustment is expected to be relatively mild
A reporter from the health client of the People's Daily combed through the previous negotiations and found that from 2018 to 2021, the average decline in drug prices in medical insurance negotiations is about 50%-60%.
Will there be fluctuations in the overall decline in drug prices in medical insurance negotiations this year?
According to the work plan for the adjustment of the medical insurance catalog issued by the National Medical Insurance Administration, in terms of price negotiations, this year, new rules for simple and new indications have been added, and innovative mechanisms such as non-exclusive drug bidding negotiations have been added.
A number of brokerage research reports believe that the overall price adjustment of innovative drugs should be relatively moderate in the negotiations on the access to the medical insurance catalogue, and that greater support will be given to "promoting innovation" on the basis of "guaranteeing the basics". , Large pharmaceutical companies with high innovation value, excellent clinical effects, and cost advantages are expected to gain advantages in fierce negotiations and fully share the dividends of medical insurance funds.
(Tan Qixin, People's Daily Health Client)