Medical network on August 29 - after 3 months of negotiations and confirmation, on July 19, people club department issued a "about 36 kinds of drugs should be brought into the national basic medical insurance, inductrial injury insurance and maternity insurance drug catalogue b range of notice.The results of the industry's attention were announced, and 36 varieties were successfully selected, and eight varieties were left out.Compared to the first price negotiations, the negotiations to join corporate benefit more direct, negotiations success breeds directly into the national health insurance b class directory, and shall not be shortlisted the drugs out of provinces and cities, directory, and adjustment shall be limited to pay limits.This could discourage more worry about the implementation of health care in the provinces.
On behalf of the interests of the state "to the volume change price", under the strong support of the price adjustment effect is obvious, according to the data of people club department, pay negotiations successful drug standard, compared with 2016 the average retail price of an average decline of 44%, a drop of the highest up to 70%.However, from the perspective of the average decline of 44%, the negotiations give up more than 50% decline in "one size fits all" mode of negotiations, negotiations are more flexible, which makes the success rate of negotiations more last time increased by more than 20%, at the same time, large part of clinical dosage of varieties to considerable decline, also good for patients or health care reimbursement department is obvious.
Eight outs
What was expected?What are the consequences?
Prior to the author's opinion on "price reduction intention of negotiation variety", the price negotiation is likely to be abandoned, and the actual results are basically in line with the forecast.
The most unsurprising result of Mr Yang's exit from English is Mr.The negotiations countries limit its health indications for crohn's disease, and the British, xidan bigger market is the kind of wind resistance disease, this makes it hard for yeung sum for part of the market capacity to reduce the overall price.
Bosheng's exit is a pity.Due to the wave before birth had voluntarily reduce our price by 80%, therefore the talks love can tyrone reduction on the negotiation well be passive, not clearly state the requirements of the decline, but obviously love but tyrone price bottom line with the national expectation gap.
The green leaves of paclitaxel are also expected.As one of the most commonly used anti-cancer varieties, paclitaxel is difficult to increase the use of medical insurance through negotiation, so the "price change" is a chicken.However, after the failure of this negotiation, whether the liposomes can enter some areas through local health insurance will have a significant impact on its sales.
A little unexpected is love.Merck snow pock EGF single resistance in the negotiations, and similar competing goods duly, bead sheet resistance with a 53% drop, and also belongs to a competitor's avastin and grace of landing, this will undoubtedly make love will be completed in the market competition in a very passive position.
In contrast to western medicine, the results of the negotiation of traditional Chinese medicine varieties are not ideal, especially for the six Chinese traditional Chinese medicines that are involved in the negotiation, only three are shortlisted, and the average reduction of the three varieties is more than 50%.For two sales a large variety of blood will net and gas injection for reasons after lyophilization of arteries and veins, slashing prices for medicare not much of a qualification may greatly expand its market sales, so give up health qualification is not surprising, but it will no doubt affect the market competition, especially yiqi complex pulse such competitive varieties of traditional Chinese medicine of heart head blood-vessel.
36 finalists
Not all is happiness: the shortlisted variety outlook
Than eight out of varieties of manufacturers, for varieties of factory after the success of the negotiations would not necessarily have more happiness, some varieties more than 50% of the decline is a painful choice for enterprises.From the conclusion of the negotiation, not all varieties of future market will continue to be optimistic, let us look into the market performance of shortlisted varieties.
Most influential products
Roche cancer product portfolio (merohua, herceptin, aventine, trocke)
Roche's four big tumor products were included in the negotiations, due to the varieties of the four big sales, occupy the roche China half of sales, provide the industry the negotiation results do not look good, especially some varieties in the future for a long time is still in a position of titles defeat.It is evidence of the first round of price negotiations, but roche still holds the bottom line against the backdrop of the success of the negotiations.The price negotiation on the basis of Troy kay has increased its three biggest single resistance varieties mabthera, herceptin and bevacizumab, among them with mabthera and herceptin irreplaceable status in the field of their treatment and huge sales, so it is generally believed negotiations difficult.
But the results were surprising, not only through negotiations, but by far more than expected., according to the author's four varieties of six products rules compared to nearly a year the bid price (product in recent year the winning average price from menet bidding database) the average reduction of 55.17%, significantly higher than the average reduction talks drug.
There are two reasons for the change in roche's position, compared with the attitude of the first.One view is that roche has demonstrated its support for domestic drug reform, sacrificing some of its interests for more non-market support, such as policy.Another argument is that is the thinking of roche reflects on the negotiations for the first time, think the negotiations countries with health care reform will be the development direction, don't want to miss this opportunity, so choose to have larger grasp the shortlisted for the reduction.But either way, it's a huge boon for both medicare money managers, prescription doctors and patients.
The drop was around 60 per cent (150mg and 100mg, respectively, down 60.2% and 59.38%, respectively), higher than the first round of isaisha and kamina.It should be noted that the decline is a comparison with the price tag in the past year, while the previous one has been compared with the original state price. Therefore, the price of tolokai is much steeper than that of the original state.After the price reduction, the daily treatment cost of trocke was reduced to 195 yuan (1 tablet per day according to the 150mg specification), which is a certain advantage of the company.However, as much as 60 percent of the decline means that sales volume will be increased by 150 percent to reach the original sales volume, which is difficult to expand in the field of EGF positive lung cancer that is currently targeted in the drug market.At the same time, there will be a trickle of the drug, which will hit the current market, especially the cheaper generic versions.And EGF drugs resistant problem that nots allow to ignore, EGF drugs listed in succession, the second generation and three generation especially for T790M mutation of the third generation of drugs such as astrazeneca's Mr Bush for his public to Troy kay will also cause a certain influence.
Market changes of EGF TKI drugs in the sample hospital in the last five years (unit: 10,000 yuan)
It is a great benefit for the patients that roche's melody (rituximab) and herceptin (trastuzumab) are the best-selling target anti-tumor drugs.According to the database of the PDB sample hospital, the sales volume of the samples of meirohua and herceptin in 2016 amounted to 980 million yuan and 750 million yuan respectively, with year-on-year growth of more than 10 percent.In view of the fact that two varieties of competing products have not been listed in China for a long time, and the existing market is mainly derived from the non-medical market, it is generally believed that the price reduction of two varieties is limited.
The result, however, was that it was a surprise to see that the price cuts of more than 40 per cent and of herceptin were more than 40 per cent and 65 per cent respectively.Of course, although more than 40% of the decline is not small, it is not difficult to expand the capacity of the current CD20 + lymphoma and HER2 positive tumor.The bigger problem is that the two varieties have already taken up a lot of health care funding, which will make it more difficult for hospitals to control the proportion of drug control.
The maximum profit and loss ratio product
Nooit, pu-youk, longmu
Press, the price negotiation for pharmaceutical companies involved in pressure is great, business negotiator is walking into holding wall out, the enterprise did not condition repeatedly with negotiators bargain bargain on behalf of the state, offer could not taken out.Cut prices in general, however, more than 40% of big background, the part for varieties remain relatively strong prices, with no more than a 20% decline for the identification and into the health of the country.This shows the strong government work and adequate preparation of pharmaceutical companies and the strong advantages of its products.
Novo nordisk's the (human recombinant coagulation factor Ⅶ a) is the only listed the purification factor F Ⅶ a preparation, the drug is patients with severe hemophilia a/B type inhibitor after hemostatic choice, because about 10% ~ 30% hemophilia a and 5% ~ 10% of hemophilia B will be the inhibitor in the conventional treatment, and serious inhibitor except F Ⅶ a no better treatment, look for the only F Ⅶ a product, it is important for these patients.Perhaps because of this, the state has agreed to include it in health care, with a 9.16 per cent drop in its bid for almost a year.Under the condition of the price cut is very limited into health care, the north it is huge, the past can't afford, the high cost of treatment of hemophilia patients have the opportunity to use it, its future is expected to use health care achieve rapid sales growth.
Market growth trend in the sample hospital for nearly five years (unit: 10,000 yuan)
Listed in 2011 of tasly PuYouKe independent research and development of thrombolytic drugs (restructuring urokinase) is the decline in the smallest domestic varieties, relative to the winning an average of nearly one year, only 13.41% of the considerable reduction.The main indications of puyouk are acute myocardial infarction, which is mainly treated by interventional and thrombolysis. Compared with other thrombolytic drugs, puyouk has high security and does not affect the fibrinolysis system.Without the support of health care, PuYouKe still maintained a rapid growth, in 2016 samples of hospital sales for three times in 2015, and with the small cut into the health care, it will be more help on the product quantity.
Yasuhiro miyata lang mu (compaq heap) is China's first entered the United States directly from the early clinical Ⅲ period of clinical medicine.As for wet age-related macular degeneration and so on angiogenesis fundus disease of the drug, the drug post-marketing sales increased rapidly, the annual report of compaq heap, 2016 sales reached 2016 yuan.Compared with the core competitor novartis, lang can significantly reduce the frequency of drug use, which will undoubtedly have a great impact on the products that need to be injected into the eye.The price negotiation although lang mu and comfortable all finalists, feeling is not the same, but the two varieties, right before the negotiation already cut the price from 9800 yuan to 9800 yuan, under the condition of the negotiations again down to 5700 yuan, and lang mu on the basis of the original price by 17.47% to 5550 yuan only.The two products are very close to the cost of the drug, but given the frequency of the pills, compaq still has a higher cost performance.
The growth trend of the market growth of the sample hospital, lang mu and nooshih (unit: branch)
Pride in self-development
Etan, love sand, xin litan, mylinda
Other independent research and development varieties in this price negotiation have been shortlisted except for the aforementioned pu-youk and lang.Before many view, independent innovation medicine in health care and other market and also supports the access level is not enough, but the medical insurance after adjustment and price negotiation results may be a reassurance for independent innovation.In recent years, a new class of innovative new drugs has been launched directly or through negotiation, which undoubtedly reflects the state's encouragement of new drug innovation at the health insurance level.In terms of price reduction, the average decline of the four varieties was 29.9 per cent, lower than the general level.
Etam (apatinib) is the TKI drug developed by the company in 2014, and is the second batch of domestic innovative TKI drugs to be approved after the ecclinib.As the world's first approved for advanced gastric cancer molecular targeted drugs, Ⅲ period clinical results show that the path for could significantly prolong survival patients with advanced gastric cancer, and other such as liver cancer, breast cancer has been at the research stage, according to a 2016 annual report, YiTan has annual sales of more than 800 million yuan.This adjustment, in comparison with other TKI drugs YiTan 37% reduction is relatively low, effect is not significant, and as access to health care and future indications amplification, YiTan there are a lot of room to grow in the future.
Love spectrum sand (west of the amine) is the shenzhen microchip biological antitumor drugs in 2014, the drug is considered to belong to the first in the world - in - class level, as a selective histone acetylation enzyme inhibitors (HDAC), the drug is first subtype selective HDAC inhibitor of profess to convinced, can be selectively inhibit HDAC subtype 1, 2, 3, 10 subtypes, and has a higher compliance.According to the clinical results of the treatment of peripheral T cell lymphoma, the objective remission rate was 28%, and the continuous remission rate was 24% for three months, and the efficacy and safety were superior to the international equivalents.But love spectrum also has a big difficulty, in the promotion of sand TKI big relative to the heat, a line for HDAC is not familiar with the doctor, in addition to adapt to the crowd is narrow, so through the health quickly open the market to more doctors prescription drug spectrum of sand is very important for love, the price negotiation spectrum love sand only compared to a 30% drop in its market expansion is also very valuable.
Compared with two special drugs, xinritan and myringda are undoubtedly more price-sensitive.It is a domestically developed ARB drug, which includes similar drugs developed by multinational giants such as ambovie, cosua and daiwen.ARB drugs currently has a relatively stable price range, conventional treatment costs $5 to 7, too high or too low will have an effect on drug promotion, xinli temple before the regular day of treatment costs nearly 10 yuan, the adjustment of the drug decreased by 28%, the new price 7.05 yuan within the range of conventional medicines, this will increase the chance of xinli, competing goods of competition, but the simple price adjustment in the highly competitive market of ARB can achieve ideal performance remains to be seen.Hausen's mellida is a new generation of nitrogen-imidazole anti-anaerobes, which include tinidazole, metronidazole and ornidazole.Some literatures and reports suggest that the anti-anaerobes are strong, quick, resistant and safe to use.From the market, morpholine indications are the key competitors left ornidazole, because price is on the high side and no health care support, morpholine indications of market performance is not ideal, but the 24.7% decline in health care will contribute to the development of the indications, morpholine but need to consider the effects of antibiotics with limited.
A variety of market development
No, no, no, no, no, no
A new generation of products have just listed because of high development costs when the prices are often higher, which makes these varieties were unable to access medical insurance directory, dosage is difficult to increase, which further makes it hard for new products to reduce its price.Therefore, for these is still in the market development of new varieties, through moderate price negotiations to reduce its price, and to enter the health care to ensure that its dosage is definitely a good choice, the negotiations will have a lot of varieties belong to this type.
Novo and lilalupeptides are glp-1 diabetes drugs, which are more convenient than the first batch of this drug, which is called the escene peptide.Compared with traditional drugs, low blood sugar is not easy to develop, and it can improve obesity and reduce cardiovascular events, so it is growing rapidly in the U.S. and European markets.In 2016, the global sales volume of nori and li reached us $2.97 billion, ranking third in diabetes medicine.Compared with the market performance of Nora and li in Europe and the United States, the drug is not warm at home. In 2016, the sales volume of its sample hospital reached 0.26 billion yuan, a year-on-year increase of 20%.The drug, which is used as a medicine for slow disease, is expensive and has not entered health care, making it harder for it to gain more market share.The talks, lalu peptide depreciate significantly, a drop of 45.84%, if the day to dose of 1.5 mg, patients on treatment from more than 1500 yuan to 800 yuan, only combined with partial coverage, this will make more people change from conventional treatments for glp-1 treatment.
The company is the latest anti-platelet agent in astrazeneca.Although the drug in 2016 samples of hospital sales reached 100 million yuan, but compared with its main competing goods clopidogrel, sales volume is very limited, although some research thought for Greg los in reducing the risk of adverse cardiovascular events and death were superior to clopidogrel.Times Linda is slow disease medication, mainly for the antiplatelet, but the price of the product before treatment costs more than 22 yuan undoubtedly hindered the selection of patients, the pricing by 23.87%, after times Linda daily treatment cost is 16.9 yuan, 16 yuan price range is consistent with wave d, plus health care support, the future part of the wave set d crowd will be times Linda.
The last time the talks failed, the price talks were negotiated with more than 60 per cent of the drop.For its certainly regret missed the first time negotiations, with the double heron generic approaches listed, the main competing goods to west marina direct access to health care, after beauty if you don't enter the health care, its market development will be very passive, so although a big drop, but for products, qualified health is more important.With access to health care and a price cut, it is expected to quickly expand its use of drugs to give it a more competitive edge in the face of competition from rivals.
Betatron (recombinant interferon beta-1b) is a first-line treatment for multiple sclerosis, but multiple sclerosis drugs in China have consistently been unfavourable.The lack of support for health insurance and the lack of drug use have led to high prices, leaving chronic sales of multiple sclerosis drugs, including betatron.The price of this product is 28.9 percent lower, which is expected to increase some patients, but the treatment cost is still high after the price adjustment, and the market expansion may not be ideal.
In addition to the previous four varieties, including MSD for invasive fungal infection, cofly () with posaconazole experienced treatment-related adverse events and the latest become castration resistant prostate cancer ze cosette first-line treatment drugs () abiraterone is also to reduce our price by 42.9% and 42.9% respectively to obtain the qualification of health care.Although the price reduction is not small, because the products are in the cultivation stage, the quick access to health insurance can also reduce the difficulty of market development.
Tangled finalists
Grace, djimei, xin xin, a capsule, ginkgolide injection
Compared with those that are still in market development, products with larger market sizes are more entangled in price negotiations.As a mature variety, these varieties have contributed a lot to the income and cash flow of their enterprises, and the steep price reduction will seriously affect the short-term financial statements of enterprises.But even if you don't choose to negotiate a price cut, giving up health care, especially the major ones, will have a big impact on sales.For these companies, the choice is no doubt long or short.
As recognised by the market's early domestic one of targeted drugs, grace degrees (human recombinant endostatin injection) listed in the early rapid growth, but growth is slowing in recent years, the sample hospitals in 2016 sales of 130 million yuan, the growth of 16%, the actual sales of about 400 million yuan.The price negotiations, for the degree of grace, if you can't enter the health care, and compared with other lung cancer targeted drugs cannot provide high quality clinical evidence, its share of the market will be preempted by other health care products, the price relative to the original average 26.5% lower price, this will require a higher degree of grace market growth.Of course, health insurance is an important reason for the sale, and this adjustment will bring a great opportunity to the health care.
In contrast to grace, bayer's djimei (sorafenib) has cut prices more, and nearly five percent of the drop has required that many of the company's sales be at least doubled to guarantee sales.As a TKI drug for VEGF, dorgius is mainly used in hepatocellular carcinoma and renal cell carcinoma. The main competitor is apatinib with similar mechanism.In recent years, along with the path for the battle that run in the treatment of liver and kidney cancer targeted drugs than down quickly, and because the path for Nepal to 37% drop into the health care, beauty so ill must also enter the health care, but in the health care for ill beauty how much market expansion also hard to predict.
Many varieties of this price is the fist varieties of each drug firms, such as Tibetan medicine new living element (recombinant human brain natriuretic peptide), both pharmaceutical CanYi capsule and chengdu lactones ginkgo biloba injection of yulin, this this several varieties was lower than the original average price more than 35% of the decline in.Although healthcare expansion period, but under the background of control costs some varieties in clinical use also faced with many problems, sales growth will not be easy, once sales lower than expected will affect the company's performance, especially the listed company.
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