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On January 21st, the results of the second batch of centralized drug procurement organized by the state were released, and 32 varieties were successfully purchased, with an average price drop of 53% and the highest drop of 93%. Many drugs selected this time are commonly used by ordinary people, involving diabetes, hypertension, colds and fever, etc., and more patients will benefit.
The commonly used drugs such as Baitangping for diabetics, indapamide tablets for hypertensive patients and acetaminophen for colds and fever have been reduced by more than half!
On January 17th, under the guidance of the National Medical Insurance Bureau and other departments, all provinces (autonomous regions and municipalities) and Xinjiang Production and Construction Corps formed a procurement alliance, and the second batch of centralized procurement of drugs organized by the state was carried out in Shanghai, resulting in the result of quasi-winning. 32 varieties were successfully purchased, and compared with the lowest purchase price in the alliance area in 2018, the average selected price decreased by 53%. On January 21st, the result of the election was officially released.
The highest drop in drug prices reached 93%
Of the 33 varieties collected this time, 32 were successfully purchased, and a total of 100 products were selected. 122 enterprises participated, resulting in 77 enterprises to be selected. Compared with the lowest purchase price in the alliance area in 2018, the proposed bid price dropped by an average of 53%, with the highest drop reaching 93%.
After this round of centralized collection, it means that there are more commonly used drugs to reduce prices, that is, 25 drugs selected before, and 32 varieties this time. The 32 varieties contain many drugs that people are familiar with, such as acetaminophen, antibiotics amoxicillin, clindamycin hydrochloride, azithromycin and cefradine, acarbose and glimepiride for diabetes, metronidazole tablets for toothache, indapamide tablets for hypertension and bisoprolol fumarate. The price reduction of these commonly used drugs will benefit more patients. For example, Bayer Acarbose Tablets (50mg30 tablets), the original drug, with the trade name of Baitangping, is used in a very large amount among Chinese diabetics. This quotation is 0.18 yuan per piece, with a drop of more than 90%.
On the 17th, 122 of the 33 enterprises preparing to purchase varieties declared their prices, including the original research drugs and generic drugs that passed the consistency evaluation. Four original drugs were significantly reduced in price, and they were successfully shortlisted for the selected results.
This centralized procurement is still the general idea of "national organization, alliance procurement and platform operation", adhering to the principles of purchasing with quantity, integrating recruitment and procurement, and ensuring use, and taking conformity evaluation as the condition for the shortlisting of generic drugs. Medical institutions and retail pharmacies designated by medical insurance can participate voluntarily.
"The second batch of state-organized centralized purchasing manufacturers can be multiple, up to six, maintaining moderate competitiveness. According to the number of selected manufacturers, the dosage is agreed to be 50% to 80% respectively. At the same time, maintain a reasonable price gap between different selected enterprises for the same drug. Among the short-listed manufacturers to be selected, the lowest quotation is given priority to two regions to ensure the dosage and protect the enthusiasm of enterprises. " Ding Jinxi, a professor at China Pharmaceutical University said.
In the next step, all localities will focus on the implementation of the selected results, and patients are expected to use the selected drugs from April this year.
Guaranteed dosage of low-priced drugs
In the "4+7" pilot project, the original drug appeared "patent cliff" for the first time, and the price was greatly reduced. This collection was not unexpected. For example, the price of acarbose, Bayer’s diabetes drug, was reduced by more than 90%, and meloxicam tablets, Boehringer Ingerham’s drug for rheumatoid arthritis, was reduced by more than 80%.
However, some drugs that were originally low-priced in history have returned to low-priced positions in this collection, and the dosage has been guaranteed to ensure a stable supply. For example, acetaminophen is 0.03 yuan per tablet, metronidazole is 0.05 yuan per tablet, and amoxicillin is 0.05 yuan per tablet.
These prices are just a few cents, but they are not generally used by people. This is because for the convenience of bidding, enterprises quote in the smallest unit of preparation (tablets, granules, sticks and bags), while in real life, people pack drugs in boxes, bottles and other units. For example, the centralized purchase of acarbose from an enterprise, the proposed bid price of 0.18 yuan is the price of each tablet, while patients buy it in boxes, and the converted price is 5.42 yuan per box.
So, are these prices higher or lower than international prices?
Guangdong dongyangguang pharmaceutical co., ltd, in this centralized procurement, three products were shortlisted, and two products were ranked first, which was the lowest among the prices to be selected for this variety. Two products to be selected are moxifloxacin hydrochloride and olmesartan medoxomil, which were originally sold abroad and just listed in China. Among them, the proposed bid price of moxifloxacin hydrochloride is 6.66 yuan.
According to Chen Yangui, the executive director of the company, the centralized purchasing organized by the state has made the market return to rationality. The company has strong technical force and strong supply chain, and it has great advantages to return to the domestic market, so it participated in the second batch of centralized purchasing. "The quotation for the shortlisted qualification is similar to that in the European and American markets."
Inquire about the price of moxifloxacin hydrochloride of the same specification abroad, and the public price is RMB 8 yuan and 9 yuan. Feng Chang, a professor at China Pharmaceutical University, explained that the actual settlement price is often lower than the public price, and China has a large market share, so there is not much difference between the two. "Enterprise quotation has its own development strategy considerations, which are normal market behaviors."
Some experts estimate that in the past, the price of generic drugs in China was more than twice the international price. After purchasing with quantity, it returned to the international normal price. Expert research has found that the part that is higher than the reasonable price occurs in the intermediate link, which is not included in the quality links such as production and research and development. Squeezing out this part of water will not affect the quality of drugs, nor will it affect the development of enterprises.
An original research drug of Boehringer Ingerham, which has been on the market for more than 20 years, entered the scope of the proposed selection this time. The drug has already passed the patent period. Although the price has been reduced by 80%, the company originally sold it mainly in Shanghai, Beijing and some provincial capitals. After entering centralized purchasing this time, the sales market has expanded to half of China. "We actively participate in and cooperate with China’s national policies." Zeng Chenghui, head of the company’s regional expansion business department, said.
The person in charge of the National Pilot Office and the Joint Procurement Office believes that the main reasons for the sharp price reduction of selected drugs are as follows: the state organizes centralized procurement and use of drugs, which truly realizes the integration of procurement with quantity and recruitment, and gives clear expectations to pharmaceutical manufacturers, which is conducive to their independent quotation and declaration according to the purchase volume, squeezing out unreasonable virtual space; Further improve the procurement rules, and realize the function of market price discovery through open and sunny competition; Timely settlement of payment for goods significantly reduces the capital cost of enterprises and leaves room for price reduction.
By purchasing with quantity and ensuring the use, enterprises no longer need to carry out sales public relations, "a batch of low-priced drugs ‘ Resurrection ’ It is also a return to international practice. " The person in charge said.
The burden on patients is significantly reduced.
According to the person in charge of joint procurement, the "4+7" pilot project and expansion are progressing smoothly.
The implementation of procurement in pilot cities exceeded expectations and the agreed procurement volume was completed ahead of schedule. By the end of December 2019, the average procurement progress of 25 "4+7" pilot areas for selected drugs was 183%, and the selected drugs accounted for 78% of the purchases of drugs with the same generic name. All the expanded areas have started to implement the results of the expanded procurement in December, and patients all over the country have used the drugs selected by centralized procurement with high quality and low price.
Due to the sharp drop in prices, the burden on patients has been significantly reduced. In addition, judging from the situation in the "4+7" pilot areas, the proportion of people using generic drugs and original drugs that have passed the consistency evaluation has greatly increased from about 50% to over 90%, which has significantly improved the quality level of people’s drug use.
Chen Qiulin, director of the Social Security Research Office of the Institute of Population and Labor Economics of China Academy of Social Sciences, said that the centralized drug procurement organized by the state is different from the previous recruitment, and it is beneficial to patients, doctors, enterprises, medical insurance funds and other parties, forming a benign mechanism. "Centralized procurement based on the consistent evaluation of quality and efficacy has prompted enterprises to return to cost and quality competition and fundamentally improved the ecological environment of the pharmaceutical industry. At the same time, it becomes a push ‘ Three medical linkage ’ The important entry point, policy connectivity and synergy, play a superposition effect. "
The person in charge of the pilot office said that the next step will be to establish a normalized and standardized centralized procurement system based on the improvement of the "4+7" pilot and expansion and the experience of the second batch of countries in organizing centralized procurement and use of drugs, and to include more products in centralized procurement. "Let the new procurement model, marketing method and industry ecology become the leading forces."
According to Ding Yilei, deputy director of the Price and Procurement Department of the National Medical Insurance Bureau, the scope of centralized procurement was fully covered, and the varieties with sufficient competition and stable supply were selected for one tender and national implementation, and the rules were further improved. "In the future, according to the practice of this round of centralized procurement, the centralized procurement of drugs organized by the state will be normalized, and qualified varieties will be included in the scope of centralized procurement." (Our reporter Li Hongmei.)