The negotiation of medical insurance catalogue is about to start. How much influence will it have if the big bargain fails?

 The negotiation of medical insurance catalogue is about to start. How much influence will it have if the big bargain fails?

Guoxin Securities is expected to start one-on-one negotiation in late November. Due to the large number of varieties and manufacturers involved, the whole process is expected to last for 1-2 weeks. It is expected to announce the adjustment results at the end of November or early December, which is expected to be formally implemented from 2021. The industry insiders point out that the end of the expert review stage directly means that the price reduction competition will soon start, and the negotiation and negotiation work that has attracted the attention of the industry chain will begin It will further test the enterprises price strategy and market determination.

The residual wave of coronary stent collection is not over

On November 5, the national organizations centralized procurement of coronary stents was implemented, and the total amount of intended procurement in the first year accounted for 65% of the total procurement of all materials in 2019. In terms of the winning price, compared with the hanging terminal price, the drop rate is basically between 90% - 96%, which is far lower than the market expected price.

Affected by the news, Shenwan pharmaceutical biological index has fallen by 4.56% since November 5, and the market value has evaporated by 397 billion yuan. In this regard, Du Xiangyang, chief analyst of medical biology of Southwest Securities, told e company that the winning price of coronary stent centralized collection was still higher than expected. The winning enterprises are better than the non selected enterprises, but there should be no beneficial enterprises compared with those before the centralized purchase.

What is the quality of coronary stents that have experienced substantial price reduction? Du Xiangyang believes that the quality should be guaranteed. First of all, the lowest price is higher than the cost of most stents. Enterprises need to continue to control costs and expenses, and the products can achieve small profits. In addition to the factors of not losing money in quality assurance, there are also policies. If there is a problem with the centralized purchase support, the enterprise will face very big problems in the follow-up, so the quality will certainly be guaranteed.

However, the latest round of adjustment of the national medical insurance catalogue has appeared.

According to the 2020 national medical insurance drug catalog adjustment work plan, the whole process of medical insurance catalog adjustment is divided into five stages: preparation stage, declaration stage, expert review, negotiation and bidding, and announcement of results.

According to the announcement of the State Medical Insurance Bureau on November 11, the State Medical Insurance Bureau has recently organized experts to conduct multiple rounds of review on the drugs that have passed the formal review of the adjustment of the national medical insurance drug list in 2020. At present, the work of the expert review stage has been completed, and each applicant can log in to the 2020 national medical insurance drug catalog adjustment application system to query the evaluation results; meanwhile, the next step will be as follows Organize and carry out negotiation and other related work according to the working procedure.

In fact, on September 18, this year, the State Medical Security Bureau announced the list of drugs that have passed the formal examination for the adjustment of the national medical insurance drug list in 2020. A total of 751 drugs have passed the formal examination, and 708 products have entered the list. They are waiting to pass the expert review and obtain the interview qualification.

751 drugs that passed the formal examination met seven requirements

1. novel coronavirus pneumonia related respiratory diseases.

2. Drugs included in the national essential drug list (2018 Edition).

3. The drugs included in the list of clinically urgent overseas new drugs, the list of encouraged imitated drugs or the list of childrens drugs encouraged to be applied for application, and approved by the State Drug Administration before August 17, 2020 (inclusive, the same below).

6. During the period from January 1, 2015 to August 17, 2020, according to the results of clinical trials, the drugs with significant changes in indications, functions and indications were supplemented and approved by the State Drug Administration.

7. Before December 31, 2019, drugs that have entered the latest edition of the basic medical insurance drug list at or above the provincial level. Among them, the main active ingredients are listed in the first batch of national key monitoring and rational drug use list (chemical and biological products).

Looking back on the price reduction range of this years medical insurance negotiation, it can be said that the price reduction has become more and more intense. From the perspective of the trend of price reduction, it is as high as 60%.

In 2017, among the 44 drugs to be negotiated, 36 drugs were successfully negotiated, with an average decline of 44%.

It is generally believed in the industry that, based on the comprehensive analysis of the pricing experience and payment situation of the last round of medical insurance negotiation, innovative pharmaceutical enterprises in subdivided fields must be prepared to reduce the price by 50% if they want to obtain the medical insurance payment qualification through this round of medical insurance negotiation.

Fierce competition for innovative drugs

In the face of the coming medical insurance negotiation and bidding, the innovative drugs approved by the State Drug Administration before August 17, 2020 are the most concerned in the industry.

The entry of new products into medical insurance is an eternal hot spot in the industry. In the list of drugs to be applied for the adjustment of the national medical insurance drug list in 2020, since January 2015, the State Drug Administration has approved a total of 171 new drugs, including hypertension, diabetes, cancer, respiratory and other indications, including 159 exclusive products.

The PD-1 mAb products, which have attracted the attention of the industry, include Roche, AstraZeneca, Squibb, MSD, Junshi, Baiji Shenzhou and Hengrui. Last year, only Xinda biological Co., Ltd. successfully entered the list of medical insurance in 2019. Its PD-1 antibody drug sindilimab injection (dabashu) dropped from 7838 yuan (10ml: 100mg / bottle) to 2843 yuan (10ml: 100mg / bottle), with a price reduction of 63.73%.

Xinda biologicals new drug has been approved to enter the medical insurance list, and its market sales have increased significantly. According to the financial report in the first half of 2020, the sales volume of Xinda biological core product PD-1 immunosuppressant dabershu reached 920.9 million yuan in six months, with a year-on-year increase of 177.7%. The PD-1 of moshadong, Junshi, Baiji Shenzhou and Hengrui will compete fiercely in this medical insurance negotiation.

Up to now, as the results of expert evaluation have not been published, only the list of drugs under formal review shall prevail. Among the drugs that meet the requirements of new generic drugs approved by the State Drug Administration from January 1, 2015 to August 17, 2020, Hengrui pharmaceutical has 6 drugs, Zhengda Tianqing and Hansen pharmaceutical have 4 drugs.

Guosheng Securities believes that the two more important events before the end of the year are the centralized collection of coronary stents in early November and the negotiation results of medical insurance in early December. Centralized procurement of stents has been implemented, and the next step is to negotiate medical insurance for innovative drugs (such as PD-1). There may be some emotional disturbance, but it is an important opportunity for the long-term layout of medicine.