14 provincial major leagues launched special procurement of imported anticancer drugs

Medical Network September 3, the last two days of August, Shanxi, Inner Mongolia, Liaoning, Jilin, Heilongjiang, Hunan, Guangxi, Hainan, Guizhou, Gansu, Qinghai, Ningxia, Xinjiang and Shaanxi, 14 provinces (districts) The inter-provincial procurement alliance has thrown a 'heavy policy'. The reporter learned from the "Procurement of the Special Procurement of Imports of Anticancer Drugs of the Interprovincial Union" from the Jilin Province Drug Collection Center on the 31st, the above provinces have issued notices to fully launch the provinces within the alliance. Special procurement work for imported anti-cancer drugs.

In the annex to this announcement, the reporter saw that according to Caishui No. 47 and Guobao Office No. 4, based on 103 anti-cancer drug preparations, the 14 drugs that the state negotiated anti-cancer drugs have been tax-reduced and price-cutting are excluded. Two PD-1 inhibitors were added, including 91 anticancer drugs including imatinib mesylate, crizotinib, cetanilide and cetuximab injection, which were included in the special procurement catalogue.

In other words, the 14 provinces and autonomous regions will open special purchases of anticancer drugs in accordance with the special procurement catalogue of anti-cancer drugs imported by the provincial alliance, and relevant anticancer drugs will quickly enter clinical use. In addition to the anti-cancer drugs listed in the zero tariffs, It is worth noting that two PD-1 inhibitors, Navolizumab and Pabolizumab, are also in the procurement catalog.

The former was approved for marketing in China in early June for the treatment of epidermal growth factor receptor gene mutation-negative and anaplastic lymphoma kinase-negative, previously undergoing platinum-based chemotherapy after disease progression or intolerable local late or metastatic non-small Cell lung cancer adult patient.

Navulitis Monoclonal Antibody Injection is the first monoclonal antibody approved by PD-1 in China, which has positive significance for solving the accessibility of clinical drug use in cancer patients in China. Bristol-Myers Squibb first launched in China. Relevant clinical trials, and the application for registration of imported drugs is submitted accordingly. Lung cancer is a globally high-grade malignant tumor with the highest mortality rate. Experts believe that the increasing incidence and mortality of cancer promotes the growth of the cancer drug market. Statistics It shows that the global cancer drug market has expanded from 72.9 billion US dollars in 2013 to 110.6 billion US dollars in 2017, with a compound annual growth rate of 12.8%. With the further expansion of the cancer drug market, it is expected that the global cancer market sales will exceed in 2030. At the same time, China's cancer drug market is still in high demand. It is expected that the market size will reach 23.4 billion US dollars in 2018, and will exceed 30 billion US dollars by 2020. Navulitis Monoclonal Antibody Injection will rebuild the competitive landscape in China. .

Pabolizumab provides a new option for unresectable or metastatic melanoma with first-line treatment failure. It is reported that Pabolivumab has only been used in China for more than five months from submission to approval. The fastest approval record for imported anti-tumor biologics. In China, the incidence of melanoma is lower than in Europe and America, but due to the large population base, the number of new cases is close to 20,000 per year. Market participants speculate that Pabolizumab The potential is evident. In fact, the treatment of melanoma is only the tip of the iceberg of anti-tumor effect of pabolizumab. Currently, Pabolizumab has been approved for use in more than 80 countries, covering more than 12 of 9 tumors. Indications, including melanoma, non-small cell lung cancer, head and neck cancer, Hodgkin's lymphoma, bladder cancer, cervical cancer, gastric cancer, B-cell lymphoma, etc.

The National Medical Insurance Bureau issued a document, downgrading the payment standards and purchase prices of 14 kinds of anti-cancer drugs negotiated by the previous countries, and deploying the price landing work. It is required that the centralized drug procurement platforms of all provinces should be openly purchased according to the adjusted new prices before the end of September. Others believe that the rapid introduction of imported drugs solves the problem of accessibility of clinical life-saving drugs, but for domestically produced innovative drugs, it will have a certain impact. First, these products will be reduced in price to participate in competition just after listing. Second, imported drugs It has a strong advantage at the academic level, which will make China's anticancer drug market competition. However, it is also reminded that imported drugs are rapidly entering China, involving the global production capacity of multinational pharmaceutical companies. It has already appeared before Herceptin was included in medical insurance. There are many out of stock phenomena, how to ensure the supply of imported anticancer drugs is also worthy of attention.

Take the lowest price in the country and start reporting on September 10

According to the bargaining plan, the above 14 provinces (districts) will apply for the special procurement of anti-cancer drugs imported by the provincial alliance, and the data review will be carried out on the basis of the Shaanxi Provincial Purchasing Platform. proxy Domestic production of commercial and imported pharmaceutical products enterprise It can be officially declared online on September 10, and the deadline is 14 days. In principle, the special procurement cycle for anticancer drugs is not less than one year.

The reporter noted that according to the joint procurement rules formulated by the alliance, the joint bargaining is determined by the members of the alliance as a province to serve as a bargaining organization. Each provincial party sends three corresponding chief physicians or pharmacists as bargaining representatives to participate in the bargaining work of the alliance. The bargaining group randomly selects the bargaining products. Face-to-face bargaining with manufacturers. Each product has two rounds of bargaining opportunities. The form is similar to the national medical insurance negotiation. For the first round of unsuccessful bargaining and applying for bargaining again, the bargaining representative will vote, and more than half will enter the second. Round of bargaining. The second round of bargaining still uses face-to-face bargaining. The bargaining representatives combine the first round of negotiations to re-send the reasonable price of the product, calculate the median price, and negotiate the price with the median price.

For products that are unsuccessful in bargaining and products that do not participate for special reasons, the members of each alliance will suspend the network, and the manufacturer and the members of the alliance will re-negotiate. When bargaining, they should refer to the bargaining reference price when the alliance purchases, and the bargaining will be successful. The results are communicated to the members of the alliance. In addition, among similar imported products, each alliance member should give priority to the use of bargaining products.

Looking deeper, the member provinces of the alliance are mostly in the western provinces or the northeastern provinces of medicine. The pressure on medical insurance control fees is very high. The market for individual purchases is changed by the market, and the chips are not enough. Once the market in 14 provinces is unified, pharmaceutical companies and Purchasing alliances can coordinate prices through the market and achieve multi-win. From this perspective, these 91 anti-cancer drugs will take the market of public medical institutions in 14 provinces in one fell swoop. It is conceivable that negotiations will not be easy. In the middle of the month, a tug of war without smoke will begin.

In fact, since the implementation of the anti-cancer drug price reduction policy, the local governments have ushered in a 'price reduction tide'. According to the Tianjin Social Security Center, at the end of August, Tianjin will include two kinds of countries to negotiate anti-cancer drugs for medical insurance reimbursement, including Bortezomib and lenalidomide capsules for injection. The newly included generic drugs are nearly 2,000 yuan cheaper than the similar imported drugs. The price of 14 anti-cancer drugs negotiated in the previous countries is between 3% and 7.8%, with an average decrease of 4.86%. Guangdong Province actively applied for price reductions including GlaxoSmithKline lapatinib tablets, Novartis Matinib tablets, 354 drugs including Beida Pharmaceutical Ektinib tablets. August 29 On the day, Hainan Province publicized 583 applications for price reduction of imported drugs and anticancer drugs submitted by companies such as Pfizer Pharmaceutical Co., Ltd., and added 19 countries that had adjusted prices the previous day to negotiate anticancer drugs, and the total number of price reduction drugs reached 602.

The announcement of the inter-provincial procurement alliance clearly stated that the bargaining price should be determined with reference to the zero tariff of imported drugs, the adjustment of value-added tax and other factors, and should not be higher than the lowest price in the country, and neighboring countries and regions. hospital purchase The price difference should not be too large, and the price difference between the domestic manufacturers and the same-named domestic manufacturers should not be too significant. The members of the alliances who have successfully negotiated the price will also perform the bargaining results at the same time, and the medical institutions in the alliance will no longer negotiate with the enterprises, and the price will be implemented. Dynamic management. 'Price reduction, will be the focus of the future supply and demand side game.'