Source | Cyber blue
Author | Koharu
Large quantities of medicines are no longer reimbursed
01
Fully tuned out
According to Hubei Daily, since December 1, Hubei Province has fully completed the digestion of provincial supplementary medical insurance drugs, and eliminated drugs with poor efficacy, high cost and inclusion in key monitoring from the supplementary drug list.
Since 2019, Hubei has optimized and adjusted the provincial medical insurance supplementary drugs, and digested them in two batches. In 2019, 164 supplementary drugs were excluded, accounting for 46.32% of the total number of drug varieties, and the reserved drugs were classified as "Hubei Province Digestion Transition Drugs (2019 Edition)".
On December 1, 2021, Hubei Province digested all 232 remaining supplementary drugs at one time, which also means that the costs incurred by these 232 drugs will no longer be included in the payment scope of Hubei Province's basic medical insurance, work injury insurance and maternity insurance fund.
Among these 232 drugs, there are 69 kinds of proprietary Chinese medicines and 163 kinds of Western medicines, involving gastrointestinal and other digestive system drugs, diabetes and other metabolic drugs, cardiovascular drugs, gynecological, pediatric drugs and other fields of drugs, including many well-known varieties.
In addition to Hubei, a batch of drugs in Beijing was also transferred out of the medical insurance list on December 1.
Previously, the Beijing Municipal Medical Insurance Bureau issued the "Notice on Announcing the Second Batch of Drug Varieties and Standardized Drug Names of non-national medical insurance drug catalogues in the city", announcing that from December 1, 2021, 182 varieties of non-national medical insurance drug catalogues such as "atropine promethazine injection" will be deleted from the city's medical insurance drug catalog, and the names and dosage forms of 48 drugs such as "Qingkailing injection" will be standardized and adjusted.
It is understood that previously, all localities had no more than 15% of the authority to independently adjust the local medical insurance catalogue to the national Class B drugs, forming a "local supplementary catalogue".
After the publication of the 2019 version of the national medical insurance drug catalog, the state clearly canceled the authority to adjust the local medical insurance catalog, requiring that except for special provisions, the local government will no longer adjust class B drugs, and the original supplementary varieties should be gradually digested within 3 years in principle, and it is clear that 40%, 40%, and 20% of the number of supplements by each province will be eliminated within three years, that is, the three batches of withdrawal work will be completed by the end of June 2022.
On September 15 this year, the executive meeting of the State Council deliberated and adopted the "14th Five-Year Plan" for the national medical security plan, once again emphasizing that the scope of basic medical insurance in the country will be basically unified next year.
According to incomplete statistics, as of now, more than 20 provinces and cities such as Gansu, Ningxia, Xinjiang, Guangxi, Zhejiang, Shaanxi, Yunnan, Hunan, Jilin, Tianjin, Hebei, Anhui, Tibet, Beijing, Chongqing, Jiangsu, Qinghai, Sichuan, Henan, Shandong and other provinces and cities have implemented the policy of transferring out the local supplementary catalogue.
Looking at the notice of multi-provincial medical insurance transfer, the climax of the new wave of local medical insurance directories is January 1, 2022.
chekiang
On August 3, Zhejiang Province issued the Notice on Transferring Some Drugs out of the Zhejiang Provincial Basic Medical Insurance, Work Injury Insurance and Maternity Insurance Drug Catalogue, clarifying that from January 1, 2022, 118 drugs will be transferred out of the Zhejiang Provincial Medical Insurance Catalogue.
Guizhou
On August 3, the Guizhou Medical Insurance Bureau and the Guizhou Department of Human Resources and Social Security issued the "Notice on Transferring Some Drugs out of the Catalogue of Drugs for Work Injury Insurance and Maternity Insurance in Guizhou Province (2021)", announcing that from January 1, 2022, 339 drugs such as sildine will be transferred out of the Drug Catalogue.
Sichuan
On July 26, the Sichuan Medical Insurance Bureau issued the Notice on Further Improving the Digestion of Class B Drugs in the Province's Basic Medical Insurance, Work Injury Insurance and Maternity Insurance (Draft for Comment), announcing that 145 drugs such as butyl boron ointment will be transferred out of the payment scope of Sichuan Province's basic medical insurance, work injury insurance and maternity insurance from January 1, 2022.
Qinghai
The Qinghai Provincial Medical Insurance Bureau issued the Notice on Printing and Distributing the Supplementary Drug Digestion Catalogue of Qinghai Province, announcing that 129 varieties will be transferred and that medical insurance and work injury insurance reimbursement will be stopped from January 1, 2021.
Jiangsu
On July 14, the Jiangsu Provincial Medical Insurance Bureau issued the "Notice of the Department of Human Resources and Social Security of Jiangsu Province on Publishing the Second Batch of Digestion Directory of Supplementary Drugs in the Province of Basic Medical Insurance, Work Injury Insurance and Maternity Insurance Drug Catalog", announcing that from January 1, 2022, 156 drugs in the second batch of digestion list will be transferred out of the payment scope of Jiangsu Province's basic medical insurance, work injury insurance and maternity insurance fund.
Chongqing
According to the arrangement of the Chongqing Medical Insurance Bureau, Chongqing local medical insurance digests drugs in the second year and stops medical insurance reimbursement from January 1, 2022. The second year digestion medicines are as follows:
Ampicillin probenecid (oral common-release dosage form, the drug has been renamed "ampicillin probene"),flucloxacillin (injectable), cefazolin pentahydrate (injection), cefloxime (injection), ceftriaxazotazol (injection), ceftriaxonazol (injection), cefotali (injection), roxithromycin (extended-release controlled-release dosage form), persemin (injection), clozoxazone (oral regular-release dosage form), gauuroxabrin (injection), compound amino acids (8-11) (oral common-release form), deoxynucleotide (injection), Compound amino acids (15) dipeptides (2) (injectables), long-chain fatty milk (OO) (injections), BCG polysaccharides (injections), pitolimod (oral regular-release dosage forms), placental polypeptides (injections), paclitaxel liposomes (injections), recombinant modified human tumor necrosis factor (injections), vinblastamine (extended-release controlled-release dosage forms), snake enzymes (injections), gustil (injections), meclofentil (injections), acetyl gastroestrin (oral regular-release dosage forms), ambroxol (extended-release controlled-release dosage forms), Cocodeine (oral liquid), cisapride (oral regular-release dosage form), matrine (oral regular-release dosage form), ornithine aspartate (granules), ginseng glucose (injectable), coenzyme Q10 (oral regular-release dosage form), levocarnitine (oral liquid), mannan peptide (injection), fructose sodium diphosphate (oral liquid), low molecular weight dextran amino acid (injection), compound electrolyte (injection), sodium potassium magnesium calcium glucose (injection), aminoiodide (eye drops), Three-dimensional mycin (suppository), intestinal laxative capsules, QianLian tablets (granules, capsules), Monkey Earrings anti-inflammatory tablets, sub-leaf bead capsules (tablets), Shalian and stomach capsules, Mustang Chase syrup, anti-brain failure capsules, yi brain heart granules, Wuzi Yanzong oral liquid (pills, tablets, soft capsules), Schizandra syrup (capsules, tablets, granules), compound Fufang Vine Combination (capsules), compound Da Hong Pao hemostatic capsules, Hekang oral liquid (granules), hemostatic treasure granules, cardiomyoplast injection, blood house stasis soft capsules, danshen for injection, Safflower Yellow Pigment for Injection, Yixinone Tablets (Capsules), Haidan Capsules, St. John's Wort Extract Tablets, Agarwood Gas Pills (Capsules), Saw palmetite Fruit Extract Softgels, Lipid-Lowering Tongluo Softgels, Stone-Killing Choleretic Capsules, Musk Shu Huo ling, Toad Crisp Injection, Jin throat Pills, Zhenhuang Pills, Dusheng Huo Blood Tablets, Calendula Dispersible Tablets, Shu Liver And Spleen Granules, Entacapone Double Dopa Tablets (II.) (Tablets, Beijing Novartis Pharmaceutical Co., Ltd.), Pioglitazone Metformin Tablets (Tablets, Hangzhou Sino-American Huadong Pharmaceutical Co., Ltd., Jiangsu Deyuan Pharmaceutical Co., Ltd.), Ratanthimo Eye Drops (Eye Drops, Pfizer Manufacturing Belgium NV), Mixed Sugar Electrolyte Injection (Injection, Jiangsu Chia Tai Fenghai Pharmaceutical Co., Ltd.), Peridole Indapamide Tablets (Tablets, Svea (Tianjin) Pharmaceutical Co., Ltd.), Fat Milk Amino Acids (18) Injection (Injection, Sichuan Kelun Pharmaceutical Co., Ltd.), Estradiol/Estradiol Didrogestrol Tablets Composite Packaging (Tablets, Tablets, Abbott Biologicals B.V.), Oshali Platinum Mannitol Injection (Injection, Sichuan Meida Kangjiale Pharmaceutical Co., Ltd., Chenxin Pharmaceutical Co., Ltd.), Fat-Soluble Vitamins for Injection (II.)/Water-Soluble Vitamins for Injection Package (Injection, Chengdu Tiantaishan Pharmaceutical Co., Ltd., Hebei Zhitong Biopharmaceutical Co., Ltd.), Kandi Hydrodi tablets (tablets, Jiangsu Deyuan Pharmaceutical Co., Ltd.), Compound Vitamins for Injection (3) (Injections, Liaoning Haisco Pharmaceutical Co., Ltd.), Omeprazole Sodium Bicarbonate Capsules (capsules, Xiamen Encheng Pharmaceutical Co., Ltd.), Diclofenac sodium lidocaine for injection (injection (lyophilized powder injection), Beijing Sihuan Kebao Pharmaceutical Co., Ltd.), Apricot Root Sodium Chloride Injection (Injection, Honghe Pharmaceutical (China) Co., Ltd.), Multiple Oil and Fat Emulsion Injection (C6-24) (Injection, Fresenius Kabi Austria GmbH), Compound Brain Peptide Ganglioside Injection (Injection). , Jilin Buchang Pharmaceutical Co., Ltd., the manufacturer changed its name to Jilin Tiancheng Pharmaceutical Co., Ltd.), compound astryptide injection (injection, Jilin Buchang Pharmaceutical Co., Ltd., the manufacturer changed its name to Jilin Tiancheng Pharmaceutical Co., Ltd.), Qufu Timo eye drops (eye drops, s.a. ALCON-COUVREUR n.v.), ambrobrobuterol oral solution (oral solution, Beijing Hanmei Pharmaceutical Co., Ltd.), 12 multivitamins for injection (injection, the drug has been renamed " Multivitamins for Injection (12)", Shanxi Pude Pharmaceutical Co., Ltd.), Compound Diclofenac Sodium Injection (Injection, Guangzhou Baiyunshan Mingxing Pharmaceutical Co., Ltd.), Alendronate Sodium Vitamin D3 Tablets (II.) (Tablets, Hangzhou Merck & Co., Ltd.), Clindamycin Glucose Injection (Injection), Ambroxol Hydrochloride Glucose Injection (Injection), Granisetron Hydrochloride Glucose Injection (Injection), Doxofylline Glucose Injection (Injection), Ozagire sodium glucose injection (injection), bromohexenazine hydrochloride injection (injection), clindamycin sodium chloride injection (injection), ambroxol hydrochloride sodium chloride injection (injection), famotetin sodium chloride injection (injection), todan setron hydrochloride sodium chloride injection (injection), potassium chloride chloride injection (injection), nicardipine hydrochloride sodium chloride injection (injection), Ozagrel sodium chloride injection (injection), Piracetam sodium chloride injection (injection) , ofloxacin sodium chloride injection (injection), betametine hydrochloride sodium chloride injection (injection), morpholine nizole sodium chloride injection (injection).
02
The challenge for pharmaceutical companies is coming
Although the varieties and times of transfer are not exactly the same, when the provinces withdraw the varieties of local medical insurance catalogs, they basically follow the principle of taking the lead in transferring out medical insurance for key monitored drugs, and giving priority to drugs with no sales volume or small purchase volume. Judging from the varieties transferred, there is no shortage of more than 1 billion varieties, exclusive varieties, and core products of some enterprises.
For enterprises whose products are transferred out of medical insurance, their operations will inevitably be affected. The most typical example is the sale of Guizhou Baite by Conn Beibei.
Guizhou Beite is a 100% shareholding subsidiary of ConnBei after a cumulative investment of 2.759 billion yuan. After the acquisition, Guizhou Beite continued to grow in revenue and net profit of DanshenChuanqiazine Injection, and contributed more to the revenue of Kangbei. In 2017 and 2018, Guizhou Beite's operating income accounted for 20% and 26% of Conn Bay's total operating income, and net profit accounted for 48% and 46% respectively.
In 2019, Danshen Chuanqiazine Injection was included in the national key monitoring drug catalog, combined with the "Opinions on Establishing a Medical Security Treatment List Management System (Draft for Comments)" issued by the National Medical Insurance Bureau at the same time, the product was adjusted out of the provincial local medical insurance payment directory in 2020.
At this point, the sales of Danshen Chuan chuanzine injection have taken a sharp turn for the worse, "by the second half of 2020, there will be almost no market sales, and it is difficult to reverse." Affected by this, Kang Enbei had to break his wrist and announced in August this year that he intended to list and transfer Guizhou Beite.
Facing similar difficulties are Buchang Pharmaceutical and Jichuan Pharmaceutical, both of which have attracted attention this year as ace varieties have withdrawn from the local medical insurance directory.
Jichuan Pharmaceutical's pediatric soy sauce clear heat granules and Pudi blue anti-inflammatory oral liquid are the top profit cows in its products, and have been withdrawn from the medical insurance directory in many places since June. Buchang Pharmaceutical's compound brain peptide ganglioside injection and Gu Hong injection have also successively withdrawn from the local medical insurance directory of Yunnan, Heilongjiang, Shandong and other places.
Generally speaking, enterprises whose pillar products withdraw from the local medical insurance directory have three ways to cope, one is to tap the out-of-hospital market, the other is to seek opportunities to enter the national medical insurance directory, and the third is to transform to find new performance growth points.
In recent years, driven by policies such as prescription outflows, the retail market has developed well. The provincial increase in medical insurance varieties that have been withdrawn, especially OTC products, can also have great opportunities in retail and e-commerce channels. However, how to develop in new business channels is a problem that enterprises need to think about.
Entering the national health insurance directory is also a good way out. For the provincial supplementary medical insurance varieties, especially the varieties that have been included in the basic drug catalog, by doing a good job in secondary development, evidence-based medicine, etc., to confirm their efficacy and safety, then there is a certain chance that they can be included in the national medical insurance catalog. However, the national medical insurance directory is fiercely competitive, and companies need to make up for their homework and be prepared for a sharp price reduction if they want to enter.
Finding new business growth points is also the choice of some enterprises. For example, the above-mentioned Jichuan Pharmaceutical, as a veteran Chinese medicine company, announced that it will invest 2 billion yuan to acquire Tianjing Bio's long-acting recombinant human growth hormone (Itan) TJ101 to explore a new way out.
It can be said that every road is not easy to walk, and enterprises need to make careful choices according to their own situation.