The national drug collection has brought about new changes in medical drugs

Since the establishment of the National Medical Security Bureau, it has actively promoted the centralized procurement of drugs, and has now carried out the sixth batch. The state implements drug collection in order to effectively reduce the burden of drug costs on patients. The 2021 Blue Book on the Progress and Effectiveness of Medical Insurance Drug Management Reform pointed out that since the collection, the burden of medication for patients has been significantly reduced, and the pressure on medical insurance funds has been greatly alleviated. As of September 2021, the cumulative savings in medical insurance fund costs will be about 250 billion yuan.

What new changes will the collection bring to the price, quantity and structure ratio of medical drugs? Is there any guarantee for the quality of drugs after collection?

"Through the comparison of data, we can observe that the medication structure of medical institutions has changed, the accessibility of medication for patients has improved, and the burden of medication has been reduced." Liu Wenxin, director of the Standards Department of the China Medical Insurance Research Association, introduced at the press conference on "Collecting and Promoting the Substitution of Generic Drugs - Changes in the Use of Original Drugs Not Selected in The Collection".

The overall decline in the purchase price of drugs, the price of unselected and selected generic drugs and original research drugs "three prices fell together"; the proportion of drug procurement structure changed, the procurement volume of unselected generic drugs and original research drugs was "two decreases", and the procurement volume of selected generic drugs was "one increase".

The China Medical Insurance Research Association selected 9 commonly used drugs such as atorvastatin oral regular-release dosage forms and amlodipine oral regular-release dosage forms, and conducted incomplete statistics on the national situation, and found that the effect of "volume-for-price" was obvious. The average price of the above 9 selected generic drugs decreased by 82.4% in the year after the collection, driving the average price reduction of the original research drugs of the same generic name to 12.9%.

At the same time, the total amount of drug procurement under the same generic name continued to rise. One year after the collection, the total annual procurement volume of the above nine drugs increased by 23% according to the generic name. The availability of drugs is improved, and the "volume effect" of selected generic drugs is significant.

Data graph of the increase in procurement volume under the generic name of 9 selected generic drugs such as entecavir oral regular-release drugs. Image source: China Medical Insurance Research Association

According to experts, in terms of total procurement volume, the structure of drug use and market share have changed, and the proportion of selected generic drugs has risen sharply. Judging from the proportion of the total annual procurement volume of the nine drugs, the original research drugs decreased from 28.9% in the year before the implementation to 12.7%, and the selected generic drugs increased from 27.1% in the year before the implementation to 80.4%. The effect of "generic drug substitution" is constantly strengthening.

For example, Hu Xin, chief pharmacist of the Pharmacy Department of Beijing Hospital, said that the state collects 21 kinds of drugs for hypertension, accounting for more than 50% of the market size of antihypertensive drugs. Among them, the price of amlodipine besylate tablets was reduced by 79%, and the annual treatment cost was reduced from 300 yuan to 60 yuan, which greatly improved the treatment rate of hypertensive diseases.

Prices fall, dosages rise, and quality is also important. The quality of drugs is directly related to the lives and health of the broad masses of the people, and it is necessary to ensure the effectiveness, safety and reliability of drugs, so that the people can use the drug with confidence. Last month, the State Drug Administration held a meeting to promote the quality supervision of the national collection of drugs, emphasizing the need to carry out full-coverage sampling of the selected drugs, and strengthen the monitoring and evaluation of adverse reactions and the investigation and disposal of risk signals.

Collecting medicines is not only to "reduce costs", but also to "promote research and development". Some experts said that the collection of drugs is "moisture", but also to ensure the reasonable profits of pharmaceutical companies to "promote research and development". Jiang Changsong, an associate researcher at the National Medical Security Research Institute of Capital Medical University, believes that on the basis of the policy of using the scale effect of the amount to benefit the people, it is necessary to encourage Chinese pharmaceutical companies to develop a virtuous cycle and promote the development of "high-end preparations". (Reporters Gu Tiancheng and Peng Yunjia)