If the collection is not selected, will the pharmaceutical company still have a chance? Henan gave a clear answer: no.
On December 17, Henan led the procurement of the Fourteen Provinces Drug Alliance to announce the plan, covering 38 kinds of drugs commonly used to "drop three highs", including many large varieties of diltiazem and lasilic equality of hundreds of millions of yuan.
The biggest difference between this inter-provincial collection is that the agreed procurement volume of all varieties is not less than 80% of the hospital demand; if there are only 1 or 2 enterprises to be selected, the agreed procurement volume is 100% of the actual demand of medical institutions.
This completely breaks the general cognition of enterprises: in the national collection, the agreed procurement volume generally accounts for 70% of the demand of medical institutions, and if only 1 is selected, the procurement volume may only be 50% of the demand. Leave some room for unselected varieties.
Nowadays, Jicai has eaten almost all the needs of the hospital, and not winning the selection is equivalent to completely losing the hospital market.
Moreover, the 14-province alliance also proposed that the unselected varieties will be included in the scope of "key monitoring", which basically blocks any space in the market outside the collection and mining.
It is worth observing whether this inter-provincial collection organized by Henan will become a template for national collection and procurement in the future.
The purchase volume is maximized, and the standard varieties are monitored
Jiangxi is one of the members of the Henan 14 Provincial Alliance. In fact, before this collection, Jiangxi basically did not give any opportunity to the unselected varieties.
At the end of November this year, jiangxi announced the progress of drug collection, showing that the number of collection varieties purchased by medical institutions in the province is much higher than 70% of the number of drugs used in hospitals, and the proportion of procurement of some drugs is close to 94% of the actual dosage.
The president of a third-class hospital in Wuhan told the Health Bureau that under the premise of quality assurance, it is an inevitable trend for varieties with large quantities to gradually collect and collect. "Drugs are now the cost end of the hospital, even if the hospital has completed the agreed procurement volume, it is willing to continue to enter the cheap collection varieties, and the space for collecting and collecting varieties is naturally small."
The procurement volume requirements of the 14-province alliance are not difficult for strong people, but meet the actual needs of medical institutions.
The Health Bureau noted that if the 14 provinces require less than 4 reporting enterprises, the maximum number of enterprises to be selected is 2. This means that if there are less than 4 varieties of competition, the selected enterprises can monopolize the entire market of the hospital.
Henan Jicai has a more ruthless move: carrots and sticks.
In the draft collection and solicitation of the Fourteen Provinces Alliance in early December, it was stated that "the varieties that are not selected will be included in the key monitoring scope". The requirements of the official document are more stringent, expanding the scope of key monitoring to the "whole group of flow standard" drugs, and requiring strengthening the review and inspection of the procurement and use of drugs in designated medical institutions.
This can be said to be a warning.
At the end of 2018, Henan, the leading province of the alliance, organized a special collection of anti-cancer drugs, and there was a "whole group of flow standards" on the anti-leukemia variety of imatinib: Novartis, Howsen and CSPC did not accept experts to suggest prices.
The Henan Provincial Medical Insurance Bureau had to give up at that time, and issued an announcement in January of the following year that in order to protect clinical drugs, the above three imatinib hospitals could be purchased. Pharmaceutical companies "win".
In this 14-province alliance gathering, Henan specially emphasized the consequences of the "collective strike": it will be "focused on monitoring", sending a strong signal to the outside world, and will not compromise on the same issue twice.
Pharmacies are included in the collection of reports, and it is better to avoid it than to face it
There is no opportunity in the hospital market, the outside market has naturally become a fragrant feast, and some industry training has also advertised the outside market as the "strongest growth pole in the future", and this future is not as beautiful as imagined.
Before this alliance procurement, the leading province of Henan has just started to start retail pharmacies, including some chain retail pharmacies in the collection pilot, and plans to gradually include all medical insurance designated pharmacies in the jurisdiction. The announcement of the fourteen provincial alliance also clearly proposed: encourage medical insurance designated social medical institutions and retail pharmacies to participate.
According to the official website of the Henan Provincial Medical Insurance Bureau, 275 retail chain pharmacies in Henan have begun the reporting work of the alliance collection.
In the third batch of national collection in 2020, 28,000 pharmacies in Guangdong Province participated in the reporting volume, accounting for 45.84% of the total procurement volume in Guangdong Province, almost equal to that of medical institutions.
Retail pharmacies have considerable procurement capacity, if the 14 provincial alliance collection, Henan, Guangdong and other provinces into the pharmacy report, the future pharmacies fully participate in the collection will not be too far.
This is in line with the national collection orientation. In September this year, the National Medical Insurance Bureau once again made it clear in a reply letter to the proposal: encourage non-public medical institutions and social pharmacies to actively participate in the collection and establishment of a market-led drug price formation mechanism.
In addition, the 14-province alliance has another feature: the production capacity of the declared drugs needs to reach more than 2 times the amount of this procurement to ensure stable supply.
In August this year, the supply cut off of North China Pharmaceutical is still fresh in the industry's memory. After winning the bid at a low price, it cannot be supplied, which is a great blow to the market and patient confidence. This 14-province alliance has taken into account the quality and production capacity of drugs. In the future, the production capacity of collected drugs may become an important assessment factor.
At the beginning of the collection, a hospital person in charge told the Health Bureau: The original intention of the collection is good, but the low price of winning the bid will affect the quality of the drug, and many life-saving drugs emphasize quality. Once the quality is in trouble, the injured person is ultimately the patient.
According to the production capacity declaration, it can ensure that the production enterprises will not cut off the supply, and some enterprises without long-term production experience may be excluded from the list of collection. This is also a major trend of national collection, which is worthy of vigilance in the industry.
Under the collection, enterprises have no choice and must face it head-on.
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