This is a true story reported by Xinhua News Agency, "A mother spent 480,000 yuan to promote her son's height, but the result was only 1 centimeter in return."
In fact, pediatricians have long made it clear that adequate sleep and balanced diet can ensure the normal development of most children. But the subconscious of "Jackie Chan" has brought parents to the point of doing whatever they want.
"Growth hormone," a prescription drug whose use is literally understood, was once hard to find in the out-of-hospital market.
It is precisely because of the pursuit of many fanatical parents that this class of drugs has the courage to say no to "price for volume".
Two of the water needle "troikas" abandoned the bid and one did not win the bid
Being included in the collection and collection means that the price reduction and performance of some pharmaceutical companies are affected for the dominant varieties of some pharmaceutical companies. As a result, from the beginning of the wind, the capital market has repeatedly responded to the decline in stock prices.
On March 10, the Guangdong Provincial Drug Trading Center released the results of the proposed selection of the 11 provincial alliances, and for the first time participated in the (alliance) collection of growth hormone, the powder needle dropped by 52%, and the water needle with the highest price reduction call was not selected.
On February 23, the Guangdong Provincial Drug Trading Center issued the "Notice on Viewing the Information Related to the Centralized Procurement (First Batch) of Drugs such as Diclofenac of the Guangdong Alliance" (hereinafter referred to as the "Notice").
Not surprisingly, in addition to Novo Nordisk's declaration of recombinant human growth hormone water injection, Changchun High-tech Holding Subsidiary Kinsey Pharmaceutical and Anke Bio both abandoned the bid.
This situation of local enterprises "abandoning bids" and foreign-funded enterprises declaring is extremely rare in collection.
Enterprises have joined hands to gather an army and ushered in the cheers of the capital market, and the stock prices of Changchun High-tech and Anke Bio have risen sharply for two consecutive trading days.
For the reasons for the abandonment of the bid, changchun high-tech responded that the company has responded to the call for medical insurance drug fee reduction in accordance with relevant policy requirements and made a declaration of some product specifications for growth hormone. The company will continue to participate in the collection with a positive attitude.
The only declared Novo Nordisk, because the price reduction was less than expected, was not selected.
The first shot was fired at the collection of growth hormone on January 19, when the Guangdong Provincial Drug Trading Center issued the "Guangdong Alliance Diclofenac and Other Drugs Centralized Procurement Documents".
This is the first release of the news that recombinant human growth hormone has been included in the collection catalog, Kinsey Pharmaceutical and Anke Bio have varieties included, which once triggered market panic, and Changchun High-tech stock price fell for 3 consecutive trading days.
At that time, even if Changchun Gaoxin released the announcement of executive holdings, it was like a "mantis arm blocking the car", and it was difficult to stop the downward trend of stock prices. Until the news of abandoning the standard water injection, the stock prices of Changchun High-tech and Anke Bio recovered slightly.
It is worth mentioning that the "flash crash" of the stock prices of these two industry leaders is not the first time, whether it is the "preview" of growth hormone collection in May 2021, or the Xinhua News Agency issued an article questioning the abuse of growth hormone, which has brought an impact on this market.
On January 21, the closing prices of Changchun High-tech and Anke Bio have fallen by 67% and 41% respectively from the highs of May 21, 2021.
In the field of growth hormone in the mainland, kinsey pharmaceuticals (a subsidiary of Changchun Biologics), Anke Biologics and Novo Nordisk are presented in a three-legged pattern.
According to the survey of Guoyuan Securities, as of the end of 2020, the market share of growth hormone in the sample hospital of Kinsey Pharmaceutical was 78.4%, and the second place was Anke Biotech, accounting for 15.9%, and the remaining market was dominated by Novo Nordisk.
Among them, in terms of water injections, according to Debon Securities, a sample hospital data from 2020 shows that Kinsey Pharmaceutical has a market share of 99.7% in the water injection market in 2020.
In terms of powder needles, the sample hospital Anke Bio market share ranked first in 2020.
Growth hormone is the pillar product of Changchun High-tech, accounting for half of the performance. According to the performance data of Kinsey Pharmaceutical, in the first three quarters of 2021, Kinsey Pharmaceutical achieved revenue of 6.161 billion yuan, accounting for 74.78% of the total revenue of Changchun High-tech, and net profit accounted for 96%. At the investor relations event held on March 17, Changchun Gaoxin said that powder needles accounted for about 10%, and revenue increased by nearly 40%; water needles accounted for more than 70%, and income increased by more than 30%.
Dongguan Securities Research Report analysis pointed out that if Kinsey Pharmaceutical wins the bid in the alliance procurement in Guangdong Province according to the maximum price limit, then the price reduction is about 71%. Based on the estimation of procurement volume, if the price is not reduced and declared, Kinsey Pharmaceutical chooses to abandon the bid in the Guangdong Alliance, which can avoid the loss of sales revenue of more than 70 million yuan.
Some reports pointed out that although Kinsey Pharmaceutical's revenue in 2021 was 8.198 billion yuan, it obviously did not give up the "small money" of 70 million yuan. It believes that the thinking of abandoning the target is that at present, the collection of regional alliances will often bring about the effect of market linkage price reduction, that is, if each region refers to the 70% decline, I am afraid that the pressure on the performance of Changchun Gaoxin will not be small. Therefore, enterprises such as Changchun High-tech may want to convey to the market the attitude of adhering to their product price system by abandoning the bid.
Is it a spoiler? Or complicity?
Although Novo Nordisk's market share is much lower than that of the two industry giants, its intention to participate in the quotation of water needle collection is very clear, "dead horse as a living horse doctor", may be able to successfully leverage the inherent pattern of the water needle market.
However, anke Bio, which is more likely to have a substantial impact on the water needle market, seems reasonable and unexpected to abandon the bid.
Anke Bio's water needle growth hormone was approved in June 2019, and after a large number of market cultivation, it began a rapid release momentum.
With this, Anke Bio achieved revenue of 580 million yuan in the third quarter of 2021, an increase of 31.3% year-on-year, and net profit of 190 million yuan, an increase of 35.6% year-on-year.
From this, we can appreciate the "entanglement" of Anke Biology - finally waiting for the harvest period of growth hormone water needles, if you participate in the collection, although you can grab a larger market share in the hospital, it is bound to make more demand outside the hospital turn to the hospital, and the price system in the field of water injections may be reconstructed.
Therefore, if Anke Bio participates in the collection, it is likely to lose the "cash cow" that has just been bred.
In this alliance collection, powder needles, water needles did not carry out group bidding, taking 15IU and 30IU two units of water needles as an example, the maximum declared price is 173.58 yuan and 295.08 yuan, while kinsey pharmaceutical two products the current hanging net price of 567 yuan, 1031 yuan, a decrease of 70%.
Weighing the interests, Ankor Bio chose to "go forward" with Kinsey Pharmaceuticals, leaving the decision to "Mr. Market" before there are more competitors.
The market is outside public hospitals
In fact, for Kinsey and Anko, the real competition is the off-campus market.
Changchun Gaoxin once pointed out in investor relations activities that more than 70% of the company's growth hormone sales revenue comes from cooperative medical institutions, and less than 30% comes from public hospitals. And the company also expected out-of-hospital revenue to continue to increase.
In a summary of an investor research activity, Ankor Bio also confirmed this.
"The proportion of growth hormone sold by the company in public hospitals is less than 30%", Anke Bio stressed that growth hormone is not a product that needs to be purchased urgently, and more than 90% of such products come from patients' own expenses, short stature, and do not seriously affect life and health.
In the top three public hospitals, new patients are enrolled, follow-up follow-up consultations, and the prescription of drugs is mainly based on the out-of-hospital market, forming a unique sales model of the above two pharmaceutical companies.
Therefore, abandoning the in-hospital market and stabilizing the price system of the outside market has allowed the two to reach a consensus.
According to the pattern of growth hormone water injections, Anke Bio's judgment is: "It is difficult to fight a price war with two opponents."
"Growth hormone as a biological product, unlike chemicals, the capacity bottleneck determines that there is no extreme 'price for volume' situation in this market." Anko Bio's attitude has long been clear.
Crazy parents
If the main battlefield is shifted from "outside the courtyard" to "inside the courtyard", the price system that has been operating for many years will face restructuring, which should be the situation that producers are least willing to face.
The more important reason for Changchun High-tech and Anke Bio to completely make up their minds to give up this collection may come from the pursuit of "irrationality" on the demand side.
According to the National Bureau of Statistics, the mainland population aged 0 to 15 in 2021 will be 263 million, and the number of children will be about 7.9 million based on the 3% incidence of short stature.
One of the core logics that has been optimistic about the field of growth hormone for a long time is that data show that the proportion of patients with short stature in China is only 5.7%.
But this figure has been controversial. In December 2021, Changchun Gaoxin said on the investor platform that the incidence of such diseases is low.
In fact, the company is "clear about this", the main cake of growth hormone is not in the treatment of shortness, but more for the purpose of increasing height. Some parents who have higher expectations for their children's height have provided more increments for the industry.
Anke Bio pointed out that from the perspective of the current treatment groups, most of them are treated by parents from the perspective of enhancing their children's future competitiveness, and pay more attention to products and manufacturer services.
"Compared with spending more than 20,000 yuan to obtain a cure of about 10 centimeters in length during the treatment period, the price is not the biggest problem. The main factor influencing patients' choice is parental awareness, not the lower the price, the better." Anke Bio stressed that many parents pay more attention to efficacy, safety and service, the price is low, but the service is not guaranteed.
The Chinese Eugenics Science Association once disclosed a set of data, "boys 175 cm, girls 165 cm" is the vast majority of parents for the future height of their children's hope value. However, the actual height of adults in China is much different from this value.
It is understood that before the age of 15 for boys and 13 for girls is the best time to inject growth hormone. Therefore, in order to make children look more perfect, parents are eager to do this.
Growth hormone has been given the consumption attribute by the parents of "Jackie Chan", so that it is no longer a simple prescription.
Magnified enhancement elixir
Growth hormone is currently divided into three dosage forms in China: powder injection, water injection and long-acting water injection, and Kinsey Pharmaceutical is the only company with three dosage forms, accounting for more than 60% of the share.
Due to the higher stability and convenience of water needles, the future or will gradually replace powder needles, the current water needles have occupied more than 60% of the growth hormone market share.
From the perspective of drug costs, powder needles have the lowest price, and powder needles have one indication that is included in medical insurance reimbursement; water injections and long-acting dosage forms are not included in medical insurance. Water needles and powder needles are usually injected daily, and long-acting water injections are given once a week. The annual fee for injection powder injection, water injection and long-acting water injection is about 20,000 yuan, 40,000 yuan and 200,000 yuan.
The high price did not stop the enthusiasm of parents, and the demand and purchasing power formed a strong positive correlation.
Changchun Gaoxin disclosed in the 2021 semi-annual report that East China, which has a relatively developed economy, contributed 39.28% of the company's revenue.
In fact, in order to improve performance, there have been individual sales that are also anxious about parents, and even advocate that "spending X million yuan can grow X centimeters in height.".
For a time, growth hormone was hard to find.
This phenomenon was not alleviated until it was exposed by authoritative media and prompted parents to avoid pit marketing traps.
The health community contacted a number of doctors to understand the current situation of the industry, but all of them did not comment on this, and the general response was: "The incident is more sensitive, it is not convenient to express opinions."
The chief physician of a third-class hospital in Beijing once posted on Weibo that many parents now have "shortness of breath", but in fact, for normal children, playing growth hormone does not benefit much. Growth hormone therapy is only suitable for a small number of children with indications, and it is necessary to find a professional doctor to evaluate, rather than listening to some institutions.
Unstoppable profiteering
At present, the vast majority of growth hormone products in the mainland are mainly used to treat children's growth hormone deficiency.
However, the adult population is also another major area for growth hormone to conquer in the future.
From the experience of the United States, about 75% of the users of long hormones in the country are over the age of 20, and the main uses are anti-aging and muscle strengthening. Therefore, from the perspective of scope of application, there is still a lot of room for the growth hormone market in the mainland.
At present, Kinsey Pharmaceuticals has the only approved adult growth hormone deficiency product in China.
Changchun Gaoxin pointed out in February that while the company actively carries out pediatric promotion, the field of adult indications is also actively expanding the market, and has made substantial breakthroughs, and will certainly become a new profit growth point in the future.
The lack of competition, huge demand, and the endorsement of consumption attributes have allowed growth hormone companies to enjoy excess returns.
According to Changchun Gaoxin's financial report data, the company's gross profit margins in 2019, 2020 and 2021 were 85.2%, 86.7% and 91.31% respectively.
Source: Changchun Biotech 2021 Annual Report
On March 31, Anke Bio released its latest financial report, in 2021, the company's operating income was 2.169 billion yuan, an increase of 27.47% year-on-year; net profit was 207 million yuan, down 42.44% year-on-year, and the explanation for this was that Ankor Bio made a goodwill impairment provision of about 323 million yuan for Soho Yiming and Sino-German Meilian.
However, the gross profit margin of Anke Bio's biological products still reached 88.38%.
Source: Ankor Biotech Annual Report 2021
That is to say, at the 1031 yuan hanging network price of 30IU, even if the channel, management, research and development and other expenses are removed, the cost is less than 140 yuan.
Therefore, once involved in the collection, the era of "lying and making money" by the makers of growth hormone will come to an end.
In fact, the "sharp blade" of the collection is still hanging high above the head of Changchun Gaoxin. On March 17, the Qinghai Provincial Centralized Procurement Network for Pharmaceutical Equipment released the "Notice on Adjusting the Price of Some Drugs", and the long-term water injection of Kinsey Pharmaceutical was reduced from 5600 yuan / piece to 3500 yuan / piece, with a price reduction of 37%.
Judging from the past situation, enterprises have taken the initiative to reduce the price of products in local procurement, which is generally regarded as a "test of the water" for the price reduction of collective procurement or medical insurance negotiations. For example, in November 2019, the original research adalimumab (AbbVie), which entered the medical insurance in November 2019, tried to take the initiative to reduce the price by half in local procurement to test the water, and finally the price after the national medical insurance negotiation was only about a quarter of the original price.
Therefore, Changchun high-tech growth hormone water injection abandoned the standard Guangdong Alliance collection, but also took the initiative to reduce prices in Qinghai, a province under the alliance region, which is also considered by the industry to be a way to "avoid significant price reductions".
The future is unknown. I am afraid that most of the parents of the children still hope that the collection can block the huge profits of growth hormone companies, after all, in China, families that can consume 50,000 or even 200,000 a year are still a minority.
However, it has to be admitted that after a long period of freedom from the shackles of the hospital scene, growth hormone has long been anchored as a "self-funded drug" by the inertial way of thinking.
Health Community Exhibits
Written by | Old Zhao next door