Jiang Changsong, National Medical Insurance Research Institute, Capital Medical University: The centralized insulin procurement policy has stabilized, allowing enterprises to take the profits they deserve

Source of this article: Times Finance Author: Zhang Yuqi

The site of the National Drug Centralized Procurement Insulin Special Continuation Declaration Information Disclosure Conference. Times Finance/Photo

At around 4 p.m. on April 23, Shanghai Sunshine Pharmaceutical Procurement Network officially announced the results of the proposed selection of the national centralized drug procurement (special insulin continuation). The results show that 13 pharmaceutical companies, including Hefei Yifan Biotech, Eli Lilly Suzhou Pharmaceutical, Gan & Lee Pharmaceutical, Hefei Tianmai Biotech, Jiangsu Wanbang, Novo Nordisk, etc., all won the bid, among them, some products of Yichang Dongyang Yangtze River Pharmaceutical, Hefei Tianmai Biotech, Hefei Yifan Biotech, Tonghua Dongbao and other pharmaceutical companies are A1 selected products.

According to the national centralized drug procurement document (special continuation of insulin), the selected products in this round of continuous procurement are divided into three groups (categories) of A, B and C according to the declared price from low to high. Among them, the proportion of the basic quantity of the selected products in class A to the purchase demand of the corresponding products in the first year is 80%~100%, the proportion of the selected products in A1 is 100%, and the proportion of the remaining selected products in class A is 80%.

The scope of this round of insulin procurement is mealtime human insulin, basal human insulin, premixed human insulin, prandial insulin analogues, basal insulin analogues, and premixed insulin analogues, a total of 6 procurement groups. A total of about 241 million pieces were reported nationwide, and the procurement cycle is from the date of implementation of the election to December 31, 2027, and the cycle is expected to reach 3.5 years.

According to the official WeChat platform of the National Health Insurance Administration, a total of 53 products from 13 companies participated in this continuous procurement, and 49 products were qualified for the selection, with a winning rate of 92%, and the winning price was stable and decreased, which was reduced by 3.8 percentage points on the basis of the first round of centralized procurement price reduction. At the same time, the price difference of the third-generation premixed group, which had the largest price difference in the first round of centralized procurement, narrowed from 2.3 times to 1.6 times, and the proportion of Class A products with lower quotations increased from 40% in the previous round to 71%.

Since the release of the "4+7 City Drug Centralized Procurement Document" in November 2018, centralized procurement has been carried out for the sixth year, and the second round of special insulin procurement has also been carried out. Over the past six years, the rules of centralized procurement have been continuously adjusted and optimized, and have gradually become mild. At the site of the continuous procurement of insulin, Jiang Changsong, assistant to the dean of the National Institute of Medical Insurance and director of the Price Procurement Office of Capital Medical University, was interviewed by many media such as Times Finance and Economics, and analyzed the rules of special continuous procurement of insulin and the considerations of enterprises and hospitals.

Q: Since the start of the national volume procurement, the rules have been constantly changing and revising, what do you think are the highlights of this year's insulin procurement? Jiang Changsong:

First of all, the procurement cycle has been extended from 2 years to 3.5 years, which is beneficial to stabilize the expectations of enterprises and hospitals, and secondly, compared with the first round of special centralized procurement of insulin, the volume of continuous reports has increased by about 13%, indicating that it has been fully recognized by the market.

On the other hand, although the reasonableness of the price is more difficult to assess due to the different economic capabilities of each person, the company is willing to reduce its products to the A line, indicating that the Class A quotation is attractive to them, and the attraction has been reached, and the enthusiasm of the enterprise in the supply side has increased.

Q: What is the actual situation of this round of centralized procurement? Jiang Changsong:

Judging from the on-site situation, among the 53 representative products of the quotation, there are 4 representative products of Novo Nordisk, Jiangsu Wanbang, Eli Lilly and other companies whose prices exceed the standard, which means that the companies do not want to win these products. From the point of view of the report, the four unselected products have decreased by more than 60% compared with the first round of insulin special centralized procurement and reporting, and for enterprises, their consideration may be that the attraction of this volume to them is weakened, and they are unwilling to reduce the price to sell; secondly, with the iteration of the third generation of insulin products, the substitution of the second generation of insulin products has become more rapid, and the past data also shows that the sales of the second generation products are declining, the sales of the third generation products are increasing, and patients are using more effective drugs, which is also in line with the sales strategy of the enterprise.

Q: After centralized procurement, how do you view the quotation behavior of enterprises, and how should enterprises consider market strategies? Jiang Changsong:

At present, the procurement cycle has changed from the past 2 years to more than 3 years, which also stabilizes the price expectations of all parties, as well as the structural expectations of clinical and patient use.

In this case, different business considerations are different. On the one hand, it is the first time to enter the special continuous procurement of insulin, they may not have obtained the profit space of the market, and hope that the price can be higher. Like some enterprises, its quotation is quoted to the A line, it hopes to keep the amount reported to them by medical institutions, and at the same time hopes to grab part of the remaining amount, but whether this can be grabbed is uncertain, so as a business side also has its own plan. There is not only an element of luck in this, but also a reflection of the strength of the enterprise. For example, Yichang East Sunshine Changjiang Pharmaceutical's prandial insulin analogue insulin aspart injection [(3ml: 300 units (refill) * 1 bottle] won the bid at 18.87 yuan to reach the A1 price line, which means that the company has the ability to report this price. Gan & Lee Pharmaceutical's offer also has an impact on its stock price today.

In fact, each enterprise is given quotation space under the centralized procurement rules, and at the same time, it will also improve its own market strategy according to the quotation situation, which is a very market-oriented embodiment.

Q: What is the feedback from hospitals and patients on the specific procurement of insulin, and how satisfied are they? Jiang Changsong:

Feedback is different from hospital to hospital. From the feedback I have learned, it can be seen that the acceptance of centralized insulin procurement in grassroots community hospitals is higher, but there is room for further improvement in the acceptance of insulin in tertiary hospitals, which is related to the education level, economic and social conditions, cultural customs and habits of the region and the population.

However, it should be pointed out that insulin has certain differences with other drugs, and patients' compliance and drug changes have attracted special attention. Some patients pointed out that I am used to a certain brand or product, and the effect is good, and he/she may not be particularly willing to change the dressing. Although the price of the drug is an important consideration, patients are still more concerned about their recovery. Based on the consideration of brand stickiness, personal compliance, etc., feedback to the trend of centralized procurement, in terms of rules, more emphasis is placed on stability, that is, clinical stability and stable supply, in terms of centralized procurement, the original selected products should also be selected in the renewal of the contract, maybe the price gap has changed, that is, the high price hopes to be lowered, and the low price is also allowed to a small pullback.

Centralized procurement does not hope that all prices will be reduced to no profit, but just hope to squeeze out the water, and enterprises will take the profits they should take, and do not make less money, but do not take what they should not take. This is the original intention of centralized procurement.