Original Weixi Meter Intranet
Highlights
On April 23, the expiration of the special agreement for insulin continued procurement was opened as scheduled, 49 products were to be selected, and the tenth batch of national procurement that has attracted much attention from the industry is also in the air, and a new round of market reshuffle is coming. From the second batch (January 2020) to the ninth batch (November 2023), 27 varieties have been included, covering 10 subcategories. After four years of national price reduction, the market pattern of diabetes medication has been reshaped, the new "drug king" was born, 8 best-selling varieties fell off the altar, and 4 domestic brands struggled in adversity with outstanding results.
Guocai swept 10 sub-categories, and the market gradually recovered its vitality
After the second, third, fourth, fifth, sixth batches (insulin special), seventh batch and ninth batch of national procurement, 38 diabetes drugs (according to product name, involving 27 varieties) have won the bid, covering a-glucosin inhibitors, SGLT2 inhibitors, DPP-4 inhibitors, sulfonamides and urea derivatives, oral compound hypoglycemic drugs, biguanides, There are 10 sub-categories such as insulin and its analogues, and at present, only GLP-1 receptor agonists have not been included in the national procurement, and the "lethality" of the national procurement on the diabetes drug market is extraordinary.
Figure 1: Sales of diabetes drugs before and after national procurement (unit: 10,000 yuan)
Source: The competition pattern of drug terminals in public hospitals in key provinces and cities of Minenet
In the terminals of public hospitals in key provinces and cities, the sales scale of diabetes drugs from 2013 to 2019 (before national procurement) showed a continuous growth trend, exceeding 7 billion yuan for the first time in 2019. After the launch of the second batch of national procurement in 2020, the sales of this class of drugs showed negative growth, and gradually recovered after 2021. According to the latest data from Minenet, the sales scale of this type of drug will rise to more than 7.4 billion yuan in 2023, and the pressure of national procurement in the past four years has been basically offset.
Table 1: Changes in the top 5 subcategories of diabetes drugs before and after national collection
Source: The competition pattern of drug terminals in public hospitals in key provinces and cities of Minenet
The three subcategories of GLP-1 receptor agonists, SGLT2 inhibitors, and oral compound hypoglycemic drugs have grown rapidly, and have become the TOP1, TOP3, and TOP5 subcategories in 2023. The former champion insulin and its analogues lost their top position in 2023, dropping one place in the rankings, and their market share fell to 22.60%, the lowest in history. It can be seen that the overall vitality of the diabetes drug market has recovered, but the category pattern has undergone earth-shaking changes.
The new 1 billion varieties rose by 118%, and 8 billion-level varieties fell to the altar
In the terminal diabetes drug market of public hospitals in key provinces and cities, there are 17 varieties with more than 100 million yuan in 2019, of which the sales of acarbose exceeded 1.2 billion yuan, 18 varieties with more than 100 million yuan in 2020, and the sales of the top 20 varieties from 2021 to 2022 exceeded 100 million yuan, and there were no more than 1 billion varieties in the past three years, and by 2023, there will be 19 varieties with more than 100 million varieties, and semaglutide has become a new variety of more than 1 billion.
Table 2: Changes in the top 20 varieties of diabetes drugs in 2019 and 2023
Note: Sales of less than 100 million yuan are indicated by *
Source: The competition pattern of drug terminals in public hospitals in key provinces and cities of Minenet
Figure 2: Sales of semaglutide (unit: 10,000 yuan)
Source: The competition pattern of drug terminals in public hospitals in key provinces and cities of Minenet
Novo Nordisk's semaglutide injection entered the Chinese market in 2021, then entered the national medical insurance negotiation catalog, and became the TOP4 variety of diabetes drugs in the terminals of public hospitals in key provinces and cities in 2022, and the sales of this variety exceeded 1 billion yuan for the first time in 2023, with a growth rate of 118.63%, becoming a new TOP1 variety. In January 2024, Novo Nordisk's semaglutide tablets were approved for import, becoming the first oral GLP-1 receptor agonist marketed in China, and sales of this variety are expected to continue to climb as new products join the battle.
Compared with the TOP20 varieties of diabetes drugs in 2019 and 2023, 11 varieties withstood the pressure and continued to stay on the list, in addition to semaglutide, dulaglutide, degludec aspart, sitagliptin metformin, pioglitazone metformin, insulin degludec, empagliflozin, pegylated losenatitide, saxagliptin metformin 8 varieties have also achieved outstanding results in recent years, and have entered the list of TOP20 varieties in 2023.
Figure 3: Sales of 3 oral compound hypoglycemic drugs (unit: 10,000 yuan)
Source: The competition pattern of drug terminals in public hospitals in key provinces and cities of Minenet
In recent years, oral compound hypoglycemic drugs have shown a rapid growth trend, and the share of the terminal diabetes drug market in public hospitals in key provinces and cities was only 1.7% in 2019, and it will rise to more than 7.5% in 2023, and the potential should not be underestimated.
Sitagliptin metformin and pioglitazone metformin have become 100 million yuan varieties in 2021, and will rise to more than 200 million yuan and 180 million yuan respectively in 2023, while saxagliptin metformin will also reach the level of 90 million yuan in 2023, and the next 100 million-level oral compound hypoglycemic drug may be born in 2024.
It is worth noting that 9 best-selling varieties on the list in 2019 have disappeared from the list of TOP20 varieties in 2023, involving 8 varieties of 100 million yuan, including proprotein biosynthesis of human insulin (protein recombinant human insulin) (proben human insulin), glimepiride, insulin lispro, repaglinide, insulin detemir, gliclazide, saxagliptin, and vildagliptin.
Figure 4: Sales of 3 best-selling insulins and their analogues (unit: 10,000 yuan)
Source: The competition pattern of drug terminals in public hospitals in key provinces and cities of Minenet
In 2019, the sales of prothiin biosynthesis of human insulin (prothin recombinant human insulin) (proton human insulin), insulin lispro, and insulin detemir reached more than 300 million yuan, 250 million yuan, and 210 million yuan respectively in the terminals of public hospitals in key provinces and cities, and then included in the sixth batch of national procurement (insulin special) in 2021, and the sales of the three major varieties from 2022 onwards showed a cliff-like plummet, and by 2023, proton biosynthesis of human insulin (proton recombinant human insulin) ( Protein human insulin) has only 75 million yuan in sales, lispro insulin in lispro sales of only 62 million yuan, and detemir insulin sales in only 59 million yuan.
In 2019, the sales of glimepiride, repaglinide and gliclazide in the terminals of public hospitals in key provinces and cities were all more than 200 million yuan, and glimepiride was included in the second batch of national procurement in 2020, and repaglinide and gliclazide were included in the fourth batch of national procurement in 2021. Under the pressure of national procurement price reduction, the sales of the three major varieties inevitably plummeted, and in 2023, there will only be 23 million yuan left for glimepiride, only 45 million yuan for repaglinide, and 83 million yuan for gliclazide.
Saxagliptin and vildagliptin are both DPP-4 inhibitors, and the sales of terminals in public hospitals in key provinces and cities exceeded 100 million yuan in 2019, and vildagliptin was included in the third batch of national procurement in 2020, and saxagliptin was included in the fifth batch of national procurement in 2021. Although the sales of the two major varieties have fallen sharply, although they will resume positive growth in 2023, there are only 65 million yuan left for saxagliptin and only 16 million yuan for vildagliptin, and the general trend of the best-selling varieties in the past has gone.
Domestic brands struggle in adversity! Yangtze River, China, the United States, East China, and Haosen "dominate one side"
In the terminal diabetes drug market of public hospitals in key provinces and cities, the top 20 brands of Chinese products accounted for 5 in 2019, 4 domestic brands in 2020, 3 domestic brands in 2021-2022, and 4 domestic brands in 2023.
Table 3: Sales of the top 20 brands of diabetes drugs in China in 2023
Note: Sales of less than 100 million yuan are indicated by *
Source: The competition pattern of drug terminals in public hospitals in key provinces and cities of Minenet
Yangtze River Nanjing Hailing Pharmaceutical's epalstat tablets are drugs for the treatment of diabetic neuropathy, with sales of nearly 120 million yuan in public hospitals in key provinces and cities in 2019, and it is the TOP2 brand of other diabetes drugs, and has become the TOP1 brand of this subcategory since 2020, and has maintained a leading advantage since then, with sales exceeding 200 million yuan in 2023.
Hangzhou Zhongmei Huadong Pharmaceutical's pioglitazone metformin tablets (15mg/500mg) had terminal sales of 59 million yuan in public hospitals in key provinces and cities in 2019, exceeded 120 million yuan in 2021, and rose to 160 million yuan in 2023, becoming the TOP2 brand of oral compound hypoglycemic drugs and the best-selling domestic brand of oral compound hypoglycemic drugs.
Pegylated loxenatide injection is a Class 1 new drug approved by Haosen Pharmaceutical Group in 2019, and its sales in public hospitals in key provinces and cities were less than 1 million yuan that year. In 2020, the brand successfully surpassed Shanghai Renhui Biopharmaceutical's benaglutide injection and became the best-selling domestic brand of GLP-1 receptor agonists. In recent years, Haosen Pharmaceutical Group's polyethylene glycol losenatitide injection has maintained a rapid growth trend, and its sales in 2023 will exceed 100 million yuan for the first time.
Insulin continued to be purchased, and 4 products exceeding 1 billion yuan were prepared for the tenth batch of national procurement
On March 29, Shanghai Sunshine Pharmaceutical Procurement Network issued the "National Drug Centralized Procurement Document (GY-YD2024-1)", announcing the continuation of the procurement work after the expiration of the special agreement for insulin, it is reported that the scope of the continuous procurement coverage is the same as the first round, including 6 procurement groups and 11 quotation units, and the bid was opened on April 23.
Table 4: Proposed selection results of national centralized drug procurement (special insulin continuation).
Source: Shanghai Sunshine Pharmaceutical Procurement Network
According to the official WeChat news of the National Health Insurance Administration, a total of 53 products from 13 companies participated in the bidding for the special continuous procurement of insulin, and 49 products were to be selected, with a winning rate of 92%. The winning price was stable and decreased, and it decreased by 3.8% on the basis of the first round of centralized procurement price reduction, and the proportion of Class A products with lower quotations increased from 40% in the previous round to 71%.
Judging from the results of the proposed selection, 11 products, including pro human insulin mixed injection (30R), insulin aspart injection, insulin aspart 30 injection, Jiangsu Wanbang Biochemical Pharmaceutical Group's insulin lispro injection and insulin glargine injection, and Shandong New Era Pharmaceutical Co., Ltd.'s insulin glargine injection, won the bid, further stimulating the market to "change cages for birds".
The tenth batch of national procurement, which has attracted much attention in the industry, is also on the verge of launch. At present, there are more than 50 products that have been evaluated/deemed to have been evaluated, and there are 7 products that have not been included in the national procurement and ≥ 5 competitors (original research + evaluation).
Table 5: Diabetes Chemicals ≥ 5 Competitors
Note: Sales of less than 100 million yuan are indicated by *
Source: Minenet's competitive landscape of drug terminals in China's public medical institutions
At the terminals of China's urban public hospitals, county-level public hospitals, urban community centers and township health centers (hereinafter referred to as China's public medical institutions), the sales of sitagliptin phosphate tablets, dapagliflozin tablets, epalstat tablets and linagliptin tablets will all exceed 1 billion yuan in 2022.
Sitagliptin phosphate tablets are currently led by Merck & Co., Ltd., and more than 20 domestic pharmaceutical companies, including Chia Tai Tianqing Pharmaceutical Group, Guangdong East Sunshine Pharmaceutical, and CSPC Ouyi Pharmaceutical, have been approved according to the new classification. Dapagliflozin tablets are currently led by AstraZeneca, and 9 domestic pharmaceutical companies, including Jiangsu Haosen Pharmaceutical Group, Chengdu Beite Pharmaceutical, and Nanjing Zhengda Tianqing Pharmaceutical, have been approved according to the new classification. Linagliptin tablets are currently led by Boehringer Ingelheim, and 8 domestic pharmaceutical companies, including Sichuan Kelun Pharmaceutical, Zhejiang Huahai Pharmaceutical, and Qilu Pharmaceutical, have been approved according to the new classification.
At the same time, with the help of national procurement to accelerate the penetration of domestic brands, the "domestic proportion" of the TOP20 brand list is expected to gradually increase.
Source: Minenet database, Shanghai Sunshine Pharmaceutical Procurement Network, etc
Note: The database of chemical drug terminal competition pattern of public hospitals in key provinces and cities is based on the chemical drug procurement data of 20+ provinces and cities and nearly 700 sample provincial and municipal public hospitals, and the sample hospital database of sample provinces and cities for continuous monitoring of all categories of chemical drugs; The above sales are calculated based on the average retail price of the product at the terminal. Statistics as of April 24, if there is any omission, please correct!