The reasons for price reductions are varied and constantly refreshed
Wen 丨 David
In the face of the general trend, foreign pharmaceutical companies have finally lowered their posture.
On July 16, the Heilongjiang centralized procurement website issued a notice: Heilongjiang Medical Insurance Bureau received applications for voluntary price reduction from 7 pharmaceutical companies, of which 6 varieties came from foreign companies, including AbbVie, AstraZeneca, Unisby, Takeda and so on.
Heilongjiang Pharmaceutical Centralized Procurement issued a drug price reduction notice
Among them, Takeda Pharmaceutical's vibutuximab decreased from 18,000 yuan to 15,000 yuan, a decrease of 16.38%. Unispec's 4 specifications of Rotigotine patches, the decline is more than 30%, one of the specifications of 18mg / 40cm², the unit price of 2297 yuan patch drop or even as high as 54.72%.
Previously, Eli Lilly's psoriasis treatment drug echizumab also fell by more than 50%. Eli Lilly told the Health Bureau that the drug price reduction was announced by Eli Lilly on March 12, 2021. When the drug entered China in 2019, it was already the lowest price in the world.
What are the reasons for the large price reductions of various foreign companies?
The Health Bureau was informed that the reasons given by each family were varied. Some said that last year's price negotiations were unsuccessful and this year's ambitions are inevitable; some are because competitors are also reducing prices, not falling; or this year's first opportunity to negotiate medical insurance, and actively strive for admission tickets.
It is reported that the National Medical Insurance Bureau has set an "entry threshold" for this year's medical insurance price negotiations: the annual treatment cost is less than 500,000 yuan to be eligible for negotiation.
Missed the "Lipidol" of the 2020 health insurance negotiations, and this year it has taken a sprint posture.
The generic name of "Lipperzol" is cyclic zirconia silicate sodium powder, which is an oral potassium lowering drug launched by AstraZeneca in China in January 2020. This is the first anti-hyperkalemia drug in China and is an almost irreplaceable life-saving drug in the clinic. "Lipperia" has two specifications, 5g and 10g, and the price is 486 yuan and 826 yuan respectively. Even in the maintenance treatment phase with the lowest dosage, the cost of patients per day is more than 160 yuan.
AstraZeneca's potassium-lowering drug Libedro
In 2020, AstraZeneca took "Libedro" to the health insurance negotiations and passed the formal examination. However, "Lipperia" ultimately failed to enter the 2020 National Health Insurance Directory. After the negotiations failed, AstraZeneca adjusted Thera's sales team and incorporated it into the team of the anti-anemia drug Arizo.
After a year of testing the waters, AstraZeneca still chose to reduce prices and seek medical insurance quotas. Judging from the price reduction notice of the Heilongjiang drug centralized procurement platform, both specifications of AstraZeneca's "Libezo" have been reduced by 30% to show "sincerity".
At the end of December 2020, the national medical insurance bureau medical insurance catalogue negotiation results, the average price of successfully negotiated drugs was reduced by 50.64%. Among them, the average decline of 14 exclusive varieties with annual sales of more than 1 billion yuan was 43.46%.
AstraZeneca's price reduction move may be a "stress test" on a small scale, judging the degree of market expansion after a 30% price cut, providing data support for health insurance price negotiations.
The two varieties of Eli Lilly and Janssen constitute direct competition, and the recent price reduction is also obvious.
Eli Lilly's echizumab injection is a drug for the treatment of psoriasis, with a specification of 80mg/ml initially priced at 6296 yuan. Data from Heilongjiang show that the price of izizizizumab was adjusted to 2896 yuan, a drop of up to 54%.
The reason why Eli Lilly is so cruel to herself has something to do with the fierce competition in the field of psoriasis.
In 2020, AbbVie's original research on adalimumab (generic name: Humira) entered the national medical insurance directory, and the indications include rheumatoid arthritis, psoriasis and so on. Before entering medical insurance, "Humile" also experienced a sharp price reduction. Around May 2019, the price of "Humira" was reduced by 58% in Jiangxi and Beijing, from 7600 yuan per bottle to 3160 yuan.
Through price negotiations, "Humira" entered the medical insurance directory in early 2020, and the price dropped to 1290 yuan per bottle. If it is a step later, in June 2020, the "competitor" Novartis' sucinumab was approved for listing in China.
In order to seek medical insurance quotas, sukinumab also took the initiative to reduce prices by 60% before price negotiations at the end of 2020, and finally successfully entered the national medical insurance directory.
The same goes for Eli Lilly's etizumab. After Eli Lilly announced the price cut in March, Janssen also announced a price cut, reducing the price of the psoriatic drug uszunuzumab by more than 40%, of which the 130mg/26ml specification of uszonumab was reduced by 45.95%, preparing to compete with Eli Lilly in the upcoming new round of medical insurance negotiations.
In March this year, Yang Sen submitted an application for a price reduction of ustinumab in Shaanxi Province
If it is a step later, the ichizumab and usinozumab will face opponents again. In May 2021, Huadong Pharmaceutical's ustinumab analog drug launched phase III clinical trials. The fierce competition in China's bio-innovative drug market can be seen.
Some high-priced rare disease drugs face another embarrassment.
Takeda Pharmaceutical's injectable vibutuximab, the original price of 50mg specifications was 18680 yuan, and the data provided by Heilongjiang this time, the price dropped to 15620 yuan, a decrease of 16.4%. This decline, while modest, is critical.
Vibutuximab is currently the only cd30-target adc drug in the world, which mainly treats anaplastic large cell lymphoma. Patients are injected by body weight, up to 16 cycles per year, and a 60 kg patient is calculated according to the current specifications of 18680 yuan / 50mg, and the annual treatment cost is about 600,000 yuan.
The Health Bureau learned from authoritative sources that this year's medical insurance price negotiations have set a threshold for entry, and only those with annual costs of less than 500,000 yuan are eligible for negotiation.
After a 16.4% price cut, Takeda can ensure that the annual treatment cost of vibutuximab falls within "500,000 yuan", so that it can secure the admission ticket to the medical insurance negotiation. As for how much it will eventually drop, it depends on the outcome of the negotiations between Takeda and the Medical Insurance Bureau.
Takeda China told the Health Bureau that it will actively participate in the government-led negotiations on the national medical insurance drug list and the access to the medical insurance directory for serious diseases in various provinces and cities.
The same is true of AbbVie's exclusive product, the Venai Clarke. Veneqa tablets are the world's first BCL-2 selective inhibitor drug, approved for listing in China in December 2020, and the dosage varies according to different therapeutic purposes, but the overall annual cost exceeds 500,000 yuan. The recent price reduction of 18.3% in China is precisely to block the "500,000 annual fee" line.
The price reduction moves of a number of foreign companies have revealed the same signal: the competition in medical insurance negotiations this year will be very fierce, the decline will be beyond expectations, and enterprises should be psychologically prepared.
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