The results of the annual national medical insurance negotiations were officially announced, and 70% of the drugs were successfully negotiated, with an average price reduction of half. Three domestic broad-spectrum anticancer drugs PD- 1 inhibitors have entered the catalogue, but this time we did not consider including high-priced rare drugs in medical insurance.

On February 28th, 65438, the National Medical Insurance Bureau held a press conference in Beijing to announce the results of medical insurance negotiations in 2020. The medical insurance catalogue adjustment, * * * 162 drug negotiation, 1 19 drug negotiation was successful, and the negotiation success rate was 73.46%. The average price of drugs successfully negotiated decreased by 50.64%. At the same time, 29 kinds of drugs were brought out of the catalogue. There are 2800 kinds of drugs in the latest medical insurance drug list, including western medicine 1426 kinds and Chinese patent medicine 1374 kinds, and the proportion of Chinese and western medicine is basically the same.

Xiong Xianjun, director of the Medical Service Management Department of the National Medical Insurance Bureau, said in an interview with the media including CBN after the conference that due to the limited affordability of the medical insurance fund, drugs with high prices and rare diseases were not considered for inclusion in medical insurance. The prices of three newly listed domestic PD- 1 are lower than those of Cindilizumab injection which entered the catalogue last year. Xiong Xianjun believes that the main reason for the failure of PD- 1 import negotiations is that the price expectations of enterprises are inconsistent with the National Medical Insurance Bureau.

Zhan Jincheng, general manager of the eastern market of Ozda Medical Device Service Group, told the First Financial Reporter that the number of medical insurance catalogue negotiations was "the widest in history": 96 exclusive and 23 non-exclusive drug transfers, of which 14 exclusive drugs with annual sales exceeding one billion yuan were successfully negotiated and the price was reduced; The future medical insurance catalogue can further negotiate the price reduction of orphan drugs with high unit price.

The average price of negotiated drugs exceeds 50%, including COVID-19's therapeutic drugs.

The average price of 1 19 drugs successfully negotiated this time was reduced by 50.64%.

The new version of the medical insurance drug list is expected to be officially implemented on March 1, 202 1. Including the special access to anticancer drugs, the National Medical Insurance Bureau has made three adjustments to the medical insurance catalogue since its establishment, and this year is the first adjustment since the adoption of the "declaration system". Starting from this year, the dynamic adjustment mechanism of China's medical insurance drug list has been basically completed.

Compared with previous years, an important feature of this adjustment is that the number of drugs transferred through negotiation is the largest, benefiting the most extensive treatment fields. 96 exclusive drugs finally negotiated and transferred, plus 23 non-exclusive drugs directly transferred, * * * involved 3 1 clinical group, accounting for 86% of all clinical groups, and patients benefited more.

Different from the previous rounds of adjustment, which included "all listed drugs" in the evaluation scope, the declaration system was implemented for the first time this year, that is, all drugs outside the catalogue that meet the conditions listed in this year's adjustment plan can be included in the adjustment scope. The adjustment range of drugs out of the catalogue changed from "sea election" to "optimization". According to the declaration conditions, 704 kinds of drugs outside the catalogue were successfully declared. Finally, 23 (non-exclusive) drugs were directly transferred to the catalogue, and 138 (exclusive) drugs were included in the negotiations.

Another feature of this year's medical insurance negotiations is the first attempt to negotiate the price reduction of drugs in the catalogue. According to the procedure, the bid evaluation experts selected 14 exclusive drugs with high price or high cost and large capital occupation for price reduction negotiations, and the annual sales amount of these drugs exceeded 10 billion yuan. After negotiation, 14 drugs were successfully negotiated and kept in the catalogue, with an average price reduction of 43.46%.

In addition, in order to support the prevention and control of epidemic situation in COVID-19, all the drugs listed in the latest version of the National COVID-19 Diagnosis and Treatment Plan, such as ribavirin injection and arbidol granules, were included in the national medical insurance catalogue in this adjustment, so as to help the prevention and control of epidemic situation with practical actions.

Compared with previous years, the success rate of medical insurance negotiation is higher this year, and the price reduction of drugs is slightly lower. Xiong Xianjun said that medical insurance negotiations do not pursue the decline of drugs, nor do they pursue the success rate of negotiations. The reason for the high success rate of the negotiation is that the communication with the enterprise is in place in the early stage of the negotiation, and the expert group allows the enterprise to grasp the key points of measurement, so that the price offered by the enterprise will be close to that of the medical insurance bureau. At the same time, the independent pricing of drugs in some enterprises is not very high. In this way, the decline in negotiations will not be great.

"The failure of the Medical Insurance Bureau to include some expensive drugs in the catalogue is a clear signal to pharmaceutical companies: even if they are not in the medical insurance catalogue, pharmaceutical companies should formulate appropriate drug prices according to China's national conditions as a developing country." Xiong Xianjun said.

Zhan Jincheng believes that from a global perspective, the targeted price reduction negotiations of the medical insurance catalogue 162 drugs adhere to the principle of "guaranteeing the basics", so that the medical insurance fund expenditure is stable and controllable by adjusting the drugs with low value first and then reducing the drugs with high cost.

A salesperson of a pharmaceutical company told the First Financial Reporter that the new drugs listed in 2020 were also included in the medical insurance negotiations, which is a bright spot, which helps to achieve rapid volume of innovative drugs after they are approved for listing, reflecting the encouragement of drug research and development innovation at the national level.

The level of protection of cancer drugs has improved.

PD- 1 is one of the highlights of this medical insurance negotiation. Among the anticancer drugs PD- 1/L 1, all three domestic drugs involved in the negotiations were shortlisted, while imported drugs were not allowed to enter the medical insurance catalogue.

According to the negotiation results, three domestic broad-spectrum anticancer drugs PD- 1 inhibitors-tierellizumab from Baekje Shenzhou (trade name: Baizean), Tereplizumab from Junshi Bio (trade name: Yi Tuo) and Karelrizumab from Hengrui Pharma (trade name: Erica) have all entered the medical insurance catalogue. However, the negotiation between imported PD- 1 product-Merck (trade name: Kreida, commonly known as "K medicine") and Nivolumab of Bristol-Myers Squibb (trade name: Odivo, commonly known as "O medicine") failed.

Xiong Xianjun said that it is not convenient to disclose the specific negotiated prices of three domestic PD- 1 products, but it is certain that it is lower than the negotiated price of Cinda PD- 1 (Xindi monoclonal antibody injection, trade name: daboshu) last year. In addition, these PD- 1 products have no special indications, and the approved indications shall prevail.

"The main reason for the failure of the import negotiation of PD- 1 is that the price expectation of enterprises is different from that of the Medical Insurance Bureau, because importing enterprises have to consider international prices, while domestic enterprises mainly consider domestic prices and markets, and they can bear the negotiation price." Xiong Xianjun said.

After three domestic PD- 1 products entered the medical insurance negotiation, the market paid close attention to their prices. First Financial Reporter from Hengrui Pharma (600276. SH), Baekje Shenzhou and other short-listed enterprises, most of the replies are "subject to the announcement of the National Medical Insurance Bureau". However, the first financial reporter learned that PD- 1 drug Treeplizumab is Junshi Bio (688 180. Shanghai, 0 1877. HK) This time, 80mg entered the medical insurance. After five rounds of quotation, the final negotiated medical insurance price is 906.08 yuan per copy, and the treatment cost for next year is 7.

In 20 18, at the beginning of the establishment of the national medical insurance bureau, special access negotiations for anticancer drugs were organized, and finally 17 drugs were successfully included in the catalogue, and the agreement expired at the end of this year. 17 class of anticancer drugs, three drugs are classified as generic drugs and included in Class B management. 14 exclusive drugs were renewed or renegotiated according to the rules, with an average decrease of 14.95%, among which some first-line anticancer drugs decreased by more than 60%. It is estimated that reducing the price of 14 kinds of anticancer drugs will save more than 3 billion yuan for cancer patients in 20021year. At the same time, this adjustment also added 17 kinds of anticancer drugs, including new and good drugs such as PD- 1 and Ranvartinib, which significantly improved the level of cancer drug protection in the catalogue.

Huang Bin, vice president of AstraZeneca Pharmaceutical Company in China, said at the press conference that China has a large population base, many patients with diseases and an increasingly aging population. Since the reform and opening up, China's economy has continued to grow and its market potential is huge. Through the medical insurance policy and a series of supporting incentive policies, the accessibility of medical insurance negotiation drugs has been significantly improved, allowing enterprises to see the space and opportunities of exchanging quantity for price. Therefore, enterprises can supply the best new drugs at the lowest price, while ensuring reasonable commercial returns and sustainable medical innovation.

On the whole, although the drugs that entered the medical insurance through negotiation have successfully entered, how to get through the "last mile" of entering the hospital is still facing a tough battle.

"After this medical insurance negotiation, we reduced the price by about 70%. For us, this should help to increase sales. In contrast, after entering medical insurance, it may be slightly smoother to get through hospital channels. " A pharmaceutical company in Guangzhou told the First Financial Reporter.

A PD- 1 business person told the First Financial Reporter that although the company's products entered the medical insurance this time, the next work in the hospital could not be taken lightly. "After entering the medical insurance, it may not be so easy to enter the hospital, so this is our next job." ?