A year ago, Changchun High And New Technology Industries (Group) Inc(000661) (000661. SZ) was a star white horse that made a northeast aunt earn 100 times. However, only a year later, the company's market value of 100 billion fell by 30% in just a few trading days.
Changchun High And New Technology Industries (Group) Inc(000661) is a domestic growth hormone leader, and it is the core product of growth hormone that makes the company "rise and fall". a few days ago (January 19), an announcement of Guangdong Provincial Drug Trading Center officially turned the rumor of centralized purchase of growth hormone into reality, which means that the era of high gross profit of growth hormone will be gone forever.
the first shot of growth hormone collection
At present, the centralized volume procurement of drugs has entered a new stage, that is, from the previous "national procurement" to the current "national procurement" and "alliance procurement".
\u3000\u3000 "The next development path of volume procurement has been basically clear, that is, the national and local levels will promote it in layers, carry out it in batches and implement policies by classification, take the lead in covering the varieties with large consumption and high purchase amount in the catalogue of basic medical insurance drugs, constantly innovate and improve the procurement rules of non over rated drugs, biological products and Chinese patent medicines, explore the appropriate procurement methods of shortage drugs and orphan drugs, and gradually cover them All kinds of drugs listed in China that are clinically necessary and of reliable quality should achieve the long-term policy objectives that should be fully adopted. " Chai Yan, management consulting director of iqvia aikunwei, made this judgment in an interview with the media.
" now the influence of alliance centralized purchase at the provincial level is still very large ." At the same time, some people from pharmaceutical enterprises told the reporter of science and Innovation Board daily.
Guangdong is at the forefront of the country on the road of exploring the centralized mining of the alliance. So far, Guangdong Procurement Alliance has carried out three rounds of drug volume procurement, but each has its own characteristics. The first round is the renewal of national volume procurement, including 45 varieties such as amoxicillin; The second round is the volume procurement of Chinese patent medicine, including 58 varieties such as Qingkailing; The third round was mainly chemical drugs and biological products (blood products and rituximab), with a total of 276 drugs.
Among them, the first round of centralized procurement has been successfully completed in November 2021, while the second round of centralized procurement of Chinese patent medicines and the third round of centralized procurement of chemical and biological products (blood products and rituximab) are still in the process of promotion.
It is worth mentioning that in the third round of centralized collection, growth hormone, blood products and rituximab, which have attracted much attention from the market, were included in the (Alliance) centralized collection for the first time.
Figure | on January 19, Guangdong Provincial Drug Trading Center issued the document on centralized procurement of diclofenac and other drugs of Guangdong alliance, which launched alliance centralized procurement of 276 drugs. Among them, growth hormone, blood products and rituximab were included in the (Alliance) collection for the first time.
The share prices of domestic growth hormone leaders Changchun High And New Technology Industries (Group) Inc(000661) (000661. SZ) and Anhui Anke Biotechnology (Group)Co.Ltd(300009) (300009. SZ) have also been hit hard because of the landing of centralized collection of growth hormone.
In this regard, both companies publicly responded that the bidding process of Guangdong alliance centralized procurement has not officially started, so there is no prediction of the impact on the company's performance. The specific impact of centralized purchase on the company's performance will also depend on the company's actual participation in bidding, winning results and winning prices.
If we refer to the procedures of the first round of centralized procurement of Guangdong procurement Union (i.e. group procurement of 45 drugs such as amoxicillin), the official document will be issued on November 4, 2021, and the bidding will be completed and the results of the proposed selection will be announced on November 24, 2021, it can be inferred that the official bidding for growth hormone is expected to be arranged around in mid and late February.
centralized collection logic of growth hormone
The market has been divided on whether growth hormone will be collected or not. Among them, optimists believe that since growth hormone is mostly used by patients at their own expense and the proportion of medical insurance payment is relatively small, the risk of medical insurance fee control and centralized collection is not large.
According to the reporter of kechuangban daily, this is because although there are many approved indications for powder injection and water injection, there is only one indication limited by medical insurance payment , that is, the slow growth of children caused by endogenous growth hormone deficiency (i.e. primary dwarfism or primary growth hormone deficiency). Therefore, in a sense, growth hormone can indeed be regarded as "self funded medicine".
Figure | Changchun High And New Technology Industries (Group) Inc(000661) approved indications for growth hormone water injection and powder injection (as of June 30, 2021)
"In our sales of growth hormone, the sales related to medical insurance reimbursement account for a small proportion, which may be only about 1% - 2%. Even in public hospitals, most of the sales revenue comes from patients' own expenses." Changchun High And New Technology Industries (Group) Inc(000661) relevant people also confirmed to the reporter of science and Innovation Board daily.
but in fact, self funded drugs are no longer 100% "centralized immunization" . For example, albumin paclitaxel, also a self funded drug, participated in the second round of drug collection as early as early as 2020.
More notably, on the long debated issue of whether implant teeth should be collected or not, the executive meeting of the State Council held a few days ago (January 10) made it clear that the coverage of high-value medical consumables will be gradually expanded, and the self funded and expensive implant teeth will be included in the collection of high-value medical consumables.
However, centralized purchase is not completely bad for "self funded drugs" . From the adjustment results of the national medical insurance catalogue in 2020 and 2021, many bid winning varieties of centralized purchase were directly transferred into the catalogue without price reduction, including paclitaxel for injection (albumin binding type).
Therefore, whether the price reduction of self funded high-value drugs and medical consumables will increase the opportunity to be included in medical insurance, which may deserve further attention.
Changchun High And New Technology Industries (Group) Inc(000661) 's "dilemma"
Growth hormone can be divided into three dosage forms: powder injection, water injection and long-term water injection. Among them, water needle is the mainstream dosage form in China, with a market share of about 60%; Powder injection dosage forms account for about 38%, and long-acting dosage forms account for only 1%.
In terms of price, long-term water acupuncture is the most expensive, with an annual treatment cost of more than 200000; Powder injection and water injection are about 25000 yuan / year and 50000 yuan / year respectively.
In terms of enterprise competition pattern, at present, there are only three enterprises in China: kinsay Pharmaceutical ( Changchun High And New Technology Industries (Group) Inc(000661) subsidiary), Anhui Anke Biotechnology (Group)Co.Ltd(300009) and Novo Nordisk, among which kinsay pharmaceutical has the first market share; The competition in powder injection is more intense. There are 6 or 7 manufacturers, Anhui Anke Biotechnology (Group)Co.Ltd(300009) is the leader of powder injection. In 2020, the sample hospital has the first market share (the amount accounts for 44% and the quantity accounts for 41%), and Kinsey pharmaceutical has the third market share (the amount accounts for 15% and the quantity accounts for 22%); The long-acting dosage form is the exclusive dosage form of Changchun High And New Technology Industries (Group) Inc(000661) , but Anhui Anke Biotechnology (Group)Co.Ltd(300009) has also completed phase III clinical, and the production line transformation is under way, ready to apply for production.
According to the document on centralized procurement of diclofenac and other drugs of Guangdong Alliance (hereinafter referred to as the document) issued by Guangdong Drug Trading Center on January 19, since growth hormone is a non exclusive product, Therefore, the grouping rule is "grouping according to the name of traditional Chinese medicine in the medical insurance drug catalogue (according to the medical insurance number) and the combined classified dosage form (based on the general principles of preparations in the Chinese Pharmacopoeia)".
According to the medical insurance catalogue, recombinant human growth hormone injection (i.e. growth hormone water injection) and recombinant human growth hormone for injection (i.e. growth hormone powder injection) belong to the same medical insurance number, therefore, the dosage forms of growth hormone water injection and powder injection will not be distinguished, and the same group will compete. But in this way, the water needle with high price is bound to face greater bidding pressure.
In addition, in the setting of the highest valid bid price (i.e. "limit price"), water injection is also under more pressure than powder injection. The price limit of powder injection is basically close to the lowest winning price in all provinces, while the price limit of water injection should be reduced by 60% - 70% on the basis of the existing online price.
Does the bidding of water injection and powder injection in the same group mean that they can replace each other? In this regard, some people in the industry told the reporter of science and Innovation Board daily that there is indeed little difference between water injection and powder injection in terms of effect, but the operation steps of powder injection are more complex and the injection experience of patients is relatively poor.
The reporter of the science and Innovation Board daily also noted that at the recent enterprise training meeting, some people also questioned that the same group bidding of water injection and powder injection is unreasonable, "because the production process and cost of water injection and powder injection are very different, and the user groups are different, which meet the needs of different patients".
This is the biggest pressure on Guangdong water harvesting alliance. according to the annual report of Changchun High And New Technology Industries (Group) Inc(000661) 2020, the company realized an operating revenue of 8.577 billion yuan and a net profit of 3.047 billion yuan in that year; Among them, the subsidiary kinsay pharmaceutical achieved a revenue of 5.803 billion yuan and a net profit of 2.76 billion yuan, accounting for 67.66% and 90.58% respectively.
In addition, according to the latest data publicly available, the sales of water injection accounts for about 70% - 80%, that of powder injection is 8% - 9%, and that of long-term effect is about 12% - 13%.
As a domestic water needle faucet, Changchun High And New Technology Industries (Group) Inc(000661) how to deal with this centralized purchase? The answer may be revealed soon.
