The success rate of medical insurance negotiation and the range of price reduction reached a new high, and guide all localities to implement the “dual channel” management mechanism
Before this medical insurance negotiation, there were 4 successful negotiations since 2016, with 153 successful varieties. In 2016, a total of 3 varieties were successfully negotiated in the first medical insurance negotiation, with an average decrease of 59%; In 2017, 36 varieties were included in the second medical insurance negotiation The average decline was 38.56%; The third round of negotiations was held in 2018, which included 17 anticancer drugs, with an average decrease of 57.06%; In 2019, the varieties of medical insurance negotiations were further expanded, and a total of 97 varieties were successfully negotiated, with an average decrease of 60.7%. The number and success of the fifth medical insurance negotiation in 2020 are the highest in history The average decline in the negotiations was 50.64%.
In this negotiation, high-value drugs are included, and “high price drugs” become “poor drugs”, and the process of cancer drugs and innovative drugs entering medical insurance is accelerated
High value drugs were included in the medical insurance negotiation for the first time, and 11 drugs with low clinical value and strong substitutability were transferred out. In 2021, the average decline of newly added cancer drugs reached 64.88% Cancer drugs include lung cancer, lymphoma, breast cancer, liver cancer, gastric cancer, myeloma and other fields At present, the three generations of egfrtki targeted drugs listed in China have entered the medical insurance innovative drugs; Seven rare disease drugs were included in the ontology negotiation. It is worth noting that from 2017 to 2021, most innovative drugs were successfully included in the medical insurance catalogue that year. In 2021, 66 of the 67 negotiated drugs outside the catalogue were just listed last year, and the proportion of new drugs included in the medical insurance catalogue reached 99%.
Differentiated development of large foreign enterprises, medium-sized foreign enterprises and Chinese local enterprises after negotiation
Leading foreign pharmaceutical enterprises should formulate the overall medical insurance access strategy of the company and make strategic choices higher than products; Whether the products of medium-sized foreign enterprises enter medical insurance depends on the product characteristics and competition, and it is particularly important for enterprises to build professional ability; Price advantage and inclusion in medical insurance are still the key factors for local enterprises to win.
Enterprise recommendation:
Jiangsu Hengrui Medicine Co.Ltd(600276) , Baiji Shenzhou, Rongchang biology
Overview of the sixth health care negotiation in 2021
On December 3, 2021, a press conference on the 2021 Medicare drug catalogue was held in Beijing, announcing the end of the adjustment of the Medicare drug catalogue this year. Since October 2015, 16 ministries and commissions (bureaus) including health and family planning established a departmental coordination mechanism to organize the first batch of national drug price negotiation pilot work, the medical insurance negotiation in 2021 is the sixth round of medical insurance negotiation. A total of 85 kinds of exclusive drugs participated in the negotiation, and 94 kinds of drugs were successfully negotiated, including 67 kinds of drugs outside the catalogue and 24 kinds of drugs in the catalogue. The total success rate of the negotiation was 80.34%, and the average price reduction of drugs outside the catalogue was 61.71%. In terms of the adjustment of the original catalogue, 11 drugs with low clinical value have been transferred out of the catalogue, which is expected to reduce the burden of patients by more than 30 billion yuan in 2021. The entry of cancer drugs and innovative drugs into medical insurance accelerated. Among the new drugs, 18 kinds of cancer drugs were added, and 68 drugs were newly listed last year. The success rate of innovative drug negotiation reached 99%.
