Recent financial media reports that exclusive and patented drugs other than proprietary Chinese medicines will be state-led price negotiations, and proprietary Chinese medicines will be responsible for the province. Why should Chinese and Western medicine be divided and ruled? Who will be the biggest beneficiary? What reasonable factors for sales and development of the industry should the government pay attention to in actual operation? Why are proprietary Chinese medicines not included?
There are inevitably two factors involved, one is safety factors, including the safety of traditional Chinese medicine injections and the recent exposure of raw materials such as ginkgo biloba preparation and not according to the declared process specifications of safety production problems.
In addition, according to the "Hong Kong Phoenix Weekly" reported that the case statistics of 16 large domestic hospitals, herbal factors accounted for 20% of the cases of drug-induced liver injury. Data from three large specialized hospitals show that more than half of the cases of drug liver disease are related to Chinese medicine, and the most important cause of acute liver failure is also Chinese medicine. It is necessary to call on the public and the government to attach great importance to the fact that Chinese herbal medicine is becoming a high pathogenic factor of liver disease, rather than the traditional Chinese medicine which is known as non-toxic and harmless.
Secondly, the price of raw materials fluctuates, the extraction link is priced at will, and the price is difficult to clarify. The high price of drugs caused by price factors is difficult to control and the shoddy quality is very common.
Some cardiovascular, anti-inflammatory traditional Chinese medicine injections for a long time in the forefront of the provincial hospital drug sales list, the two policies of Chinese and Western medicine and rule, the market will throw countless question marks, the country gradually launched each batch of price negotiation list is a more robust approach.
Is national negotiation good or bad?
It is not difficult to see from the terms and conditions of Article 70 that the national guidance document has blurred the dividing line between basic drugs and non-basic drugs, breaking the previous pricing rules that basic drugs do not distinguish quality levels, and take the lowest price in the country. Scientific group, each group does not exceed 2 bidding quotas the biggest beneficiaries are joint venture drugs, patented drugs, original research drugs. The Hunan standard also blurs the boundary between the two, resulting in the fact that the non-basic drug is tight and the basic drug is loose. No doubt this is also the result of the operation of many powerful enterprises.
National negotiations have their positive side, centralized and unified, once done, there is no need to tender one by one as in the past, and it will take three years to wait for the provinces to recruit again. In the past two years, affected by the pharmaceutical environment and institutional personnel changes, the progress of hanging the network is more delayed, and few non-basic new standard areas have been implemented in the past two years, seriously affecting the sales of new products of enterprises.
Foreign-funded enterprises and large varieties of powerful government affairs capabilities have once again been fully developed and reflected. The results will also be polarizing. The good is better, the bad is worse. How to formulate strict and fair negotiation rules is more critical.
Factors that need attention at the government level
1. Are all patents and exclusive products included in the national negotiations, or are existing high-sales products or national medical insurance catalog products directly managed by the state?
In the first half of the year, some officials introduced that the national negotiations are for high-priced products that have not entered the medical insurance, and some serious disease medical insurance catalog products, mainly joint ventures, are to reduce prices in exchange for entering the catalog. It is precisely because of the limited sales of the product at its own expense, it can not amortize the high costs of research and development, production and marketing, and can only maintain high-priced sales, and the government, enterprises and the public will win by giving up profits in exchange for large-scale sales after entering the medical insurance.
In the past, local health care and pricing departments have led these two tasks. After the release of drug prices or the rush to promote price linkage around the network fails to respect and consider the sales law and pricing law of the product, resulting in medical insurance areas and non-medical insurance areas of pain and happiness, medical insurance prices have not been adjusted, non-medical insurance areas with reference to the low price of medical insurance areas can not maintain the survival of enterprises.
This report is for all products. For the first time, the state directly dominates and handles price negotiations, does it have enough energy to understand every product? Whether the rules are scientific and reasonable, open and transparent determines whether the enterprise product can survive, and many enterprises rely on one or two fist products to survive. An unreasonable price setting has sentenced the death of products and enterprises, and we need to be cautious and responsible for the industry and enterprises.
2. Is the price negotiation gentle or harsh? Or is it full of imagination?
Exclusive products and patented products research and development costs tens of millions or even hundreds of millions, enterprise GMP transformation investment of more than 100 million. The number of burdens and cost inputs does not count. This is what the state needs to take into account for the survival and development of the industry and enterprises when setting the expected goals of price negotiations. We should reduce the burden on the people, and at the same time, we should not destroy industries and enterprises without limit.
The price of each product is reduced by 5%, and the national pharmaceutical market saves hundreds of billions of drug costs for the country and the people every year. The pharmaceutical industry has been actively cooperating with the state to reduce drug prices, but whether the reduced prices are transmitted to patients, or because the medical reform is only a structural adjustment rather than an essential radical cure, resulting in a larger black hole in medical institutions, resulting in soaring medical costs? So what\'s the point of lowering drug prices?
Purchasing with volume may bring two results, one is that the enterprise profits, but there is no sales to ensure. Cut-price products entering the market are abandoned by medical institutions and into the cold palace, which is simply not enough for enterprises to raise sales teams and find distribution customers. One is to yield profits after the monopoly of the finalists led to widespread use, just like the noble drug into the basic drug into everyone, even if the price of profit products is still high, the former let the industry and enterprises hurt, the latter let the patients and the country more heavy burden.
National price negotiations are different rules, artificial operation space is large, or the same as Zhejiang for large sales of products, although controversial, but clear to follow. Even like the last round of Fujian hanging net, even if the price is the lowest in the country, but all products are low, there is no favoritism, medical institutions will not be picky, will not let enterprises fail to win is dead, low bid is dead.
Each product with large sales needs to go through the operation of the medical insurance link, and the medical insurance department takes over the price negotiation board how to fall, whether there is light and heavy, there is sparse or impartial law enforcement.
It can be expected that national price negotiations should be included, and the negotiation rules should be more rational and fair in theory. At the same time, it is also recommended that the government change its management thinking and style, listen to the market voice, provide enterprises and industries with conditions to support development, and provide professional guidance and services, rather than blindly crack down and impose requirements. Reasonable suggestions and feedback from the industry and enterprises also need the attention and care of the government.
3. Is the reference basis scientific and reasonable?
1) Should the "national lowest price theory" be improved?
More and more places have thrown out the national price linkage, taking the lowest price as the price limit rule. Guangdong, Shandong, Sichuan and other provinces are more professional and rational, taking the lowest 3-5 province average price is more reasonable. Fujian is also collecting the winning results within two years of execution. The low price bid record of which the enterprise has no supply record shall be reasonably eliminated.
In the past, various enterprises scattered bidding network, hundreds of products, tendering personnel often only one or two, the quotation time is often only one or two days, need to undertake a large number of internal coordination of data confirmation and report transmission work. The occasional mistake is inevitable in such intensive bidding.
Some enterprises do not have professional sales ability, encountered malicious bidders are not a few. Enterprises can not scrap the bid, sales can not, the entire bid period is empty there. If this is used as the normal sales price of the enterprise is not reasonable, the enterprise should be given a reasonable opportunity to correct mistakes.
2) Differentiated treatment of medical insurance and non-medical insurance products;
As mentioned above, medical insurance is another core entry condition for product sales, and the sales volume of medical insurance products far exceeds that of self-funded products after the start-up conditions are met. At the self-payment stage, enterprises should be given independent pricing authority to facilitate enterprises to maintain survival in the low-sales stage. After entering the medical insurance stage, the government will impose price limits.
3) Sales of mature products and immature products distinguish treatment;
Enterprises have the ability to reduce prices after the scale of sales, the larger the sales volume, the more dominant the cost control, the longer the sales time, the thinner the amortization of expenses. The research and development cost of newly listed products is tens of millions, and the marketing cost is millions, if coupled with the investment and construction cost, it is impossible to beat. If the enterprise has no sales at all, directly ask the enterprise to cut prices, and the new product can only be all out.
4) Is price important or is efficacy, safety, comprehensive treatment cost and cost performance more important?
Some products are cheap, but the side effects are large, or the dosage is large, and the cost of stage treatment is much higher than that of new dosage forms of slow-release products and next-generation drugs. Although the price of some products is higher, the curative effect is irreplaceable. A comprehensive scientific view is needed.
5) Reasonable view with international drug prices;
There are three factors that cause the high prices of joint ventures and imported products that cannot be ignored. First, tariffs and commercial taxes; second, the high operating costs in China. Even if the products have not been put into the market, the salaries of employees have to be paid, and the cost of academic promotion is more enormous. Third, the sales of new products are limited, and the investment is huge, and the market stage of other countries and regions with mature sales is different, the drug habit is different, the cost amortization and conversion ratio is different, and the pricing is not the same.
This is the same reason that the price of imported milk is generally lower than that of domestic milk, and the cost of living in Beijing and Shanghai is higher than that in London and New York. Socio-economic operating costs are completely different. High-tech, high-cost pharmaceuticals are only more expensive to run than the food industry. Reasonable reduction of price differences through national negotiations, but can not ignore the law of sales and economic law to force consistency.
How to speed up the bidding and medical insurance start-up process in a scientific, reasonable and fair way, improve the marketing efficiency and results of enterprises, leave a reasonable development space for the pharmaceutical industry and enterprises, and truly benefit the people, not just put the tearfully profits of enterprises into the bottomless pockets of medical institutions, resulting in even higher medical costs. It is the downstream pharmaceutical industry that takes the blame.
To give enterprises a normal and reasonable space for development and fair and reasonable treatment, gather the hearts and minds of the industry and the general public to turn back and move forward, in order to truly reverse the realistic problem of medical insurance cost overspending.
Information source: Mi Intranet