Across 19 provinces, 76 large varieties are facing big exams... Is the national centralized procurement of Chinese patent medicine still far away?

It is here to collect proprietary Chinese medicines covering more than half of China
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"The AB group + double envelope + volume purchase model will ensure the stability of the original market to a greater extent
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" "Those small and complex companies without technical content and development strength, even if the price drops very low, It will be difficult to win the bid
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" "Traditional Chinese medicine companies have more pressure to cut prices, and the price cuts are relatively modest
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" "The lack of a unified quality evaluation standard is a major obstacle to the unified national organization and joint procurement
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" As Hubei Province recently released the "Eji" Shanxi, Fujian, Fujian, Jiangxi, Hunan, Qiongyu, Sichuan, Guizhou, Shaanxi, Gansu, Ningxia, Xinjiang Corps Centralized Procurement Document of Proprietary Chinese Medicines Alliance, the largest provincial-level centralized procurement of Chinese patent medicines so far is about to open.
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… 01 Do you take the low price? In fact, the Hubei 19 Provincial Union of Proprietary Chinese Medicines is the first official document of the large-scale inter-provincial alliance for centralized procurement of Chinese patent medicines.
Whether it is the setting of centralized procurement rules or the included varieties, it can be used as a reference for the subsequent centralized procurement of Chinese patent medicines.
Meaning
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First of all, in terms of procurement varieties, this collection is divided into 17 product groups and 76 varieties according to ingredients and administration routes.
There are many varieties involved, such as Bailing capsules, Jinshuibao tablets, Xueshuantong injection, and Xuesaitong injection.
Variety
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The biggest bright spot of Hubei Union's centralized procurement is its rule setting, which to a certain extent can reflect the mild and radical price drop
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On the whole, the centralized procurement of Hubei Union mainly adopts the model of "A and B grouping + double envelope + quantity procurement"
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It is about to merge the 2020 purchase amount of all products reported by the medical institutions in the alliance area of ​​the same product group, and the amount accounted for 10% or more of the total amount of the same product group, or sort the amount from high to low, and the top 3 reporting companies will belong to A bit group, the other group are B
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If a company wants to be shortlisted, it also needs to pass a comprehensive score, "comprehensive score = price competition score × 60% + technical evaluation score × 40%"
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Regarding the proposed selection rules, for Group A, the top 70% of the companies with the decline rate will be directly eligible for the proposed selection, and the last 30% will enter the bargaining process to accept the median decline of the finalists of all A competition units in the 17 product groups (50%) For Group B, if the number of shortlisted companies is more than 4, the shortlisted companies will be directly eligible for the proposed selection
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If the number of shortlisted companies is less than or equal to 4, the price drop of the shortlisted companies will reach the lowest drop of the top 70% of the top 70% of the finalist companies in the A competition unit of the 17 product groups, and they will be eligible for the proposed selection; those who have not reached the bargaining process will accept 17 product groups The median rate of the shortlisted companies in all A competition units dropped and they were eligible to be selected
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In summary, companies must first compete for the finalists based on factors such as innovation, safety, supply capacity, and credit evaluation, and then price competition
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Why set up such a grouping rule? Niu Ben, a researcher in the pharmaceutical industry of the National Think Tank and an investor in the pharmaceutical industry, believes that the setting of this rule is mainly based on three considerations: First, it will be more convenient to calculate the price according to the ingredients and the route of administration and divide the A and B groups.
Obviously, the technical indicators of ingredients, dosage forms and other factors need to be considered
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The second consideration is in favor of corporate bidding.
"In order to get more volume, companies basically compete in the top 70%, and do not even consider entering the next 30%
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" The third consideration is the alliance's purchase price.
The controllability of the top 70% of companies as the proposed selection rule for the majority of companies in the two groups is conducive to promoting companies’ price cuts
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At the same time, Niu Ben also believes that the "double envelope" adopted by the Hubei Alliance for the centralized procurement of Chinese patent medicines, based on the comprehensive scores and the rules of enterprise competition, also makes price reduction not the only criterion for winning bids.
"I believe that the future will be the same as that of chemical medicines.
Slowly balance, just like 4+7 centralized procurement renewal, price reduction is no longer the biggest criterion, mainly because the basic standards and industrial scale are in line with the national industrial upgrading
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" A senior industry observer told the E-pharmaceutical manager that relative Yuhuayao's centralized procurement, after grouping A and B, will still have a "moderate" effect on reshaping the market structure.

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According to the rule document, the companies that enter Group A are still companies with a large market share, which retains the original market competition pattern
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After setting up two groups of A and B, companies with large market scales will be pushed to reduce prices in order to obtain a higher market share
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In addition, earlier in September, Guangdong Province also announced a draft for the collection of proprietary Chinese medicines in the alliance.
Compared with the rules in the two documents, what will the decline be? "In fact, there are certain differences.
Relatively speaking, the rules in Hubei Province are more stringent than those in Guangdong Province.
In terms of the probability of winning the bid and the rate of decrease, the rate of decrease in Hubei Province may be relatively larger than that of Guangdong
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" According to Zhang Tingjie, founder and exclusive author of Fengyun Medicine Talk
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According to the Guangdong draft, the rules do not incorporate exclusive products; Hubei’s rules mainly divide product groups according to ingredients and route of administration.
From this point of view, Hubei’s price competition will be more intense
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02 Real "exclusive varieties" can only laugh to the end.
So far, it is clear that, unlike the innovative medicines of chemical medicines, the name of "exclusive varieties" of Chinese patent medicines is not a "talisman" that can evade centralized procurement
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Those companies that rely on a single exclusive product to dominate the situation, if they do not actively embrace centralized procurement, the competition will be even more fierce
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At present, whether it is the "Opinions on Promoting the Normalization of Centralized Drug Acquisition" (Guobanfa [2021] No.
2) issued by the State Council at the beginning of the year, "Explore the combination of different generic drugs with similar indications or functions Procurement"
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It was also put forward by the National Medical Insurance Administration in reply to the “Recommendations on Accelerating the Entry of Chinese Medicines and Formula Granules into Centralized Procurement” by the National Medical Insurance Bureau, “On the basis of improving the quality evaluation standards of Chinese patent medicines and formula granules, we insist on quality first and be guided by clinical needs.
Start with high-priced and large-volume varieties, and scientifically and steadily promote the reform of centralized procurement of proprietary Chinese medicines and formula granules
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” None of them discriminates against exclusive varieties of proprietary Chinese medicines
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Hubei’s 19-provincial alliance’s collection is divided into 17 product groups including Ginkgo biloba, Salvia miltiorrhiza, Shuanghuanglian and a total of 76 products based on the product’s functions, indications, route of administration, and ingredients.

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The drugs in the same product group are the Chinese patent drugs produced by many companies that have a large amount of clinical use and high purchase amount
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There are also many exclusive varieties of well-known companies
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This method of dividing groups into groups by function and composition for centralized procurement has resulted in the same composition, the exclusive products and non-exclusive products of some companies in the therapeutic field competing in the same group
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Geng Hongwu, an expert on medical reform policies and access to the pharmaceutical industry, believes that this will inevitably increase bidding pressure on proprietary Chinese medicines
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If the exclusive products of proprietary Chinese medicines do not enter the centralized procurement and get as much as possible in the hospital market, then it will not only face the competition of the same curative effect of Chinese medicines, but also the competition of chemical medicines, biological medicines, or biological similar medicines.

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The situation facing enterprises will be even more cruel.
“At that time, you will find that nothing is truly exclusive, and many can be replaced
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” Niu Ben said
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The aforementioned senior observers in the pharmaceutical industry also believe that the other side of this policy is to further promote the reshuffle of the industry.
Only those "exclusive varieties" of Chinese patent medicines with truly unique curative effects, special ingredients, and higher gold content can be proud of the world
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03 "4+7" of proprietary Chinese medicine? In 19 provinces, Hubei has a large scale of centralized procurement of proprietary Chinese medicines this time, and the provinces covered include more than half of China
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Whether it was the centralized procurement exploration carried out by Qinghai Province, Jinhua, Zhejiang Province, Puyang, Henan and other places for some varieties of Chinese patent medicines with high demand and high value; or the procurement of the Guangdong 7-province alliance that published the draft of the procurement of Chinese patent medicines; and now Hubei The formal announcement of the formal procurement documents for proprietary Chinese medicines in 19 provinces all revealed a signal that the centralized procurement of Chinese patent medicines in the provincial alliance centered on the region is accelerating
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Some analysts believe that the provincial-level alliance procurement between Hubei and Guangdong is similar to the “4+7” of chemical medicine in the past.
Is the national-level Chinese patent medicine coming soon? Judging from the current lack of uniform quality evaluation standards and relatively complex price mechanisms for proprietary Chinese medicines, the conditions for centralized procurement of various proprietary Chinese medicines by countries at this stage are not mature, and it is unlikely that the state will organize joint procurement in a unified manner.

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Many industry experts pointed out that the current centralized procurement of Chinese patent medicines still faces many problems
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First of all, the biggest problem with proprietary Chinese medicines differing from chemical medicines is that a unified quality standard has not yet been formed
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The centralized procurement of chemical drugs has the consistency evaluation of quality and efficacy as the standard, and the quality control indicators are clear and clear
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However, the composition of proprietary Chinese medicines is complex.
The factors that determine the quality of proprietary Chinese medicines include not only Chinese herbal medicines and production processes, but also effective components of Chinese medicines, Chinese medicine processing, preparation technology, excipients, packaging, storage conditions, transportation, etc.
Current quality inspection items and data It is difficult to completely represent the "real" product quality of a Chinese patent medicine, and the quality of qualified Chinese patent medicines is also uneven
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Second, the price formation mechanism of Chinese patent medicines is relatively complicated
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Geng Hongwu said in an interview with the manager of E-pharmaceuticals that in the price formation mechanism, the state has adopted cost pricing in the past 30 years, stipulated the zero-batch rate, only the highest price, management markup rate, zero markup or differential markup, and independent pricing by enterprises.
, Different management methods such as the formation of transaction prices through bidding, for Chinese patent medicines, because there is no effective price formation mechanism and standard, the price imbalance is serious
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Whether in Hubei or Guangdong, provincial-level alliance procurement is the exploration of the current stage of the bidding procurement model of Chinese patent medicines.
In the future, the procurement of Chinese patent medicines will continue to form alliance procurement centered on regions or by treatment areas
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Niu Ben believes that the current Chinese patent medicine industry is not standardized, and the gap between companies is also large
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In terms of the core underlying logic, the ultimate goal of mass procurement is to promote the upgrading of the pharmaceutical industry
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Establishing a unified quality standard for proprietary Chinese medicines is the basis for the ability to carry out mass procurement of Chinese patent medicines at the national level in the future
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We can see that relevant state departments are also making efforts to this end
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In April this year, the National Pharmacopoeia Commission issued the "Notice on Matters Concerning the Implementation of the National Drug Standards for Chinese Medicine Formula Granules", promulgating the first batch of 160 uniform standards for Chinese medicine prescription granules, which will be implemented in November
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Obviously, the exploration of the quality evaluation of Chinese medicine formula granules has opened up a new direction for the purchase of Chinese patent medicines under the current medical reform environment where centralized procurement is a breakthrough
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