Negative growth for the first time in the past 5 years!

On July 28, Chen Jinfu, a member of the Party Leadership Group and Deputy Director of the National Medical Security Administration, presided over a work symposium to listen to the opinions and suggestions of relevant companies and industry associations on the reform of centralized insulin procurement
.
At present, the number of diabetes patients in China ranks first in the world, with a prevalence rate of 10.

Diabetes chemical drug retail market shows negative growth for the first time in recent 5 years

Diabetes is a group of metabolic disorders characterized by high blood sugar caused by insulin secretion defects or insufficient insulin action.
The patients are mainly type 2 diabetes, and type 1 diabetes and other types of diabetes account for a relatively small proportion
.
Type 1 diabetes is caused by pancreatic β-cell failure.

The drug treatment of diabetes is based on chemical drugs, which are divided into insulin treatment, non-insulin hypoglycemic drugs (ie oral hypoglycemic drugs) treatment and other diabetes drug treatments
.
According to data from Menet.

Figure 1.
The sales scale of the terminal diabetic chemical drug market in physical pharmacies in cities in China (100 million yuan)

Source: Mi Nei.
com, China's urban physical pharmacy terminal competition pattern

Sales of half of the top 10 non-insulin hypoglycemic drugs declined year-on-year

In 2020, the market share of TOP10 non-insulin hypoglycemic drugs totaled 71.
4%, sales fell by 7.
0% year-on-year, and market concentration declined
.
Among them, the sales of five varieties declined year-on-year, namely acarbose tablets, repaglinide tablets, glimepiride tablets, gliclazide sustained-release tablets and metformin hydrochloride enteric-coated tablets

Acarbose tablets and glimepiride tablets, the main varieties, belong to the second batch of centralized procurement.
The policy will be implemented in April 2020, which will have a greater impact on the market in 2020.
The sales of both varieties have declined year-on-year, but the first The implementation period of the three batches of metformin hydrochloride tablets is in November 2020, which has little impact on the market this year, and sales in 2020 will continue to grow
.
Then, vildagliptin, empagliflozin, gliclazide, canagliflozin, nateglinide, repaglinide and glipizide and other diabetes drugs have successively entered the national drug centralized procurement catalog, and diabetes drugs The market will undergo a new round of shuffling

Table 1.
TOP10 varieties of non-insulin hypoglycemic drugs in China's urban physical pharmacies in 2020

Source: Mi Nei.
com, China's urban physical pharmacy terminal competition pattern

Metformin hydrochloride tablets: the original research company Bristol-Myers Squibb's dominant position remains unchanged, and the domestic company CSPC Ouyi has a brilliant performance

The biguanide drugs currently used clinically are mainly metformin hydrochloride
.
The guidelines for the diagnosis and treatment of diabetes developed by many countries and international organizations recommend metformin as the first-line medication for the control of hyperglycemia in patients with type 2 diabetes and the basic medication in the drug combination

In 2020, metformin hydrochloride tablets will surpass acarbose tablets and become the top variety of non-insulin hypoglycemic drugs
.
According to data from Meinenet, the top five manufacturers of metformin hydrochloride tablets in physical pharmacies are Bristol-Myers Squibb, Aihua, Shenzhen Zhonglian Pharmaceutical, CSPC Ouyi Pharmaceutical and Beijing Jingfeng Pharmaceutical Group

CSPC Ouyi Pharmaceutical's sales doubled year-on-year to 1948.
1%, and its market share increased by 1.
2 percentage points from 2019, mainly due to the increase in its distribution rate in various cities in 2020
.
The third phase of centralized procurement will be implemented in November 2020.

Table 2.
Competitive landscape of metformin hydrochloride tablets enterprises

Source: Mi Nei.
com, China's urban physical pharmacy terminal competition pattern

Acarbose Tablets: Baitangping's market share dropped significantly under centralized procurement

ɑ-glucosidase inhibitor is a backup first-line hypoglycemic agent, and acarbose is the first choice for elderly diabetic patients
.
According to data from Meinenet, the ranking of acarbose tablets in non-insulin hypoglycemic drugs in 2020 has fallen from the top in 2019 to second
.
Acarbose tablets are sold in physical pharmacies by Bayer, Hangzhou Sino-American Huadong Pharmaceutical, Beijing Fuyuan Pharmaceutical, and CSPC Ouyi Pharmaceutical
.
In 2020, the sales of Bayer's acarbose tablets in physical pharmacies fell by 39.
6% year-on-year, and the market share fell by 9.
4%.
The market share was seized by Hangzhou Sino-American Huadong Pharmaceutical and Beijing Fuyuan Pharmaceutical
.

Baitangping dropped sharply.
On the one hand, it was due to the extremely low price in January 2020 to snatch the qualification of acarbose, and the linkage of the price drop of the winning bid led to the decline in the price of physical pharmacies, but the volume exchange price failed to stop the loss; on the other hand, In the second half of the year, the shortage of supply in physical pharmacies enabled Sino-US Huadong Pharmaceutical to win the opportunity to replenish the supply and erode the market share of Baitangping
.

Sino-U.
S.
East China entered the international market.
After obtaining the EU Austrian marketing license, Acarbose tablets will gain access to the U.
S.
market in 2020.
In December, the Acarbose chewable tablets successfully became the "Medical Insurance Catalog" (2020 edition) negotiation It remains to be seen whether the future trend of acarbose tablets in East China and Central America will strengthen
.

Table 3.
Competitive Landscape of Acarbose Tablets Companies

Source: Mi Nei.
com, China's urban physical pharmacy terminal competition pattern

Glimepiride tablets: Sanofi's position remains strong

Sulfonylureas are insulin secretagogues.
The main pharmacological action is to stimulate the pancreatic β-cells to secrete insulin and increase the level of insulin in the body to lower blood sugar
.
Compared with other sulfonylureas oral hypoglycemic agents, glimepiride tablets are more convenient to take than other products because they are administered only once a day, and are very popular among patients
.
According to data from Minei.
com, glimepiride tablets ranked fifth among non-insulin hypoglycemic drugs in physical pharmacies in 2020
.
The top five manufacturers of glimepiride tablets in the physical pharmacy terminal are Sanofi, Jiangsu Wanbang Biochemical and Pharmaceutical Group, Shanghai Tianci Fu Bio, Guizhou Tianan Pharmaceutical and Chongqing Kangker Pharmaceutical
.

Among them, the growth of the first two manufacturers is relatively good.
In 2020, Sanofi's sales scale will reach 200 million yuan.
With its good reputation and brand strength, its market share has further increased to 46.
0%
.
Jiangsu Wanbang Biochemical & Pharmaceutical Group's sales increased by 9.
8% year-on-year, and its market share increased by 3.
1 percentage points.
It has become a beneficiary of the consistency evaluation bonus due to the early passing of the consistency evaluation
.
Jiangsu Wanbang is one of the member companies of Fosun Pharma.
Diabetes treatment drugs are one of its main varieties.
The product Wansuping is also active in major medical journals.
It has won the Excellent Brand Award in the endocrinology field for 5 consecutive years
.

Table 4.
Competitive landscape of glimepiride enterprises

Source: Mi Nei.
com, China's urban physical pharmacy terminal competition pattern

Insulin and its analogues: a very oligopolistic market

Since the end of 2018, many varieties with high clinical demand and high medical insurance payment ratio have undergone multiple rounds of centralized procurement.
Insulin is one of the few large varieties left
.

In 2020, the concentration of TOP5 terminal varieties of Chinese urban physical pharmacies will reach 68.
6%, of which Novo Nordisk relies on three varieties of insulin aspart 30 injection, protamine biosynthetic human insulin injection (pre-mixed 30R), and insulin aspart injection.
Occupying 43.
1% of the market share, the local company Ganli Pharmaceutical's recombinant insulin glargine injection share is 7.
5%, and the insulin glargine injection manufacturers have 90% of the original research company Sanofi and 10% of the local imitation companies.
United Laboratories, Tonghua Dongbao
.
If the collection of insulin starts, then the three varieties of insulin aspart 30 injection, insulin glargine injection and insulin aspart injection are expected to become the first products due to their relatively high share, large clinical demand, and more companies with over-reviewed generic drugs.
Insulin-type centralized procurement varieties
.

Table 6.
Top 5 varieties of insulin and similar drugs in China's urban physical pharmacies in 2020

Source: Mi Nei.
com, China's urban physical pharmacy terminal competition pattern

The market for insulin and its similar drugs is extremely oligopolistic, with foreign-funded companies Novo Nordisk, Sanofi, and Eli Lilly occupying a total of 82.
1% of the market, and local companies from Ganli Pharmaceutical and Tonghua Dongbao Pharmaceutical occupying a total of 13.
8%.
Market share
.
In the trial in Wuhan at the beginning of last year, companies such as Novo Nordisk, Sanofi, Eli Lilly, Ganli Pharmaceutical, and Tonghua Dongbao all won the bid for insulin varieties
.
Compared with foreign-funded companies, domestic companies have a greater advantage in production costs and may occupy more shares in centralized procurement
.
Recently, news broke out in the industry that a small number of companies in mass procurement have been "out of stock" after winning the bid, and they have begun to adjust their direction: multiple companies may be shortlisted together
.
For insulin varieties with few manufacturers of the same variety, most manufacturers are selected.
How will the amount of centralized procurement be divided? This is also the focus of corporate attention
.

Table 5.
Top 5 manufacturers of insulin and similar drugs in China's urban physical pharmacies in 2020

Source: Mi Nei.
com, China's urban physical pharmacy terminal competition pattern

Concluding remarks

With the normalization of centralized procurement, companies must not only strive to maintain the existing market stock, but also seek incremental methods
.
At present, some companies are also actively seeking breakthroughs, such as prolonging the product life cycle of compound preparations, increasing the applicable population of original products, and entering the list of medical insurance negotiations
.
For physical pharmacies, under the dual-channel policy, as the range of price linkage between physical pharmacies and hospitals for centralized procurement is further expanded, domestic companies in physical pharmacies may share the market share of the original research companies by volume-for-price
.
On the other hand, the product prices of the original research companies are quite different from those of domestic companies.
If they enter centralized procurement, their prices will drop sharply and their market share will be squeezed to a certain extent
.
In the future, insulin will be included in the ranks of centralized procurement, and under the dual-channel policy, the physical pharmacy terminal may usher in an increase
.

Data source: Mi Neiwang database

Note: China's urban entity pharmacy terminal competition pattern database is an enlarged version of the urban entity pharmacy database that covers 293 prefectures and cities across the country (excluding county and rural entity pharmacies), and continuously monitors all categories
.
The above sales are calculated based on the average retail price of the product at the terminal
.