Official implementation of medical insurance catalogue local supplement channel blocked

The new version of the medical insurance catalogue has been officially implemented since January 1, 2020 One of the key points of the new edition is to cancel the authority of adjusting the local medical insurance catalogue That is to say, the medical insurance catalogue is a unified national standard, and the original 15% adjustment authority of the local government is no longer available The right of medical insurance catalogue shall be taken over by the State Medical Insurance Bureau Before that, provinces, districts and cities had a certain extent of independent adjustment right to the drug catalog, which led to many problems Local supplement programs relied excessively on price indication, and there were administrative intervention factors, which led to new power rent-seeking and local protection Even some provinces provide key support to enterprises in their own provinces, and set up "provincial supplement directory direct train", and timely include or supplement relevant specifications and dosage forms into relevant provincial directories with reference to existing products in relevant directories At present, local governments do not have the right to adjust their catalogues independently, so the varieties that previously entered the market relying on local supplementary catalogues will be gradually removed For this reason, the country has given a clear time limit and cleaning proportion: the drugs in the key monitoring catalogue are first removed from the medical insurance catalogue, and the supplementary varieties in other places are cleaned up in principle within three years, with the cleaning proportion of 40%, 40% and 20% respectively In theory, it is three-year adjustment, and the actual implementation will be completed within one year, especially the key monitored varieties may die suddenly Second, once the varieties that have been removed from the national health insurance catalog are removed, there is no chance to seek local supplement, and the flexible local health insurance catalog will become history In the past, if a drug variety could enter the supplementary medical insurance catalogue of more than half of the provinces in China, or if the sales volume of a drug variety in individual provinces accounted for the majority of the national sales volume, then whether the drug entered the national medical insurance catalogue or not is not very different for enterprises Therefore, when drugs fail to enter the national health insurance, pharmaceutical companies will generally try their best to make their drugs enter the local health insurance catalog through supplement In terms of the number of medical insurance catalog additions in 2017 and 2018 (15 provinces and regions are selected according to the network data), each province will increase by at least 200, and some provinces and regions will increase by up to 500 varieties, or even nearly 2000 There is a large difference between the number of varieties in Shanghai's medical insurance catalogue and that in the national medical insurance catalogue It is the province with the largest number of supplementary varieties of medical insurance The number of supplementary varieties is nearly 2000, which is about 10 times that of the two provinces with the smaller number of supplementary varieties, such as Ningxia and Qinghai (data source: flint creation) This means that for some drugs that fail to enter the national medical insurance catalog, pharmaceutical companies hope to enter the local catalog through negotiations with local medical insurance departments This road will be blocked, which also means blocking local relevant interests In terms of the varieties transferred out from the national medical insurance catalog, 150 varieties were transferred out, mainly focusing on the drugs whose number was revoked by the State Drug Administration, while the rest were mainly drugs with low clinical value, obvious abuse and better substitution Among them, on July 1, 2019, the health care Commission announced the first batch of national key monitoring and rational drug use catalogue 20 drugs including calf serum deproteinization, rat nerve growth factor, vinpocetine, RNA, etc were under key monitoring and were kicked out of the medical insurance catalogue Although seven of the 20 key monitored drugs are listed in the 2017 version of the medical insurance catalog, before that, local governments can make or modify new catalogs, and the remaining 13 varieties are supplementary products of the local medical insurance catalog Now, the state health insurance bureau clearly requires that all localities should strictly implement the drug catalog, and should not make their own catalog or use alternative methods to add drugs in the catalog, nor adjust the limited payment scope of drugs in the catalog This means that the 20 drugs that have been monitored will be kicked out of health insurance All the 20 drugs have been transferred out this time, which is expected to have an impact on the market and pharmaceutical enterprises According to the MI Nei net database, the total sales of these 20 varieties in China's public hospitals in 2018 reached 65.3 billion yuan, involving more than 200 enterprises, including Fosun Pharmaceutical, Shuanglu pharmaceutical, Lizhu group and other listed companies Some of the 20 drugs are exclusive to the enterprise, such as compound coenzyme for injection, calf serum deproteinization injection and troxerutin cerebroprotein hydrolysate injection, which are exclusive to Shuanglu pharmaceutical, Fosun Pharmaceutical, Jinzhou AoHong pharmaceutical and Jilin Sihuan pharmaceutical respectively There are also some varieties involving many large pharmaceutical enterprises, such as Yangzijiang Pharmaceutical Co., Ltd., which is one of the main producers of transforming sugar and electrolyte injection, Lizhu Pharmaceutical Co., Ltd., olacetan Ouyi Pharmaceutical Co., Ltd and Yidalafeng injection Co., Ltd of Nanjing xianshengdongyuan Pharmaceutical Co., Ltd Data source: minenet Oxiracetam is one of the largest varieties in China's drug terminal market Although the frequency of drugs listed as auxiliary / monitoring drugs is as high as more than 50 times, it does not affect their access to the local supplementary medical insurance catalogue, and 22 provinces have included them in the supplementary medical insurance According to the public data, in 2016, the market terminal sales of this variety was close to 9 billion yuan, which decreased in 2017, but there was still a scale of more than 8 billion yuan The market is divided by Guangdong Shixin Pharmaceutical Co., Ltd., Sinopharm group Ouyi Pharmaceutical Co., Ltd and Harbin Sanlian Pharmaceutical Co., Ltd Danshen ligustrazine in the domestic market is mainly divided by Guizhou Baite Pharmaceutical Co., Ltd and Jilin Sifang Pharmaceutical Co., Ltd under Kangenbei The former accounts for more than 80% of the market share In the past two years, the frequency of drugs listed as auxiliary / monitoring drugs has reached 45 times, and they are still listed as supplementary varieties of medical insurance in 18 provinces In 2017, the terminal market scale of this variety was about 4 billion yuan Traklutin cerebroprotein hydrolysate is the exclusive product of Jilin Sihuan Pharmaceutical Co., Ltd., which has been growing rapidly in recent years, and is also one of the main incomes of the enterprise in recent years In recent years, although it has been listed as an auxiliary / monitoring drug for 35 times, it is still listed as a supplementary type of medical insurance in 20 provinces In 2016, the terminal market scale of this variety was close to 1.8 billion yuan, with an average annual growth of over 15% in the previous three years, a decline in 2017, and a terminal scale of about 1.5 billion yuan.