Say goodbye to "involved" innovation, and return the barbaric price war to the clinical value war

On July 30, the National Medical Insurance Administration issued the "Announcement on Publicizing the Preliminary Formal Review of Drugs and Information for the 2021 National Medical Insurance Drug List Adjustment", including domestically produced PD-1, domestically produced CAR-T and other major local innovative drugs

Passing the formal review is only to get an admission ticket.

Although prices have generally fallen sharply after the negotiations, many pharmaceutical companies have no other choice in exchange for the market

"Soul bargaining" has brought about a sharp drop in drug prices and a significant reduction in the burden on patients.

The above is only a comparison between the same target and the indicated drugs.

Faced with the subsequent dozens of similar products under research, the first-mover companies directly reduced the annual treatment cost to less than 50,000 yuan, and the imported pharmaceutical companies did not get involved in the price war under the global price system

However, judging from the actual situation in the early stage, domestic antibodies have pulled the price ceiling to a position that foreign pharmaceutical companies cannot accept

Therefore, on the one hand, products such as anti-PD-(L)1 monoclonal antibodies and KRAS inhibitors are crowded into the domestic market; on the other hand, low-level repetitive innovative products adopt barbaric price wars, forming the so-called "bad money drives out good money" status quo , Squeeze the industry's innovation and development space

Medical insurance should encourage local innovation on the premise of balancing reasonable cost control

As stated in the previous "Asian Experience, Safeguarding the Experience of Pharmaceutical Innovation" by Yaodu, in recent years, we have been delighted to see the emergence of China’s indigenous innovative medicines, with more and more high-quality products, and national-level policy support and guidance.

1.

At the same time, strengthen the supervision of the medical insurance fund to ensure that the people use clear, safe and reliable therapeutic drugs, reduce the waste of the medical insurance fund, and ensure the safe and stable operation of the medical insurance fund

2.

3.
Premiums are allowed for the treatment of major diseases, rare diseases, pediatric diseases, etc.

Encourage innovative pharmaceutical companies to research and develop clinically urgently needed therapeutic drugs for major diseases, rare diseases, and pediatric diseases, and provide a certain premium for medical insurance access pricing and catalog adjustments
.
As major diseases seriously endanger the lives of patients, there is an urgent need for the development of high-efficiency therapeutic drugs.
However, the number of patients with such diseases and rare diseases is much lower than other diseases.
After they are listed, they are restricted by medical insurance access prices, resulting in a limited market size
.
Innovative drug companies do not have much enthusiasm for this, and the logic of price-for-quantity cannot be fully established for this type of drug
.

Another example is the relatively small scale of medications used by children and higher safety requirements.
Children can be divided into different age levels.
The enthusiasm of enterprises is also limited.
Medical insurance institutions, as the payer, can provide a premium on the payment standard and exempt measures such as CEA
.

4.
Encourage local innovation and development, not limited to local companies

Encouraging the development of local innovative drugs is not limited to supporting local companies, but at a higher level, promoting the inflow of high-tech R&D projects and personnel into domestic innovative R&D, and driving the overall improvement of the level of domestic scientific research personnel
.
With reference to international experience, for domestic clinical research projects of a certain scale, such as international early, exploratory and critical clinical research, first or at the same time, the world’s first new drug registration project in China will be given a certain amount in the pricing of medical insurance access Premium space
.

Due to the numerous "hot spot innovations" and "me-too" innovations in the early stage, it is foreseeable that more fierce price wars will be staged year by year in the future, and PD-(L)1 is just a microcosm
.
And the major foreign companies have also taken their heart to join the battle, and have frequently shown their good intentions to the medical insurance
.
For example, recently Hunan, Liaoning and other provinces have announced that pharmaceutical companies have voluntarily applied for price cuts on online drugs.
Pharmaceutical companies including Yang Sen and Pfizer have taken the initiative to cut prices, and some products have even cut prices by more than 60%
.

So in the near future, the price has really fallen to the level that companies cannot afford.
How will the policy be implemented? Will local innovation still maintain the current enthusiasm? Medical insurance should be balanced and reasonably controlled, and more consideration should be given to "using science".
"Measurement method" to determine the price of local innovative drugs
.

The prosperity of China's local innovation is inseparable from the joint efforts of all relevant stakeholders.
Only by "freshing the source of water" can we truly promote the transformation of China's biomedical industry
.