The latest | 2016-2020, the sales progress of medical insurance negotiations

01 Overview

From 2017 to 2019, the average decline in negotiations was 44%, 56.

The overall sales of medical insurance products successfully included in each year have increased from 11 billion yuan, 3 billion yuan and 14.

The sales growth rate after the negotiation in each year varies greatly, which may be related to the price reduction, the length of implementation time and the variety structure, compared with the 2018 negotiations, the negotiation implementation time in 2017 is longer, the decline is milder, but in 2018, all the drugs included in medical insurance are tumor drugs, and in recent years, anti-tumor drugs have generally grown faster

Although the negotiations in 2019 had the largest decline, they had the shortest implementation time, and they encountered the outbreak of the new crown epidemic at the beginning of the implementation, hospitals could not operate normally, and their price-for-volume effect was not fully reflected, so the increase was the smallest (only 94%) (Figure 1

Looking at the sales growth of specific varieties, it is of little significance to compare the sales growth of varieties ("barefoot" varieties) with too low or even blank sales bases before the negotiation, and the following is to select the varieties with a large sales base before each negotiation and compare

02 Sales increased significantly

After the 2016-2018 negotiations into the varieties of medical insurance, due to the implementation time has been a long time, the price-for-volume effect has been released more fully, except for one variety of erlotinib (2017 negotiations), other varieties have all achieved sales growth

1.

For example, the sales of exetinib (Beida) continued to grow in 2021 after the negotiations landed 5 years later, and its sales of 690 million yuan in 2021 increased twice

Gefitinib (AstraZeneca) and tenofovir ester (GSK) peaked at 750 million yuan (2018) and 480 million yuan (2019) after their inclusion in medical insurance, respectively, an increase of 1.

II.

Among the 36 varieties successfully included in medical insurance, in 2013, the top 5 varieties of sales, in addition to erlotinib, which fell by 65%, the other 4 varieties all achieved positive growth after being included in medical insurance, and rituximab (Roche), trastuzumab (Genentech), bevacizumab (Roche) and radzumab (Novartis) increased from 1 billion yuan, 790 million yuan, 480 million yuan and 300 million yuan in 2016 before the negotiation to 1.

Among them, rituximab, trastuzumab and bevacizumab were reduced by 34%, 66% and 62% respectively in 2017 (Figure 3).

III.

In 2018, the 17 varieties successfully negotiated, of which the top 5 varieties of sales in 2013 achieved positive growth after being included in medical insurance, and octreotide (Novartis), cetuximab (Merck), sunitinib (Pfizer), pemetriae (Hengrui) and nilotinib (Novartis) increased from 700 million yuan, 240 million yuan, 140 million yuan, 0.
9 billion yuan and 0.
8 billion yuan in 2021 to 860 million yuan, 760 million yuan and 270 million yuan in 2021.
170 million yuan and 130 million yuan, an increase of 23%, 2.
2 times, 88%, 92% and 66%
respectively.

The price reductions for the five varieties in 2018 were octreotide (40%), cetuximab (71%), sunitinib (66%), pemenascerase (31%) and nilotinib (69%) (Figure 4).

03 It will take time

After the 2019-2020 negotiations to include the variety of medical insurance, in addition to the barefoot variety, only a small number of varieties of sales achieved positive growth
.

Because the sales growth of the negotiated medical insurance varieties must go through a process of first suppressing and then rising, in the early stage of the implementation of the landing, the growth of its sales volume is not enough to make up for the impact of the decline in sales caused by the negotiation of price reductions, the price-for-volume effect takes a long time to fully reflect, the time between the implementation of the 2019-2020 negotiation results from the landing to the end of 2021 itself is shorter than the previous batches of negotiations, and the new crown epidemic that began in 2020 has greatly affected the effective operation of the hospital
。

After a longer period of sales, after the price-for-volume effect is fully released, the sales of varieties that are negotiated to include medical insurance in 2019-2020 will also increase
significantly.

2019.
Negotiations in <>

In the medical insurance negotiations for new varieties in 2019, a total of 119 varieties participated, 90 were successful, the success rate was 59%, and the average reduction was 60.
7%.

Among the 36 varieties successfully negotiated in 2019, the varieties with sales ranked top 5 in 2013, in addition to the price-for-volume effect of hemobijing, danshen polyphenolic acid for injection and raltetrexed for injection, the sales of infliximab for injection and euriclin for injection (Guangdong Tianpu Biochemical) increased from 190 million yuan and 120 million yuan in 2018 to 370 million yuan and 200 million yuan in 2021, respectively, an increase of 1 times and 67%, respectively.
The price reductions negotiated by the two in 2019 were 59% and 72.
4%,
respectively.
(Figure 5)

II.
Negotiations in 2020

In the 2020 medical insurance negotiations, a total of 138 new varieties participated, 96 were successful, the success rate was 70%, and the average reduction was 53.
8%.

The results of the 2020 medical insurance negotiations will not be implemented until March 2021, which is less than a year from the end of 2021, and the price-for-volume effect is even less fully
reflected.

The sales of 96 varieties successfully negotiated in 2020 in 2021, compared with 2019 before the negotiation, in addition to the increase in the barefoot varieties just listed, needless to say, the sales of Top6 varieties in 2017, only one traditional Chinese medicine variety Leech Snake Tongluo Capsule (Shaanxi Jianmin Pharmaceutical) achieved positive growth, and sales increased from 363.
3 billion yuan in 2019 to 396.
3 billion yuan in 2021, an increase of 9%, and its medical insurance negotiation price fell by 28% (Figure 6
).

The paclitaxel liposomes for injection, which ranked top 1 in sales in 2017, are not displayed on Figure 6 because of the large differences with Top2 to 6 products, so they are not displayed
on Figure 6.

The effect of medical insurance negotiations is obvious, and the varieties included in medical insurance have achieved both sales volume and sales growth in the case of sharp price reductions, reducing the burden on patients at the same time, and enterprises have also been rewarded and achieved a win-win situation
.