Will these drugs be monitored?

Author: Xiao Bobo

On September 3, the General Office of the National Health Commission issued a notice on the adjustment of the national key monitoring and rational use of drug catalogues, indicating that the key monitoring catalog has entered the era of standardization, and it also marked that the key monitoring catalog will become an important, important issue for health authorities.

In July 2019, the Health Commission released the first batch of key surveillance catalogs

The release of the key monitoring catalogue directly caused the company's sales to plummet and suffered a heavy blow

In 2020, the loss was 79.

Focus on monitoring to change the destiny of an enterprise.

This result, from the point of view of the competent authority, is positive and fruitful.

For this reason, this initiative will become a routine work from this year.

The drugs included in the catalogue management should be chemical drugs and biological products that have many problems with unreasonable clinical use, abnormally high amounts of use, and have a greater impact on the rationality of drug use

According to the "Review of the Chinese Hospital Medicine Market in 2020" released by IQVIA, the top ten treatment areas of Chinese hospital medicines, ranked by annual sales, are:

It can be seen from the data that this coincides with the focus of the competent authority

Antitumor drugs

In the Top10 treatment field of hospital drugs, anti-tumor drugs bear the brunt

Some cancer drug companies implement a new patient daily report system, and even report three times a day, in the morning, at night and in the WeChat group to release the new patient's medication status

Most oncology drug companies are referring to this promotion model.

Among the big oncology drug companies, foreign companies mainly include Roche, AstraZeneca, Merck and other companies, and domestic companies mainly include BeiGene, Hengrui, Zhengda Tianqing and Qilu

antibiotic

The delay of antibiotics in key monitoring is related to the characteristics of their products

According to data from Ai Kunwei, the only antibiotic among the top ten varieties of sales is Pfizer's Shupushen, and anti-infection is the focus of Pfizer, with a very high proportion of sales.

Pfizer has been singing its praises all over the world with vaccines, but it is experiencing the hardest days in history in China.

The brand and efficacy of Supushen have been deeply rooted in the hearts of doctors, and it is difficult to change the prescription habits
.
Moreover, the price of Shupushen has dropped again and again, and it can maintain the third place in total sales and the first place in the field of anti-infection.
Naturally, there are reasons for the unique advantages of its products
.

Another major anti-infection player is Merck.
Taineng, Coses, and the newly listed posaconazole have escaped all national collections.
Will the key surveillance still be lucky this time?

Proton pump inhibitor

The market application potential of proton pump inhibitors is large, and involves a wide range of departments, and has always been focused on by the competent department
.

In the medical records of 3005 inpatients using proton pump inhibitors in Guangdong Provincial Hospital of Traditional Chinese Medicine from 2015 to 2016, the use of proton pump inhibitors was evaluated and analyzed: 1352 cases (44.
99%) were given intravenously, of which 581 cases had no indication for medication; 2334 cases of preventive medication (77.
67%), of which 1,008 cases had no indication for medication, and the proportion of irrational use was close to half
.

The department that uses proton pump inhibitors the most is not gastroenterology, but orthopedics, accounting for 22.
7%, surgery accounts for 19.
03%, and the digestive tract disease department uses only 6.
79%
.

Among the top ten varieties, although there is no proton pump inhibitor, this market of more than 10 billion is an area of ​​treatment that the competent authorities urgently need to regulate
.
The main layout companies in this field include AstraZeneca, Takeda, and Oseca
.

Glucocorticoid

The entry of glucocorticoids into key monitoring has nothing to do with sales, but is related to the characteristics of its products
.

Glucocorticoids are a double-edged sword.
They exert their therapeutic effects and bring great side effects.
The hormones have been abused and misused, and some doctors will use them with caution because of the side effects
.

The largest sales amount in this field is Pfizer’s methylprednisolone and Metzolac.
The total sales amount does not exceed 1 billion, which is a small area in terms of amount.
However, the number of hormones used is large, especially dexamethasone and prednisone.
Overuse, the impact on patients is lifelong
.

These products are mainly some domestic pharmaceutical companies, because the sales volume is not large, even if they enter the key monitoring, it is not relevant to the business of the enterprise
.

Parenteral nutrition

Parenteral nutrition is the main battlefield of Fresenius Kabivari Pharmaceuticals
.

It can be seen from the company's official website that 16 parenteral nutrition products are involved, and the possibility of entering the key monitoring catalog is the greatest
.

Various studies have been published on the irrational use of parenteral nutrition
.
According to a study, a total of 1944 hospital parenteral nutrition prescriptions were retrieved from May 2018 to September 2019 through the hospital HIS system to evaluate the stability and effectiveness of the prescriptions.
Unreasonable prescriptions accounted for 881 prescriptions, which is close to the proportion.
Half
.

summary

Most of the 20 varieties in the first edition of the catalog were identified as adjuvant drugs or traditional Chinese medicine injections, and their efficacy and safety are worthy of further consideration
.

The products involved in this round of key monitoring catalogues will be larger and broader.
For the ten major varieties, even if evidence-based evidence is sufficient, it is difficult not to be abused in the complex Chinese pharmaceutical market
.
I personally think that in addition to strength, you have to fight for luck.
After all, the top ten varieties of the provinces will not escape
.

It is also dangerous to rank 10-20 in sales, and the threshold is more than one billion yuan.
It is more likely to enter the key monitoring catalog
.
The product characteristics and clinical application status have their particularities, and there is still some room for operation
.

Drugs ranked 20-30 in sales are the most promising not to enter the key monitoring list.
This part of the company is also the hardest.
This part is whether the medicine can be imported or not.
It seems that reasonable use can be ensured through expert argumentation
.

Time is running out, and companies need to work hard to start this life-and-death battle against time
.

Reference materials:

1.
The Beijing News focuses on monitoring "expansion".
These types of drugs are being targeted.
Are relevant companies ready?

2.
Notice of the General Office of the National Health Commission on Printing and Distributing the Working Regulations of the National Key Monitoring and Rational Use Drug Catalogue Adjustments

3.
IQVIA Ai Kunwei, heavyweight! IQVIA Release: A Review of China's Hospital Medicine Market in 2020

4.
Li Chunyan, Zhang Jie, Wang Xiaohui, Luo Yinni.
Investigation and analysis of the application of proton pump inhibitors in 3005 inpatients[J].
Evaluation and Analysis of Medication in Chinese Hospitals,2017,17(03):406-409.

5.
Li Yingmei, Li Jinchao, Lai Baolong, Wang Liqing.
Analysis on the rationality of 1944 parenteral nutrition prescriptions[J].
Evaluation and Analysis of Drug Use in Chinese Hospitals,2020,20(06):712-715.