2023-01-08 00:04:01

On the third day of the medical insurance negotiat

On the third day of the medical insurance negotiation, Pfizer talked for more than four hours (Photo source: Qu Yixian/photographer)

On January 7, Qu Yixian, a reporter from Economic Observer Network, the delayed national medical insurance negotiations due to the COVID-19 were carried out to the third day, and the highlights were staged. Several blockbuster products in the field of cancer and rare diseases were negotiated. The high-profile Pfizer COVID-19 drug Paxlovid might end the negotiations in the morning.

Economic Observer Network saw at the negotiation site that Qian Yun, vice president of Pfizer Global Biopharmaceutical Business Group in China and head of market access, entered the negotiation infield at 8:30 a.m. and did not leave the negotiation infield until 1:20 p.m., which was close to the entrance time of enterprises in the afternoon. The negotiation time for each drug stipulated by the Medical Insurance Bureau is half an hour.

The morning session officially started at 9 o'clock. According to this calculation, Pfizer talked for more than 4 hours today.

In terms of enterprise negotiators on the 7th, Yin Min, the chief commercial officer of Greater China, led the team of Baekje Shenzhou (06160. HK/688235. SH), and Wu Xiaobin, the president, chief operating officer and general manager of China of Baekje Shenzhou, was also sitting outside the venue in casual clothes; Ou Silang, global vice president and general manager of Alberville China, Zhu Ning, head of China market access and commercial operation of GlaxoSmithKline, and Wan Jiang, senior vice president and chief operating officer of Beida Pharmaceutical (300558. SZ) all entered the negotiation.

Economic Observer also learned that if the negotiation is successful, the enterprise needs to take the agreement back to the company for a series of processes such as stamping, and then return the formal agreement with the official seal to the medical insurance bureau. This time, the medical insurance bureau only gave enterprises 3 days to complete this process, while in previous years, this process took 7 days.

A number of business people speculated that the medical insurance bureau would speed up its progress and perhaps want to announce the results of the negotiations and release a new version of the medical insurance catalog before the Spring Festival.

Pfizer P or the negotiation ends

In this medical insurance negotiation, the most concerned drug is undoubtedly Pfizer COVID-19 Paxlovid.

Including Paxlovid, Pfizer has seven products in the medical insurance negotiation this year. Qian Yun appeared at the negotiation site on the afternoon of the 6th. However, according to industry news, Paxlovid negotiated in the morning of the 7th.

Unlike other enterprises, Qian Yun walked out of the negotiation site alone at more than 1 p.m.

Paxlovid was approved in China in February 2022 and will be used in the epidemic situation in Shanghai in March 2022. By the end of 2022, with the great change in the situation of epidemic prevention and control, Paxlovid, like domestic Azovudine, will quickly become the COVID-19 oral drug of public concern.

It is understood that Azovdin also participated in the medical insurance negotiation this time, and the indication in question is the treatment of AIDS. Since COVID-19's indication was approved in late July 2022, after the time window of this medical insurance negotiation, COVID-19's indication did not enter this medical insurance negotiation.

Coincidentally, on the evening of January 6, the Office of the National Health Insurance Bureau issued the Notice on the Guidelines for the Price Formation of COVID-19 Therapeutic Drugs (Trial), which provides a system framework for the supervision of the price of COVID-19 drugs.

According to the above notice, Paxlovid and other COVID-19 therapeutic drugs approved before January 1, 2023 should take the initiative to re evaluate and dynamically adjust their prices, and COVID-19 therapeutic drugs approved after January 1, 2023 should be quoted for the first time according to the guidance of the above notice.

Back to Paxlovid, in the early days, its online price in various places was 2300 yuan/box, and one box is a total of 5 days of treatment. On December 28, Paxlovid's online price was lowered to 1890 yuan/box in some places. On December 30, MSD COVID-19 oral drug Monoclavir capsule was approved by the State Food and Drug Administration under emergency conditions, and the first batch of Monoclavir was delivered to the warehouse of Waigaoqiao Free Trade Zone on January 4.

The industry generally believes that the approval of Monovir has accelerated the price reduction of Paxlovid. In addition, the approval of COVID-19 drug Ensetvir of Yanno, Japan, and 3CL protease COVID-19 drug of Pioneer Pharmaceutical are also imminent, which also brings price pressure to Paxlovid.

On the second day of the medical insurance negotiation on January 6, the industry heard that the price of Paxlovid after the medical insurance negotiation would be reduced to 700 yuan/box.

In fact, Paxlovid has strict indications for the treatment of adults with mild to moderate novel coronavirus pneumonia who have progressed to severe high-risk factors, such as patients with advanced age, chronic kidney disease, diabetes, cardiovascular disease, chronic lung disease and other severe high-risk factors. In practice, the drug is usually used within 5 days after symptoms appear. In other words, the drug is used to prevent the transfer to severe and critical diseases, not to treat them.

According to the confidentiality agreement signed between the Medical Insurance Bureau and the enterprises participating in the negotiation, the enterprise shall not disclose the negotiation results and the negotiated price and other details before the announcement of the results. Therefore, whether Paxlovid has successfully negotiated and if so, what the negotiated price is has not been known.

Other blockbuster drugs

The only CAR-T drug that was shortlisted in the preliminary review list in this medical insurance negotiation is the Regiolenze injection of Mingjunuo, and the Aquilenze injection of Fosun Kate is not on the list that passed the preliminary form review.

However, the published price of Regeolencel injection is 129 yuan/needle, slightly higher than the price of Aquilence injection of 120 yuan/needle. At the end of the medical insurance negotiation in November 2021, the National Medical Insurance Bureau came forward and said that Aquilence injection only passed the formal review and did not enter the medical insurance negotiation.

Therefore, it is still unknown whether Riceolencel injection will appear on the scene of medical insurance negotiation this year. However, because the National Medical Insurance Bureau has the unspoken rule of "not talking about more than 500000, not entering more than 300000", and the preparation process of CAR-T is extremely complex, the cost is very high, so it is very difficult for CAR-T to enter medical insurance.

PD-1/L1 is still the focus of attention every year. The PD-1 of "Four Little Dragons" Hengrui Medicine (600276. SH), Baekje Shenzhou, Xinda Biology (01801. HK) and Junshi Biology (01877. HK/688180. SH), which were previously listed in the medical insurance list, are all facing negotiations on new indications this year, and all have major indications.

The new entrants also include Slulimab from Fuhong Hanlin, and Envolimab from Corning Jerry/Thinkdi/Xiansheng Pharmaceutical.

With the competition of various enterprises and the price pressure brought by the medical insurance negotiation, including those not included in the catalog, most PD-1 prices are currently between 30000 yuan and 50000 yuan. The Economic Observer Network has learned that there are PD-1 new entrants who are not prepared to significantly reduce the price, because the original price is also very low, and the actual sales are not affected by the lack of access to medical insurance.

In terms of drug use for rare diseases, Takeda Pharmaceutical's hereditary angioedema drug Lanarizumab, and drug injection verasidase for Gaucher disease α, Sanofi in the treatment of mucopolysaccharide storage disease: concentrated laronidase solution for injection, and veradinase for injection in the treatment of Gaucher disease α Both passed the preliminary formal examination.

However, according to the Economic Observer Network, many of the above rare disease products were also unable to be put on the negotiation table due to the hidden rule of "no discussion if more than 500000, no entry if more than 300000".