1. [para. 1][para. 2] A record ten brand-name drugs won bids in China's 12th round of national centralized volume-based procurement (VBP), marking a notable shift in a program that multinational pharmaceutical companies have historically shunned due to steep price cuts. The round granted winning status to 521 products from 327 companies, covering treatments for infections, tumors, thrombosis, diabetes, and hypertension.
2. [para. 3][para. 5] Historically, the 10th round saw zero originator drugs selected, and the 11th only two. In this round, 27 originator products entered, and 10 won, including Novartis's sacubitril/valsartan, Bayer's iopromide, Eisai's betahistine, Abbott's dydrogesterone, and Guangzhou Green Cross's compound amino acid. Novartis and Bayer each hold over 90% of their market share for these respective generic names.
3. [para. 6] The high success rate of originator drugs is tied to a "revival mechanism" introduced in the rules. The mechanism was explicitly expanded to include originator drugs this time, offering a second chance to bid, and all 10 winners secured their spots through it.
4. [para. 4][para. 7][para. 8] Under pressure from health insurance payment reforms and the centralized procurement system, the accessibility of originator drugs has been widely discussed, prompting institutional adjustments. The NHSA stated the program allows brand-specific volume needs, letting originator drugs enter with smaller price cuts. Zhao Heng of Latitude Health noted entering the list shields them from restrictive pricing measures like red- and yellow-label warnings.
5. [para. 9][para. 10][para. 11] Financial institutions offered procurement loans at the bidding session. Exact price cuts are undisclosed but further reductions appear inevitable. Shanghai piloted a fixed-rate reimbursement system requiring patients to pay out-of-pocket above the standard. Zhao argued rising expenses will cause patients to switch to cheaper alternatives, challenging the high-price model, and cited Germany’s reference system which drastically compressed the market.
6. [para. 12][para. 13][para. 14] In the Shanghai pilot, only about 20% of patients continued using non-winning originator drugs. Sales of pravastatin sodium fell by 84%. Zhao predicted inevitable price cuts if rolled out nationally. The article notes that price is only one factor; improving patient access ultimately depends on relaxing subsequent clinical performance assessments.
7. [para. 15][para. 16] A Shanghai doctor stated that doctors must prioritize fulfilling volume quotas for procured drugs, leaving no room for originator drugs. Patients specifically requesting them are directed to outside pharmacies. Peking University People’s Hospital established a dedicated originator-drug window at an external pharmacy to ease hospital quota pressure.
8. [para. 17] Looking ahead, a health insurance expert predicted future DRG payment systems will likely establish a separate payment-exemption list covering both essential insurance medications and self-funded drugs.
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