On November 18, at the 44th China Pharmaceutical Industry Development Summit Forum, Geng Hongwu, executive deputy director of the Medical and Health Research Center of the Tsinghua University Association of Senior Scientists, pointed out that the basic ideas of my country's medical insurance drug price management at this stage mainly include: management scope, quality-price matching, reasonable price difference, medical insurance guidance, strict supervision, etc. "Exerting the effectiveness of drug price governance" is one of the key tasks of the National Medical Insurance Administration this year. That is, to promote special governance of online drug prices, explore new mechanisms for drug price formation, and increase the disclosure of price procurement credit evaluation.

Recently, the Shanxi Provincial Drug and Equipment Centralized Bidding and Procurement Center issued the "Notice on the Adjustment and Disposal of the Centralized Procurement Prices of Amoxicillin and Other Drugs of the Guangdong Alliance". The relevant companies of 20 specifications refused to accept the price rectification requirements of Guangdong Province. Shanxi Province will cancel the qualification and price of the relevant drugs and transfer them to the alternative catalog. The platform will increase price risk warnings. At the same time, the task volume of the centralized procurement agreement for related drugs of medical institutions will be cancelled. According to the requirements of Shanxi Province, medical institutions give priority to purchasing other selected products with lower prices under the same generic name. Earlier, Shanxi Province issued the "Notice on the Announcement of the Results of the Centralized Work on Linking the Prices of Online Drugs", which cancelled the listing of 35 drugs and gave credit ratings to related companies.

In addition to Shanxi Province, the Guangzhou Public Resources Trading Center also announced that some companies refused to confirm the price information within the required time for confirming the price information of online drugs, and 59 drugs were suspended from listing. The above experts said that some companies chose to refuse to adjust the online prices of drugs, which is their strategy for development in the area. Although they lost some markets, they focused more on developing other markets. However, some pharmaceutical companies "had to do it". Considering the cost of some drugs, price cuts may have a greater impact on their own profits.

In the second half of 2023, a "Notice on Implementing Information Interconnection and Promoting the Governance of Online Drug Prices" circulated in the industry, and the national drug price governance kicked off. In order to eliminate unfair and discriminatory high prices for drugs with the same generic name, manufacturer, dosage form and specification in various provinces, the National Medical Insurance Administration has issued the "Notice on Promoting Fair, Honest, Transparent and Balanced Prices of Drugs with the Same Generic Name and Brand" since the beginning of this year, requiring all localities to compare local online prices with monitoring results by the end of March 2024, investigate and find abnormal values that significantly deviate from the monitoring results, and urge companies to correct unfair high prices. The tide of drug price governance has risen. Recently, the National Medical Insurance Administration has deployed provincial medical insurance bureaus to guide the coordinated regions to speed up the construction of designated pharmacies. The public comparison program or module for medical insurance drugs provides services such as price comparison and location navigation of designated drugs, and further guides retail pharmacies to improve the standardization of drug pricing.

Geng Hongwu believes that the trend of drug governance at this stage has shifted from within the enterprise to between enterprises; policy guidance, local governments first; online prices to full terminal prices. The pharmaceutical industry has "unified the market" prices and formed a new situation of "one game": first, a unified platform, using classification codes and medical insurance codes; second, normalization of volume-based procurement and price monitoring; third, continuous advancement of price governance in depth and breadth; fourth, inter-provincial price comparison and linkage adjustment of online prices; fifth, establishment of a price integrity mechanism to improve the credit evaluation system.

Specifically, methods such as "public price comparison + index monitoring" and "public price comparison + price reminder" are being piloted in various provinces. Provinces represented by Jiangsu and Shanghai have begun to publish drug price warnings and lists of publicly negotiated procurement supervision varieties every month. Shanghai has included 17 drugs in the key monitoring list in order of drug purchase amount; Jiangsu has named more than 1,400 drugs that triggered warnings. Jiangsu and Shanghai have imposed restrictions on the use of some named drugs on the basis of reminding the online prices of drugs. The above-mentioned experts in pharmaceutical marketing and management believe that the regular publication of the key monitoring list prevents the occurrence of commercial bribery while adjusting drug prices.

The local drug price adjustment methods are different, and measures such as price linkage, centralized procurement drug price management, drug price supervision and punishment are constantly being taken.
In order to ensure reasonable drug prices, many provinces have compared the prices of drugs listed in the province with those in other provinces through the price linkage mechanism; classified and managed drugs that have been listed and those that have not been listed, and required enterprises to declare according to the lowest effective listing price in the country.

For example, Hunan Province issued the "Notice on Carrying out the Inter-provincial Drug Price Linkage and Listing in 2024", requiring the price linkage of drugs that have been listed and those that have not been listed, and the average price of different online and offline platforms for newly listed products to be filled in as a linkage reference. In addition, all regions have unified and standardized the prices of drugs selected in the centralized procurement; and adjusted the prices of non-selected drugs to ensure that they maintain a reasonable gap with the prices of selected drugs.

For example, Shanxi Province issued the "Notice on the Special Adjustment of Listing Prices in Non-Supply Provinces of Nationally Organized Centralized Procurement Drugs", requiring the centralized procurement selected price to be used as the price anchor, and the listing price in non-supply provinces to be reduced to no more than 1.5 times the selected price. Not only that, according to incomplete statistics, Jiangsu, Tianjin, Zhejiang, Guangdong, Sichuan, Henan, Hainan and other places have adjusted the prices of national procurement products, and the number of drugs that need price adjustment has reached more than 2,000. The price supervision and management of online drugs continues to be strengthened. For companies that do not cooperate with price reductions or engage in price fraud, they will directly face penalties such as credit deductions or suspension of online qualifications.

Geng Hongwu pointed out at the 44th China Pharmaceutical Industry Development Summit Forum that pharmaceutical companies need to deal with drug price governance from many aspects at this stage, such as re-examining and adjusting corporate pricing strategies, strengthening channel construction and process management, optimizing corporate supply chain management, strengthening market monitoring and tracking policy changes, participating in centralized procurement and medical insurance negotiations with high quality, and improving drug quality and brand influence.

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