Source | Minai.com (authorized reprint by Cyberland)
Written by Dr. Zhang Ziran
TOP20 The brand structure has changed so much that it has subverted the traditional concepts of marketing and R&D projects. In 2017, five traditional Chinese medicine injections among the top 20 brands in the three major terminals and six major markets (see definition at the end of the article) gave way to biological drugs.
In 2021, the total sales of the TOP20 brands will be 100.2 billion yuan, accounting for 5.6% of the total sales nationwide. Among them, AstraZeneca has 3 ( Pulmicar, Tagrisso, 3.8 billion), Bayer ( Bayer, Xarelto 4.9 billion), Pfizer (Lipitor 5.9 billion, Suprashen 4.4 billion) and Yangtze River ( Dezocine 7.1 billion, Dexmedetomidine 4 billion) each have 2, large varieties have been achieved. Large enterprises need to be supported by large varieties (Figure 1).
01 Scale: Garonine is the largest
In 2021, the brand with the largest sales was Yangzijiang’s Dezocine Injection (Garonine), which sold 7.1 billion yuan (Figure 1), a year-on-year increase of 9.7%, and continued to retain the championship.
There are also 4 products with more than 6 billion yuan, namely human albumin (Jetbelin), insulin aspart 30 injection ( Novo Nordisk 's NovoRapid), nifedipine controlled-release tablets (Bayer's Baixintong) and injectable trastuzumab (Roche's Herceptin) were sold for 6.7 billion yuan, 6.3 billion yuan, 6.2 billion yuan and 6 billion yuan respectively, an increase of 22% and 6 billion respectively year-on-year. 0.6%, 19% and 3%.
Except for nifedipine controlled-release tablets (Baixintong), the other three products are all biological drugs.
In 2021, the fastest growing year-on-year growth among the TOP20 brands is Qilu’s bevacizumab injection (Anchor), mainly as the biosimilar replaces the original drug Roche Avastin in the market and replaces Avastin ranks in the TOP20 and has become a model for biosimilar drugs to replace original drugs.
There are three products with a growth rate of more than 20%, namely, the two imported human albumins of Octopamax and Jetbelin and Bayer's Rivaroxaban tablets (Xarelto), with a growth rate of 29 respectively. %, 22% and 21%.
All TOP20 brands have achieved positive growth. In 2020, the sales base was low due to the impact of the epidemic.
2
Traditional Chinese medicine injections: giving way to biological drugs
In 2017, there were 5 traditional Chinese medicine injections in the TOP20, and all of them were eliminated in the TOP20 in 2021 (Figure 2). Instead, there are 6 biological drugs, namely , trastuzumab (Roche’s Herceptin), bevacizumab (Qilu’s Enda), 2 monoclonal antibodies, Jetbelin and Octavia Mar's 2 albumin , and recombinant human growth hormone injection (Changchun Jinsai) and recombinant human thrombopoietin (Shenyang Sansheng's TPIAO). Insulin, which is also a biological drug, has not changed. There are two insulins in the TOP20 over the years.
2 monoclonal antibodies are on the list, reflecting the upgrading of pharmaceutical technology and the rise of domestic biosimilars, one of the results of the great wave of medical innovation in recent years. Two proteins are on the list because there are no specific drugs for prevention by improving one's own immunity. COVID-19 demands. Recombinant Human Growth Hormone Injection (Changchun Jinsai) is on the list because, except for the first injection, which must be prescribed by the hospital, the rest can be sold outside the hospital, thus avoiding the heavy impact of medical insurance fee controls. Recombinant human thrombopoietin (TPIAO from Shenyang Sansheng) was included in medical insurance through negotiation in 2020, achieving a price-for-volume exchange.
In fact, the TOP20 did not directly clear out traditional Chinese medicine injections, but went through a process. From 2017 to 2021, the number of traditional Chinese medicine injections in the TOP20 brands in descending order was 5, 3, 2, 1, and 0. , On the contrary, biological drugs are listed from few to many, with 2, 4, 6, 9 and 8 being on the list respectively from 2017 to 2021.
The vacancies vacated by traditional Chinese medicine injections in the TOP20 were not given to oral traditional Chinese medicines or chemical drugs, but were replaced by biological drugs.
Traditional Chinese medicine injections were off the list due to the widespread penetration of the concept of auxiliary medication. The rise of biological drugs reflects the progress of pharmaceutical technology and the achievements of domestic innovation.
03 Imported drugs: increased by half
The number of imported drugs in the TOP20 increased from 8 in 2017 (Figure 2) to 12 in 2021 (Figure 1), an increase of half. One illustrates the optimization of the domestic drug structure, consisting of " The upgrade from "non-therapeutic" to "therapeutic" and from small molecule chemical drugs to large molecule biological drugs shows that it will take time for domestically produced original drugs to replace imported original drugs. With the encouragement of domestic policies and the blessing of capital, the R&D strength of local pharmaceutical companies has continued to improve. Improvement, domestic substitution is accelerating.
In recent years, the market share of imported drugs in hospitals has continued to increase, from 26% in 2017 to 28.6% in the first quarter of 2022, an increase of 2.6 percentage points in more than four years. Mainly due to the widespread penetration of non-therapeutic concepts, in addition to the market vacated by traditional Chinese medicine injections, the market for varieties included in the national and local versions of the key monitoring and rational drug use catalogs has also given way to more "therapeutic" drugs. Imported medicines.
04
4 varieties have fallen out of the TOP20 list in 2021, including 3 biological drugs and 1 traditional Chinese medicine injection.
The three biological drugs that fell off the list are Roche’s bevacizumab (Avastin) and rituximab (rituximab), and Hengrui’s PD-1 (camrelizumab, Erica).
Bevacizumab injection (Avastin, Roche)
Bevacizumab injection (Avastin, Roche) After three medical insurance negotiations from 2017 to 2019, the price increased from the median winning price before the negotiation to 5,253 yuan /branch has dropped to 1998 yuan, 1934 yuan and 1500 yuan /branch, a 71% reduction. Later, due to the expiration of the patent, it was sold out by Qilu (Anchor), Xinda ( Dayoutong ), Luye and Hengrui Domestic bevacizumab biosimilars are aggressively carving up the market.
Rituximab injection ( Rituximab , Roche)
Rituximab injection (Rituxan, Roche) is an original drug, and a considerable part of its market is occupied by Hanlikan (Fuhong Henlius) and Dabohua (Innovent) has been replaced by two rituximab biosimilar drugs. In 2020, Henlius's Hanlikang's in-hospital sales were nearly 2.7 billion yuan. In 2021, rituximab injection was included in the Guangdong centralized purchasing. It is also the first biological drug to be included in the centralized purchasing. After the centralized purchasing significantly reduces its price, its sales will further decline.
Among Roche’s troika, Avastin and Rituximab have both fallen off the list, leaving only Herceptin still in the TOP20.
Camrelizumab for injection (PD-1, Hengrui)
Although Camrelizumab for injection (PD-1, Hengrui) quickly surpassed the two imported PD-1 (K drugs) as soon as it was launched. , O drugs), and ranked among the TOP20 list in 2020. However, due to two consecutive medical insurance negotiations, substantial price reductions and Cinda (Cindili), Junshi (Tuoyi), BeiGene ( Baiji) Ze'an ) and many other domestic PD-1 divided the market and fell out of the TOP20 in 2021.
In 2021, Yangzijiang’s dexmedetomidine hydrochloride injection sold for 4 billion yuan, an increase of 12% year-on-year, and has been ranked in the TOP20 for two consecutive years. In 2018, before the first batch of national procurement, its sales were less than 10 million. During the 4+7 national procurement pilot in 2018, it exclusively won the bid with a slight drop of less than 12% and a high price of 133 yuan/bottle. The 4+7 expansion There was no need to lower the price during the siege to continue to win the exclusive bid. In less than two years, it almost skyrocketed from 0 to 3.5 billion yuan, and further increased to 4 billion yuan in 2021. This should be the most beneficial variety from the national harvest. At present, dexmedetomidine hydrochloride injection has been reviewed by more than 10 companies such as Hengrui, Enhua, and Kelun. The price has also dropped from the winning bid price of 133 yuan/tube for the first batch of national procurement to the Hubei renewal price. The renewal price in Shandong is 8.5 yuan/piece and Shandong renewal price is 4 yuan/piece, a decrease of 97%. The glory has become history, but the national classic created by Yangzijiang Dexmedetomidine Hydrochloride Injection will never be forgotten. TOP20 The dramatic change in brand structure is a true reflection of the implementation of the policy of controlling medical insurance fees and vacating the cage for birds. The concept of auxiliary medication continues to ferment, and the development of biopharmaceuticals accelerates. It has important reference significance for marketing product selection, corporate R&D project establishment, investment and merger valuation, and even corporate transformation and upgrading. In the past, the traditional marketing model and R&D project establishment concept that relied on promotion to increase sales has been subverted. Clinical value-oriented, meeting unmet clinical needs and taking into account the ability to pay for medical insurance are the directions for future marketing and R&D project establishment. . Note: ① The sales in this article are calculated based on the retail prices of the three major terminals and six major markets, which are different from the concept of sales revenue based on sales invoices disclosed by each company. ②Three major terminals and six major markets ( meter network definition): urban public hospitals, county-level public hospitals, urban community health centers/stations, township health centers, urban physical pharmacies and online pharmacies. Excludes private hospitals, village clinics and private clinics. 05 was included in the list due to national procurement
