Antidiabetic Drugs are About to Enter the Price Storm

The fourth batch of centralized procurement of drugs is expected to be officially launched around February 2021.

While covering diabetes, hypertension, respiratory disease, psychotherapy, cancer, fungal infections, anesthesia pain, eye drops, and other drug areas, this centralized procurement mainly focuses on oral products, along with eight injection products. It is noteworthy that the fourth batch of centralized procurement includes various antidiabetic drugs, like empagliflozin, canagliflozin, repaglinide, nateglinide, and gliclazide.

Empagliflozin and canagliflozin are SGLT-2 inhibitors, which original drug patent holders are Boehringer Ingelheim and Janssen Pharmaceutica, respectively. Domestically, four generic drugs of SGLT-2 inhibitors are approved by China NMPA: Hansoh Pharmaceutical Group Co. and Kelun Pharmaceutical Co.—have their generic empagliflozin approved, while Hansoh Pharmaceutical Group Co. and Chia Tai-Tianqing Pharmaceutical Co. are approved for canagliflozin. Up to the end of 2018, the domestic market share of SGLT-2 inhibitor is only 0.2% of whole antidiabetic drugs market, which still has room for increase, compared to the 10% market share overseas.

In addition to SGLT-2 inhibitors, the centralized procurement will also include gliclazide sustained-release tablets which belong to the sulfonylurea class of insulin secretagogues. In 2019, their sales exceeded ¥1 billion in the Chinese governmental medical institution terminal.

Antidiabetic drugs also appeared in the previous batches of centralized procurement, including metformin, glimepiride, acarbose, and so on. Antidiabetic drugs selected in the centralized procurement face fierce competition among enterprises, resulting in large price reductions. For example, in the third batch of centralized procurement, the metformin hydrochloride tablets, involved in more than 40 pharmaceutical companies, have an average price of ¥6 cents per tablet of 0.5g. After the price reduction, single patient’s monthly spending on metformin hydrochloride is even less than ¥7, approximately 4% of the original expense. In the second batch of centralized procurement, the originally developer Bayer AG wins the tender of Acarbose at a very low price of ¥0.18, outperforming Huadong Medicine Co. Besides, in this batch of centralized procurement, Glimepiride tablets have the largest price reduction as much as 96%, enabling Sanofi to give up offering prices. The fourth batch of centralized procurement includes five antidiabetic drugs. Referring to the previous price decline in related products, a large price reduction is expected to take place again this time.

China, as the most populous country in the world, has seen a sharp rise in the prevalence of diabetes in recent years. So the incorporation of antidiabetic drugs in centralized procurement is beneficial for local medical insurance cost control.

In addition, it’s predicted by pharmaceutical industry that insulin will be included in the centralized procurement nationwide in 2021, no later than the end of the year.

Antidiabetic Drugs are About to Enter the Price Storm
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