China's fourth round of national centralized drug procurement has begun, according to Jinfu Chen, deputy head of the National Healthcare Security Administration (NHSA) in Beijing on Jan. 29, 2021. This time five new diabetes medications are included in the procurement list. They are empagliflozin, canagliflozin, repaglinide, nateglinide, and gliclazide.
China launched the centralized procurement pilot program in April 2019 and made the first round in December of the same year. The Joint Procurement Office has published four procurement lists so far, with a total of 159 medicines, including 11 antidiabetic drugs.
Details of the diabetes drugs newly included in the fourth round of procurement 1
Drug name | Mechanism | Relevant companies | Type |
Gliclazide | Sulfonylurea | Beijing Fuyuan Pharmaceutical Co., Ltd | Approved through supplementary application for the consistency evaluation |
Yichang Humanwell Pharmaceutical Co., Ltd | Approved through supplementary application for the consistency evaluation | ||
Servier (Tianjin) Pharmaceutical Co., Ltd | Reference list drug locally produced by the originator | ||
Nateglinide | Sodium/glucose cotransporter 2 (SGLT-2) inhibitor | Zhuhai Tongyi Pharmaceutical Co., Ltd | New registration of generic drugs |
Jiangsu Deyuan Pharmaceutical Co., Ltd | Approved through supplementary application for the consistency evaluation | ||
Beijing Novartis Pharma Co., Ltd | Reference list drug locally produced by the originator | ||
Repaglinide | Meglitinide | Beijing Fuyuan Pharmaceutical Co., Ltd | Approved through supplementary application for the consistency evaluation |
Jiangsu Hansoh Pharmaceutical Group Co., Ltd | Approved through supplementary application for the consistency evaluation | ||
Empagliflozin | SGLT-2 inhibitor | Sichuan Kelun Pharmaceutical Co., Ltd. | New registration of generic drugs |
Jiangsu Hansoh Pharmaceutical Group Co., Ltd | New registration of generic drugs | ||
Boehringer-Ingelheim | Imported brand-name drugs | ||
Canagliflozin | SGLT-2 inhibitor | Chia Tai Tianqing Pharmaceutical Group Co., Ltd. | New registration of generic drugs |
Jiangsu Hansoh Pharmaceutical Group Co., Ltd | New registration of generic drugs | ||
Janssen Pharmaceuticals | Imported brand-name drugs |
Note: The Document on National Centralized Drug Procurement2 says four types of drugs are allowed to submit applications for supplying drugs in the procurement. They are
(1) Brand-name drugs and reference listed drugs (RLD) that have been approved by National Medical Products Administration (NMPA).
(2) Generic drugs that passed NMPA's consistency evaluation of the quality and efficacy of generic medicines.
(3) Generic drugs that were registered under the new classification system for registration of chemical drugs according to NMPA's No. 51 Announcement on the Classification System Reform in 2016.
(4) Drugs that are included in the Catalogue of Medications that Have Accessed Chinese Market.
Joining the centralized procurement list is arduous
The total number of diabetics in China has reached 129.8 million3, says the latest large-scale epidemiological investigation on diabetes. Some diabetic drugs thus have already sold a lot due to the large amount of patients. Gliclazide's 2019 sales volume in the country's public healthcare institution terminals exceeded one billion yuan. The incidence of diabetes will continue to rise with an aging population. The Chinese diabetes market scale will reach 116.7 billion yuan by 2023.4
Facing such a huge market, more and more companies bid to provide medicines in the centralized drug-procurement program to increase sales. Nevertheless, the procurement usually sees a substantial drop in prices. For example, the antidiabetic drug gliclazide's bid price was cut to 0.5057 yuan for each 0.5 mg tablet in the fourth round of procurement. 5
Moreover, the competition for bids is also fierce. In the third round of centralized procurement in July 2020, forty-four pharmaceutical firms bid to supply metformin hydrochloride (HCL). The average bid price for a 0.5mg metformin HCL tablet came down to only 0.06 yuan. In the second round of procurement in Dec. 2019, Bayer AG defeated Huadong Medicine in the tender of Acarbose with a bid price of 0.18 yuan per tablet; Glimepiride's bid was cut by 96%, prompting Sanofi, the drug's original developer, to abandon its bid.
With favorable policies and increasing demands, China's diabetes treatment market is going to boom and will continue attracting more companies from home and abroad to join in the competition. BaiPharm has also noticed some local governments like Wuhan Pharmaceutical and Equipment Joint Procurement Office included insulin in the city's procurement list in May last year. It implies that insulin is much likely to enter the national procurement list soon. 6
