A detailed explanation of China’s centralized drug procurement policy: Why are imported drugs being withdrawn from public hospitals?
In recent years, China's centralized drug procurement ( abbreviated as " centralized procurement " ) policy has become a hot topic in the pharmaceutical industry . Since its launch in 2018 , the implementation of centralized procurement has brought about tremendous market changes , especially for foreign-funded original research pharmaceutical companies . Why are more and more imported drugs gradually withdrawing from Chinese public hospitals? What are the underlying reasons behind this ? How should patients respond ? This article will analyze these issues in depth based on actual cases .
I. The original intention and core objectives of the centralized procurement policy
The core goal of China's drug centralized procurement policy is to " lower prices, improve quality , and benefit the people . " Through unified regulation and volume-based procurement , the government hopes to achieve " small profits but quick turnover, " which will both reduce the burden on patients and regulate the drug market order.
Actual case: Drug prices dropped significantly
In the third round of centralized procurement, the price of Pfizer 's " Lipitor " (atorvastatin calcium tablets ) dropped from 100 yuan to less than 10 yuan, a drop of 90% . This result allowed patients to use affordable lipid-lowering drugs , but it also led to a significant reduction in Pfizer's market investment in the drug .
The three core features of the centralized procurement policy are:
- Volume-based procurement : By exchanging quantity for price, drug prices can be significantly reduced , allowing patients to obtain drugs of the same quality at a lower cost .
- Reduce costs: Through the scale effect of centralized procurement , the costs of intermediate links are reduced , providing guarantees for the sustainability of medical insurance funds .
- Universal access to medicines : Ensure that the drugs selected for centralized procurement are popularized nationwide and improve the accessibility of medicines .
2. Reasons behind the withdrawal of imported drugs from public hospitals
Although the centralized procurement policy brings significant price advantages , its impact on imported drugs cannot be ignored .
The following are the main reasons why imported drugs are gradually withdrawn from public hospitals:
1. Excessive price pressure
The core competitiveness of centralized procurement lies in price. However, the R&D costs of foreign-funded original drugs are relatively high , making it difficult for them to compete with domestic generic drugs in terms of price .
Actual case: Pfizer's azithromycin withdraws from the mainstream market Pfizer 's azithromycin is the first choice for treating mycoplasma pneumonia in children and has long dominated the market . However, in the centralized procurement, its price reduction failed to match that of domestic generic drugs , and it was eventually withdrawn from the centralized procurement list , resulting in almost no drugs available in public hospitals .
2. Market space is compressed
The centralized purchasing policy focuses hospitals’ purchasing efforts on selected drugs, and other unselected drugs have almost lost their market space in public hospitals .
Actual case: Xeloda was replaced by generic drugs Roche 's " Xeloda " (capecitabine ) was once the standard treatment for colorectal cancer patients , but after its patent expired , a large number of domestic generic drugs entered the market at lower prices . Although the generic drugs passed the consistency evaluation , patients reported an increase in gastrointestinal side effects and a poor treatment experience .
3. Global strategic adjustment
Faced with the pressure of centralized procurement in the Chinese market , many multinational pharmaceutical companies have chosen to readjust their global strategies .
Actual case: Eli Lilly's "Zestad " withdraws from China Eli Lilly's " Zestad " ( atomoxetine hydrochloride) is a drug used to treat attention deficit hyperactivity disorder ( ADHD ) . In 2024 , Eli Lilly announced its withdrawal from the Chinese market due to adjustments in its business strategy . Patients can only turn to domestically produced generic drugs , but many parents report that the efficacy of the drugs is not stable enough and even has more side effects.
3. Profound impact on patients and the market
1. Patients ’ right to choose is limited
The implementation of the centralized purchasing policy has limited patients’ medication options , especially within the public hospital system.
Actual case: Merck's " Janovi " withdrawal Merck 's diabetes drug " Janovi " (sitagliptin phosphate) was not selected in the centralized procurement , resulting in many patients being unable to obtain the drug through medical insurance channels and having to buy cheaper generic drugs instead . Some patients reported that the blood sugar control effect of generic drugs was not as good as expected .
2. Market restructuring and localization trends
As imported drugs gradually withdraw, domestic pharmaceutical companies have been able to rise rapidly.
Actual case: Hengrui's generic drugs replaced many of Hengrui Medicine 's generic drugs and quickly occupied the market after passing the consistency evaluation , becoming the preferred supplier of public hospitals , but some patients still have doubts about the efficacy and safety.
3. Implications for innovative drugs
For innovative pharmaceutical companies that have not yet entered the Chinese market, the centralized procurement policy is undoubtedly a wake - up call .
Actual case: Roche 's " Herceptin " strategy Roche 's breast cancer drug " Herceptin " adopted a high-price strategy during the patent protection period, and chose to withdraw from centralized procurement after the patent expired , leaving the market to domestic generic drugs .
IV. Future Challenges and Opportunities
The centralized procurement policy is a " double-edged sword " . It has played an indispensable role in reducing drug prices and improving the efficiency of medical insurance funds , but it has also caused problems such as reduced patient choice and reduced market diversity .
- Optimize the pricing mechanism : Set more reasonable price evaluation standards for high- value drugs to avoid “ one-size-fits-all ” price cuts.
- Support innovative research and development : Through policy support and market incentives, encourage domestic pharmaceutical companies to make efforts in the field of high-end innovative drugs .
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Enhance patient education: Improve public acceptance of generic drugs and help patients better understand the differences between generic drugs and original drugs .
Conclusion : How to deal with the withdrawal of imported drugs ?
For ordinary patients , the withdrawal of imported drugs does not mean that there are no drugs available, but they need to find suitable alternatives under the guidance of doctors . At the same time, with the continuous progress of domestic pharmaceutical companies , we have reason to believe that in the future there will be more high-quality and low-cost domestic drugs to meet the needs of the majority of patients.
For example, when purchasing antibiotics , patients can choose domestic generic drugs recommended by doctors and make choices based on real- world clinical data . For patients with special needs, they can pay attention to legal and compliant personal imported drug channels .
The impact of the centralized procurement policy continues to emerge . Patients, pharmaceutical companies and policymakers all need to find a new balance in this complex environment and jointly promote the high-quality development of China's medical system .
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