最高降幅95%！第四批藥品帶量採購競標新出爐
今日，第四批國家藥品集中帶量採購在上海開標，共涉及45個品種、80個品規。
此次集採首次納入注射劑臨牀大品種，例如泮托拉唑注射劑、氨溴索注射液、帕瑞昔布注射劑、硼替佐米注射劑、多索茶鹼注射劑等8款一線注射劑大品種。米內網數據顯示，儘管化藥注射劑增速放緩，但其市場規模仍逐年上漲。2019年中國公立醫療機構終端化藥注射劑市場規模突破6300億，比2018年增長約200億元。
其中用作治療胃酸過多引起疾病的質子泵抑制劑泮托拉唑，在2019年樣本醫院銷售額達到30億元。而一線祛痰藥氨溴索注射劑，2019年終端銷售額也達到24億元，上述兩款注射劑分別是此次集採中銷售規模前兩大的品種。
從此次報價信息上看，注射用泮托拉唑鈉領域，除了原研藥商武田藥品漲價外，其他國產商華潤雙鶴、揚子江、四環製藥等7家均降價超過80%，其中華潤雙鶴降價95.6%。氨溴索注射劑方面，勃林格殷格翰的報價與現價基本持平，而科倫藥業、美大康華康藥業、山東華魯則大幅降價90%。
其他注射劑品種亦是如此。如治療手術後疼痛的注射用帕瑞昔布鈉，該藥物原價為140元/支，而目前市場流出的信息來看，最低價格為2.98元，相較原價大降97.87%。其中，恆瑞醫藥報價8.03元，科倫藥業5.64元，降價均超過90%。但是原研藥商輝瑞報價88.38元，僅降價5.9%。
可以看到，在產品報價上，其實並沒有太出乎意料的地方，國產產品報價最高降幅達95%，而相比之下，大部分外企降價幅度很小。也就是説，外資藥企幾乎放棄了集採這一部分的市場份額。
但與口服制劑不同，注射劑的銷售渠道基本通過醫療機構，患者難以自行使用或到院外治療，對於注射劑藥企而言，一旦過評卻又無緣集採，也很可能會失去整個市場。
當前，在國內的注射劑市場上，外資藥企仍佔據主導地位。譬如氨溴索注射液，米內網數據顯示，2019年其原研企業勃林格殷格翰佔據中國公立醫院氨溴索注射劑23.56%的市場份額。可以預見的是，長期被外資藥企壟斷的格局或將隨着集採到來而改變。
如今，藥品集採已進入常態化。國務院日前印發《關於推動藥品集中帶量採購工作常態化制度化開展的意見》，進一步明確藥品集採的常態化機制。《意見》指出，重點將基本醫保藥品目錄內用量大、採購金額高的藥品納入採購範圍，儘量提高採購比例，超出約定採購量部分，優先採購中選產品。另外，將探索對適應症或功能主治相似的不同通用名藥品合併開展集中帶量採購。
在此背景下，醫藥生物板塊對於集採消息的邊際效應也在逐漸遞減。從二級市場表現來看，今日集採並沒有給醫藥板塊股價帶來顯著影響，醫藥ETF上漲0.49%，。以參與本次集採的科倫藥業為例，該股收漲2.78%至20.36元/股；恆瑞醫藥下跌0.94%；復星醫藥收跌2%；恩華藥業收漲0.93%。
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