According to the official website of the National Medical Insurance Administration, recently, the Administration organized various provinces across the country to continue purchasing insulin after the expiration of the centralized procurement agreement. The bid was opened in Shanghai on April 23. This follow-up procurement involves more than 35000 medical institutions nationwide, with a reported insulin demand of over 240 million units, covering commonly used second-generation and third-generation insulin in clinical practice. Insulin production enterprises actively participate, and all bidding enterprises have all or part of their products selected. The selected price for subsequent procurement is basically the same as the previous round of prices. In November 2021, the national organization's centralized procurement of insulin included biopharmaceuticals in the scope of centralized procurement for the first time, with an average price reduction of 48% for selected products. The price of insulin in China has dropped from a global high to a lower level globally. In the past two years since the implementation of the selection results, the actual procurement volume has exceeded twice the agreed procurement volume. Compared with before centralized procurement, the proportion of third-generation insulin with better efficacy and safety has increased from 58% to 70%, approaching the medication structure of European countries. A total of 53 products from 13 companies participated in this follow-up procurement, and 49 products obtained the qualification for selection, with a selection rate of 92%. The selected prices remained stable and slightly decreased, with an additional 3.8 percentage points decrease on the basis of the first round of centralized procurement price reduction. The third-generation premixed group with the largest price difference in the first round of centralized procurement has reduced the price difference from 2.3 times to 1.6 times, making market competition more fair and enterprise supply more secure. Meanwhile, the proportion of A-class products with lower quotations has increased from 40% in the previous round to 71%. Among the A-class products with lower quotations, there are both products from internationally renowned enterprises and domestic big brands, as well as products from newly listed companies, which better meet the needs of the public. This follow-up procurement adheres to the principle of "combining bidding and procurement, and linking quantity and price". Based on the overall reasonable price level formed by the previous round of centralized procurement, with the goal of stabilizing prices, supply, and clinical practice, the procurement rules have been continued and optimized. One is to fully respect clinical choices, and medical institutions should report the quantity according to the brand. While requiring medical institutions to report sufficient quantities, adjustments are allowed between second-generation and third-generation insulin to meet the needs of improving medication structure. The second is to guide orderly competition. While adhering to bidding and being shortlisted, enterprises that have not been selected during the competition but still have the willingness to make concessions, and whose prices are not higher than a certain level of the previous round of centralized procurement, will be given the qualification to revive the selection process, allowing more enterprises to be selected and ensuring stable and diversified supply. The third is to implement gradient pricing, where the proportion of products with lower selected prices is higher, while the proportion of products with higher selected prices is lower, further reflecting the positive incentive of quantity price linkage. The responsible persons of relevant national departments and some supervisors of centralized pharmaceutical procurement obligations participated in this bid opening activity. The selection results of the follow-up procurement will be implemented nationwide in May, smoothly and orderly connecting with the previous round of centralized procurement, allowing patients to continue to benefit. (Lai Xin She)