The Ministry of Human Resources and Social Security of the National Health Insurance Administration issued a notice on the issuance of the "National Basic Medical Insurance, Work-related Injury Insurance and Maternity Insurance Drug Catalogue (2023)", officially announcing the 2023 National Medical Insurance Drug Catalogue.
A total of 126 new drugs will be included in the medical insurance this time, which will be implemented from January 1, 2024. In the field of breast cancer,Trastuzumab injection (subcutaneous injection).RebociclibNewly included in the medical insurance,AbeciliDarsilyPyrotinibMedical insurance indications have also been updated.
Medical insurance class A drugs: Drugs with a large number of users, good efficacy and moderate efficacy. This type of drug must be used in clinical practice**, and medical insurance can be 100% reimbursed.
Category B drugs under medical insurance: It can be used clinically, and the efficacy is also good, which is slightly higher than that of "Class A drugs". Patients need to pay a certain percentage of their own pocket first, and the rest can only be reimbursed by medical insurance.
Chemotherapy drugs
Doxorubicin
Medical insurance: Category A
Doxorubicin is an antineoplastic drug of the antibiotic class with sufficient evidence-based medical evidence and definite efficacy. Also known as red potion, ** cheap, currently relatively few in China, pay attention to the distinction with doxorubicin liposomes.
Doxorubicin liposomes
Medical Insurance: None
Doxorubicin liposome is an antibiotic antineoplastic drug, which is a domestic self-funded drug.
Epirubicin
Medical insurance: Category B
Epirubicin is an antibiotic antineoplastic drug, another red syrup.
Pirarubicin
Medical insurance: Category B
Pirarubicin is an antibiotic antineoplastic drug, another red syrup, in the absence of doxorubicin and epirubicin, pirarubicin can be selected.
Cyclophosphamide
Medical insurance: Category A
Cyclophosphamide is an antineoplastic drug of the alkylating agent class and one of the chemotherapy drugs, which is cheap, imported and fully reimbursed. This drug is also available in oral version, which is also a Class A reimbursement and can be selected under certain conditions.
Docetaxel
Medical insurance: Category B
Docetaxel is an alkaloid antineoplastic drug, also belonging to the taxy class, which is the most commonly used and recommended drug at home and abroad. It is often used as a routine chemotherapy once every three weeks.
Paclitaxel
Medical insurance: Category A
Paclitaxel, as the name suggests, is also an antineoplastic drug of the purple shirt class. Because it is a fat-soluble drug, it is insoluble in water, it is easily metabolized by the liver, and the residence time in the cells is short.
Medical insurance: Category B
Albumin paclitaxel is a nanoparticle formed by the combination of human blood albumin and paclitaxel, which can greatly increase the absorption and utilization of paclitaxel molecules by the human body, with smaller side reactions, and from the mechanism point of view, it is also more effective.
Albumin-paclitaxel is commonly used in advanced breast cancer** or neoadjuvant**. This year, albumin paclitaxel ushered in a new wave of centralized procurement, and the price was reduced to114-148 yuanOne.
Paclitaxel liposomes
Medical insurance: Category B
Breast cancer patients or ** metastatic breast cancer paclitaxel liposomes who have been reimbursed by medical insurance reimbursement are limited to a unique nanotechnology, and the co-solvent is also replaced with cholesterol and lecithin particles, but the patient still needs to be desensitized before infusion.
Capecitabine
Medical insurance: Category B
Capecitabine is an antimetabolite oral chemotherapy drug commonly used for intensification of early-stage triple-negative breast cancer and advanced breast cancer.
Vinorebine
Medical insurance: Category B
Vinorelbine is an alkaloid antineoplastic drug, available for intravenous injection and oral type, commonly used for advanced breast cancer, which can be reimbursed by medical insurance.
Gemcitabine
Medical insurance: Category B
Gemcitabine is an antimetabolite antitumor drug, which is often used for advanced breast cancer**, which can be reimbursed by medical insurance.
Carboplatin
Medical insurance: Category A
Carboplatin is a platinum-based chemotherapy drug. Commonly used drugs for breast cancer, A medical insurance, can be fully reimbursed.
Cisplatin
Medical insurance: Category A
Cisplatin is a platinum-based chemotherapy drug. Class A medical insurance, which can be fully reimbursed, is often used for advanced breast cancer**.
Fluorouracil
Medical insurance: Category A
Fluorouracil is an antimetabolite antineoplastic drug, which used to be a routine drug for breast cancer, but is currently used less frequently and has been replaced by new ** drugs and regimens.
Methotrexate
Medical insurance: Category A
Similar to fluorouracil, but with some significance for intrathecal meningeal metastases**.
Eribulin
Medical insurance: Category B
Medicare reimbursement is limited to locally advanced or advanced breast cancer that has received at least two chemotherapy regimens including anthracyclines and purple shirts. A very important chemotherapy drug in advanced breast cancer**It is the first single-agent** chemotherapy drug to achieve improved overall survival (OS) in patients with advanced breast cancer.
Eutidrone
Medical insurance: Category B, medical insurance reimbursement is limited to patients with ** or metastatic breast cancer who have received at least one chemotherapy regimen. For advanced breast cancer**, it can be combined with capecitabine.
Etoposide
Medical insurance: Category A
The injection is fully reimbursed by Class A medical insurance, and the oral drug is partially reimbursed by Class B, and etoposide is an alkaloid chemotherapy drug, which can be used as a chemotherapy drug for advanced breast cancer.
Targeted drugs
1. Monoclonal antibodies
Trastuzumab
Trastuzumab injection (subcutaneous injection).
Medical insurance: Category BLimited to 1Adjuvant and neoadjuvant ** for HER2-positive patients with early-stage breast cancer, paid for up to 12 months;2.HER2-positive metastatic breast cancer.
Pertuzumab
Enituzumab
2. Tyrosine kinase inhibitors
Neratinib
Medical insurance: Category BMedicare reimbursement is limited to booster rates for early-stage HER-2-positive breast cancer that have received trastuzumab**.
In addition to early intensification**, neratinib can also be used for anti-HER2-targeted** in advanced breast cancer.
Pyrotinib
Medical insurance: Category B
After this update, the reimbursement conditions are:
1.Patients with epidermal growth factor receptor 2 (HER2)-positive** or metastatic breast cancer;
2.Neoadjuvant** in patients with epidermal growth factor receptor 2 (HER2)-positive early- or locally advanced breast cancer.
Lapatinib
Medical Insurance: None
Lapatinib is an imported anti-HER-2 tyrosine kinase inhibitor, commonly used in advanced HER-2-positive breast cancer**.
3. ADC drugs
Trastuzumab
Medical insurance: Category B
Medical insurance reimbursement conditions: 1. Adjuvant of non-PCR HER-2 positive breast cancer after taxy + trastuzumab neoadjuvant**;;2. Unresectable late or **metastatic breast cancer** after taxane + triptal**.
Also known as T-DM1, it can improve the prognosis of the post-neoadjuvant** non-PCR population, and can also be used in the second line of patients with advanced HER2-positive breast cancer**. As the only breast cancer ADC drug currently included in the medical insurance, trastuzumab can bring new hope to more breast cancer patients and reduce their financial burden.
Vidicitumab
Medical Insurance: None
The domestic ADC drug is a drug for advanced HER-2 positive and HER-2 low expression breast cancer, and there is no indication for breast cancer.
Gosatuzumab
Medical Insurance: None
The TROP2-targeting ADC, gosatuzumab (Topavid), has been approved for patients with unresectable locally advanced or metastatic triple-negative breast cancer who have received at least two prior systems, at least one of which is for metastatic disease.
Trastuzumab
Medical Insurance: None
T-DXD, a.k.a. DS-8201. In a head-to-head comparison with enmetuzumab, detrastuzumab performed well and has been classified by the NCCN as the second-line preferred choice for patients with advanced HER2-positive breast cancer, and can also be used for HER2-low breast cancer**.
4. CDK4 6 inhibitors
Abecili
Medical insurance: Category B
In this health insurance updateNew indications have been added, and the updated constraints are:
1.In combination with endocrine ** (tamoxifen or aromatase inhibitors) for hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative, node-positive, high** risk and KI-67 20%.Patients with early-stage breast cancer**Auxiliary**.
2.Hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative locally advanced or metastatic breast cancer: in combination with aromatase inhibitors as initial endocrine in postmenopausal female patients**;In combination with fulvestrant in patients with disease progression after prior endocrine**.
Perbociclib
Medical insurance: Category BReimbursement is eligible for HR-positive, HER-2-negative locally advanced or advanced breast cancer**.
It is commonly used in advanced endocrine breast cancer**.
Darsily
Dalsili Medical Insurance: Category B.
After this medical insurance updateNew indicationsReimbursement Restrictions UpdateFor:
1.Hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative patients with locally advanced or metastatic breast cancer;
2.Used in combination with aromatase inhibitors as initial endocrine**;
3.In combination with fulvestrant in patients with disease progression after prior endocrine**.
Rebociclib
This year, it is newly included in the medical insuranceLimited to hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative locally advanced or metastatic breast cancer, in combination with an aromatase inhibitor as initial endocrine therapy in female patients**.
5. Other drugs
Everolimus
Medical insurance: Category B, reimbursement conditions are HR-positive, HER-2-negative postmenopausal advanced breast cancer patients after failure of letrozole or anastrozole**.
An MTOR inhibitor commonly used in patients with advanced HR-positive, HER-2-negative breast cancer**.
Apellix
Medical Insurance: None
A PI3K inhibitor for HR-positive, HER-2-negative advanced breast cancer with PIK3CA mutation, which has not yet been marketed in China.
Chidamide
Medical Insurance: None
An HDAC inhibitor that acts on epigenetic regulatory pathways for HR-positive, HER-2-negative advanced breast cancer and has not yet been approved for breast cancer indications.
Apatinib
Medical Insurance: None
A VEGFR inhibitor that acts on tumor vascular endothelium and can be used for advanced breast cancer, especially triple-negative breast cancer**, and has not yet been approved for breast cancer indications.
Anlotinib
Medical Insurance: None
A VEGFR inhibitor, similar to apatinib, has not been approved for breast cancer.
Olaparib
Medical insurance: Class B, but not yet approved for breast cancer indications.
A PARP inhibitor for breast cancer patients with BRCA1 2 gene mutations**, which has not yet been approved for breast cancer.
Endocrine drugs
Tamoxifen
Medical insurance: Category A
Classical drug for endocrine breast cancer** with sufficient clinical evidence.
Toremifene
Medical insurance: Category B
Tamoxifen's similar drugs are currently being used more and more in clinical practice, and the efficacy is similar to tamoxifen, ** theoretically lighter, but the evidence does not include tamoxifen, and it is theoretically optional.
Letrozole
Medical insurance: Category B
An aromatase inhibitor that suppresses estrogen levels in the body.
Anastrozole
Medical insurance: Category B
An aromatase inhibitor similar to letrozole. At the laboratory level, anastrozole is not as good as letrozole for the inhibition of aromatase, but there is no difference in clinical efficacy, and it can also be used with confidence.
Exemestane
Medical insurance: Category B
An aromatase inhibitor, similar to the two above. Exemestane has relatively more evidence in premenopausal patients, is more bone-friendly, and has no difference in efficacy from other aromatase inhibitors.
Fulvestrant
Medical insurance: Category B
An ER degrader that inhibits and degrades estrogen receptors and is commonly used in advanced endocrine breast cancer.
Goserelin
Medical insurance: Category B
An ovarian castration** drug that can inhibit the secretion of estrogen by ovarian cancer, so that premenopausal breast cancer patients can reach menopausal status and reduce the risk of endocrine breast cancer.
Leuprolide
Medical insurance: Category B
Similar to goserelin, it is also optional.
Immune medications
Pembrolizumab
Medical Insurance: None
Imported PD-1 immune** drugs can be used for neoadjuvant and adjuvant ** in patients with early high-risk triple-negative breast cancer who have positive PD-1 L1 test.
Toripalimab
Medical Insurance: None
The domestic PD-1 immune** drug has shown good results in the first-line ** of patients with advanced triple-negative breast cancerAnd triple negative breast cancer does not need to test PD-L1 levels, and it can also live longer under the combination regimen.
This article is **, original forSeeking health and mutual assistance