Just this week, the 2023 National Medical Insurance Drug Catalogue was announced, and a total of 126 drugs were added to the medical insurance catalogue this time. Among them, there are 38 in Shanghai, a record high, and these 38 drugs are all innovative drugs. Previously, many negotiated drugs encountered the problem of "getting into the medical insurance, not entering the hospital", has this situation changed?
Hua Medicine, from Zhangjiang, Shanghai, participated in the negotiation of the medical insurance catalogue for the first time with an original innovative drug for diabetes. After several rounds of bargaining, the original price of this drug dropped from 15 yuan per pill to 5 per pill39 yuan, successfully entered the medical insurance.
Although they have made a lot of profits, they are still very excited to finally enter the medical insurance catalog. Hua Medicine began to develop this new drug in 2011 and invested a lot of energy, and it was not until the end of last year that it was finally approved for marketing. However, there are many types of diabetes drugs, and although this new drug has core competitiveness, the number of people who have really used it for a long time in the past year is not large.
Li Tiejun, executive deputy director of the Department of Pharmacy of Renji Hospital Punan Branch, said frankly: "Innovative drugs, because they are a new thing, many patients may not know much, so on the premise of meeting the needs of patients and clinical directors, first a small amount of drugs is introduced, and then according to the effect, and then gradually and stably procure drugs for use." ”
Ms. Chen, who suffers from diabetes, has taken too many drugs** and her blood sugar level cannot be lowered. A month ago, the attending doctor suggested that she try this innovative drug, and the effect was not bad after a month, but the ** of the drug was not cheap, according to the amount of two oral pills a day, a month, the patient had to pay more than 800 yuan.
In order to allow more patients to understand and afford this new drug, the company has been preparing for this medical insurance catalog negotiation since a year ago.
Yi Zhang, Senior Vice President and Chief Medical Officer of Drug Development at Hua Medicine, said, "In recent years, the access of medical insurance drugs has paid more and more attention to the evaluation of comprehensive value, and we have made careful preparations based on data and evidence. ”
After the new drug is covered by the medical insurance, the burden of medication on patients like Ms. Chen can be greatly reduced. Ms. Chen said, "It really saves a lot of money for our patients. Because of this ** diabetes medicine, you have to take it for a long time as soon as you take it. ”
Liu Lianyong, executive deputy director of the Department of Endocrinology of Renji Hospital's Punan Branch, said: "After entering the medical insurance, it is not only more convenient and reasonable for doctors to use these good drugs for suitable patients. I think there are more people who will benefit from this medicine. ”
In recent years, more and more innovative drugs have been involved in the medical insurance negotiation table, and more and more new drugs have finally been included in the medical insurance. The tumor immunotherapy drugs developed by Zhangjiang pharmaceutical company Junshi Biosciences have been included in the medical insurance for 6 indications such as advanced nasopharyngeal cancer and melanoma, and the beneficiary group continues to expand.
Li Cong, Co-CEO of Junshi Biosciences: "If it is not included in the medical insurance catalog, the number of people who use it will be very limited. In addition, from the current point of view, when doctors prescribe drugs, whether the drug has a very big impact on medical insurance, so entering the medical insurance can expand the user group and enhance the influence. ”
Not only that, in order to enter the medical insurance of new drugs and good drugs, more hospitals are willing to purchase. In the past two years, Shanghai has also introduced a series of incentive measures, such as the implementation of separate payment for innovative drugs that are covered by medical insurance. "The so-called separate payment is to let hospital doctors rest assured that it will be applied, so that it will not be affected by some medical insurance quota assessments, and ultimately benefit patients. Xu Hong, second-level inspector of the Shanghai Municipal Medical Insurance Bureau and director of the Pharmaceutical Service Management Division, explained.
Chen Ting, a staff member of the medical insurance office of Renji Hospital Punan Branch, also said: "For these innovative drugs, doctors will consider less of these hard conditions in the assessment of drugs, and will mainly consider the needs of patients' conditions. ”
By solving the worries, more hospitals can be more willing to purchase innovative drugs according to demand, so that pharmaceutical companies will have more confidence to enter overseas markets and invest in new project research and development, forming a virtuous circle.
The state has given us such a channel, and we have opened this door, hoping that there will be more policies for medical insurance to benefit more patients. Dong Qing, vice president of the pharmaceutical marketing department of Hua Medicine, said.
Chen Wen, a professor at Fudan University and head of the pharmacoeconomics expert group for the adjustment of the 2023 National Medical Insurance Drug List, said: "There are many local companies that not only pay attention to the domestic market when developing new products, but also hope that such innovative drugs can enter the international market in the future, which is also a very important step for the development of China's pharmaceutical industry." ”
With the acceleration of the R&D, production and marketing of new drugs in China, more innovative drugs will be included in the medical insurance catalog, which can not only solve part of the economic burden of innovative pharmaceutical companies, but also increase the confidence of pharmaceutical companies to continuously invest in the research and development of innovative drugs, which will ultimately benefit more patients.
Reporter: Pan Miao, Wang Yi.
Editor: You Yinghui.