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Original Title: New Health Insurance Drug Catalog Launched March 1 – 96 New Cancer Drugs Added, Including 17 Cancer Drugs. Source: CCTV News Client
A few days ago, the National Medical Insurance Directorate and the Ministry of Human Resources and Social Security announced the “Catalog of Medicines of the National Basic Medical Insurance, Work Accident Insurance and Maternity Insurance (2020)” (called the “Catalog” ). In this setting, 119 drugs were transferred and 29 drugs were transferred. The final “Catalog” has 2,800 drugs, including 1,426 Western drugs and 1,374 Chinese patented drugs. The ratio of Chinese and Western medicines is basically the same. The new “Catalog” will be officially implemented on March 1 of this year.
The adjustment of the National Catalog of Health Insurance is unprecedented, and is the first attempt to negotiate a reduction in the price of drugs in the catalog. A total of 162 drugs were negotiated, the most in history. The newly transferred drugs include 96 exclusive drugs and 23 non-exclusive drugs, involving a total of 31 clinical groups, accounting for 86% of all clinical groups. Experts said the shortlisted new drugs have achieved “higher cost performance” in terms of price reduction and clinical effects.
What impact will the adjustment of the National Health Insurance Catalog have on ordinary people? The reporter interviewed relevant officials, experts, and businessmen from the National Health Insurance Office.
Drug prices fell dramatically
The National Directorate of Medical Insurance indicated that in this adjustment of the Catalog, a total of 162 drugs were negotiated, 119 drugs were successfully negotiated, with a success rate of 73.46% and the average price of the drugs successfully negotiated was reduced by 50.64%. Take for example the most concerned cancer drugs. In 2018, the National Health Insurance Office organized special access negotiations for cancer drugs. In the end, 17 drugs were successfully included on the list through negotiations, with the agreement expiring at the end of 2020; 14 proprietary drugs met the rules The contract was renewed or re-negotiated, with an average drop of 14.95%, and individual first-line cancer drugs fell by more than 60%.
According to estimates, reducing the price of 14 cancer drugs is expected to save cancer patients more than 3 billion yuan by 2021. This adjustment adds 17 new cancer drugs, including new drugs and good drugs such as lenvatinib. and cancer in the catalog. The level of protection of the medication has improved significantly ”. Xiong Xianjun, Director of the Department of Medical Services Management of the National Health Insurance Administration, said that the successfully negotiated drugs involved 31 clinical groups, accounting for 86% of all clinical groups, and patients benefited widely.
“The new cancer drugs recently launched in 2020 are all the major drugs recently included in the last two years and have clear clinical indications.” Shi Yuankai, vice president of the Cancer Hospital of the Chinese Academy of Medical Sciences, said that the “Catalog” basically covers all major organ cancers. Common treatment drugs, common drugs for lung cancer and breast cancer have increased, and some rare tumors also have drugs available.
Talking about children’s medicines, Ji Xiaohua, chief physician of the Pediatric Department of the Xiyuan Hospital of the Chinese Academy of Medical Sciences of China, said that a total of 7 pediatric medicines were included in this health insurance negotiation. The safety and efficacy of the drugs were fully considered. The drugs were mainly oral liquids and granules. , Easy to take for patients. Supplemented medications for children are the most widely used clinically, since respiratory and digestive diseases of the pediatric clinic account for a large proportion, this medication adjustment is specifically included for these two diseases.
The National Health Insurance Office estimates that most of the 119 newly added drugs are proprietary drugs that have been negotiated to achieve price reductions. The largest spending of funds in 2021 is expected to be basically equivalent to the space left by negotiations and transfer of drugs. On the other hand, from a patient burden perspective, by negotiating price cuts and health insurance reimbursement, the cumulative patient burden is expected to be reduced by about 28 billion yuan in 2021.
Economic improvement of health insurance
The journalist learned from the National Health Insurance Office that from October to December 2020, based on company statements, the National Health Insurance Office established a database to review medications. Move from the expert review stage to the negotiation stage to perform calculations on the drugs to be negotiated. During the period, companies were invited to communicate face-to-face one by one, their opinions and suggestions were listened attentively, and negotiation experts were organized to carry out their work intensively.
“Simply put, it is guiding pharmaceutical companies to offer the lowest acceptable price under the bargaining rules,” said Gong Bo, director of the Pharmaceutical Pricing and Bidding and Purchasing Department of the Shanghai Medical Security Bureau. , and you should not stop participating in insurance out of personal sympathy. The negotiating duty of the staff to fight for the greatest concession is never to “stop” in the negotiation.
“Our fund measurement team tries to comprehensively and comprehensively consider various factors in the calculation process, expand the breadth and depth of the calculation, objectively assess and assess the true value of the drugs traded, taking into account the affordability of the fund. to offer a reasonable negotiated price. “In order to protect people’s basic medical needs, so that the majority of patients can enjoy the results of drug negotiation,” said Zheng Jie, director of the Insurance Center Beijing Physician and leader of the National Health Insurance DRG Payment Technology Steering Group.
In fact, the drug negotiations set the application conditions for a difficult day: one is to better meet clinical needs and the other is to better integrate with new drug approval work, to achieve a “seamless connection” between approval of drugs and the health insurance review, reflecting the stimulus for the creation of new drugs. The third is to take care of the continuity of clinical medication.
Even for drugs from the original catalog, the economy must be continually improved. A feature of this negotiation is the first attempt to negotiate a reduction in the price of drugs in the catalog. Based on the procedures, the reviewers selected 14 unique drugs with high prices or costs and a large amount of funds for price reduction negotiations. The 14 drugs were successfully traded and kept in the “Catalog”, with an average price reduction of 43.46%. Xiong Xianjun said, “It will become the norm for China to carry out the adjustment of the medical insurance drug catalog every year and expand the breadth and depth of medical insurance in terms of ‘cost-effectiveness’.”
Support the declaration of new drugs
It is worth noting that to better meet patients’ needs for newly included drugs, the health insurance catalog adjustment will include all drugs that will be marketed before August 17, 2020, and 16 drugs will be included in the “Catalog”. recently listed. “The business community said that this negotiation has unveiled clear guidance to support new drugs and focus on the needs of patients. While ensuring that patients can use reduced-price drugs, they have also made efforts to ensure that patients can use new drugs in a timely manner, which has further encouraged companies Confidence in the development of new drugs.
“Everybody knows how difficult it is to innovate, especially to make original innovative drugs more difficult: the drug development cycle takes at least ten or even decades – high investment, high risk, and long ROI cycle. If you can’t get into health insurance in time, it will seriously affect the development and even survival of pharmaceutical companies. ” Huang Yuesheng, chairman of Beijing Wuhe Boao Pharmaceutical Co., Ltd., holder of the total alkaloid listing license for mulberry, said the “catalog” has been adjusted to implement the enterprise declaration system and channels are more fluid . Efficient.
Thanks to the reform of the policy to adjust the medical insurance catalog in 2020, the new hypoglycemic drug “Total mulberry alkaloids” is fortunate to become one of the few varieties that was approved that year and entered the national policy of health insurance that year. Huang Yuesheng said: “Although the price of the product was lowered as soon as it was launched, as a corporate representative, I still felt the recognition and strong support given by the National Health Insurance Bureau and experts to innovative medicines. We are willing to enter to the market with little profit to promote the healthy development of the industry.
“The health insurance negotiations and related support policies are aimed at providing companies with a stable expectation of price per quantity. While lowering drug prices, reducing the financial burden on patients and reducing pressure on patients. health insurance funds, also provide companies with reasonable profit margins for continuous innovation and development. For example, Huang Bin, vice president of AstraZeneca Pharmaceuticals China, said AstraZeneca’s osimertinib tablet is a third-generation targeted drug for the treatment of non-small cell lung cancer, which has obvious clinical advantages over previous products.After successfully passing two rounds of medical insurance catalog negotiations for new indications in 2018 and 2020, the current national price of tablets osimertinib is much lower than in other countries and regions, fully demonstrating the commitment to benefit patients as much as possible. .
Article Source 丨 Economic Daily
(Edited by Chen Hankun)
