Aunt Li, 62, is a patient with psoriasis. She has been ill since the age of 8 and has a history of more than 50 years. Adalimumab injection has a good therapeutic effect on Aunt Li's psoriasis, but this drug is more expensive, 7900 yuan a piece. Aunt Li is only willing to use it when her condition is serious. After her condition is relieved, stop the drug, resulting in repeated illness.
In January 2020, the doctor told Aunt Li that adalimumab injection was included in the medical insurance, and the cost of each injection was reduced to 1290 yuan. After the medical insurance reimbursement, Aunt Li only had to pay more than 200 yuan. "I need two each month. If I count, I only have to pay more than 500 yuan a month," said Aunt Li, "Because my disease is a chronic disease, if I can't use drugs regularly in time, my condition will not only be easy to repeat, but also cause other serious complications. Since I can be reimbursed, I have been treated according to the regular dosage. At present, my condition has been completely controlled, and all inspection indicators have basically returned to normal."
In 2018, the National Medical Security Bureau was established, and China's medical insurance drug reform entered a new stage. Aunt Li is one of the many beneficiaries. Through a series of measures such as promoting the national centralized procurement of drugs and optimizing the national medical insurance drug catalogue, the medical insurance drug reform enabled 433 new and good drugs to enter the medical insurance catalogue, with an average price reduction of 54%, and 183 drugs with uncertain curative effect and easy clinical abuse were transferred The catalogue has provided the people with better quality, fairer and more effective drug security, and effectively benefited every patient.
The national centralized procurement has significantly improved the accessibility of life-saving new drugs such as anti-cancer
On November 14, 2018, the fifth meeting of the central Deep Reform Commission approved the pilot scheme for centralized drug procurement organized by the state, and the state began to carry out volume procurement pilot in 4 municipalities directly under the central government and 7 sub provincial cities, referred to as "4 + 7" So far, the state has organized and carried out five batches of centralized procurement, covering 218 kinds of drugs, with an average decrease of more than 50%, saving about 250 billion yuan.
Cancer drugs are the focus of intensive purchase. Leng Jiahua, deputy chief physician of Peking University Cancer Hospital and director of medical insurance service department, said that before the national centralized purchase did not include many new cancer drugs in the medical insurance catalogue, the field of cancer treatment often faced the problem of "making bricks without straw" In recent years, tumor therapy is developing towards precision medicine, and innovative drugs such as biological targeted therapy, immunotherapy and cell gene therapy are increasing. However, most of the tumor drugs in China's previous medical insurance catalogue still remain in the stage of cytotoxic drugs.
Leng Jiahua said that even though the clinical guidelines of many tumors are constantly updated and clearly recommend the use of innovative drugs, patients often don't use the urgently needed drugs because of the three obstacles of high price, non-standard clinical use path and limited market, "Even high-income patient groups with strong economic affordability are unable to use innovative drugs.".
Blue Book It shows that in the first quarter of 2021, the use of anti-tumor drugs increased by 126.6% compared with the first quarter of 2015. In addition, monoclonal antibodies and protein kinase inhibitors increased sharply from 2019, while the use of traditional chemotherapy drugs such as anti metabolism and plant alkaloids decreased rapidly from 2019. Liu converted Yang analyzed that new anti-tumor drugs continued to enter medical insurance and partially replaced traditional drugs For chemotherapy drugs, the drug security level of tumor patients has been significantly improved.
Leng Jiahua cited his field of colorectal cancer as an example. Before the national organization of centralized procurement, there were only cytotoxic drugs in the medical insurance directory, and no targeted drugs were available. After the centralized procurement, the medical insurance directory has included the patients' first-line, second-line and third-line targeted therapeutic drugs.
In terms of price, taking gefitinib as an example, the price before centralized collection was 132 yuan / tablet, and the annual treatment cost was more than 47000 yuan. After centralized collection, the price decreased to an average of 41.8 yuan / tablet, a decrease of 69%. The annual treatment cost was controlled at about 15000 yuan. After medical insurance reimbursement, individual patients only bear about 6000 yuan, which greatly reduces the burden. Blue Book It shows that 17 anticancer drugs were successfully negotiated in 2018. In the first quarter of 2021, the consumption of these 17 drugs increased by 25.8 times compared with the first quarter before the negotiation (the third quarter of 2018), but the amount only increased by 8.8 times.
Leng Jiahua said: "with the establishment of the national medical insurance bureau and the establishment and gradual improvement of the dynamic adjustment mechanism of the medical insurance drug catalogue, the introduction of a large number of emergency and life-saving drugs has optimized the catalogue structure and improved the medical ecology."
The design and implementation of health insurance policy reform have fully taken into account the drug needs of special groups such as patients with rare diseases and children, and more and more relevant drugs have been included in health insurance. Medical security is a major institutional arrangement to reduce the medical burden of the people, improve people's well-being and maintain social harmony and stability. It is an important part of the national governance system. Since 2018, a new round has been launched The medical insurance reform has been carried out for three years, and remarkable achievements have been made in the reform, which highlights the original intention and fundamental compliance of always adhering to the "people-centered" in the process of medical insurance reform, and safeguarding the fundamental health rights and interests of the overwhelming majority of the people.
Source: China Youth Daily
http://www.chinanews.com/gn/2021/11-09/9605068.shtml
