A large number of anti-tumor drugs at provincial price reduction experts call for targeted gene testing to be included in the medical insurance

In October 2018, the National Health Insurance Bureau issued a notice to announce that the results of a new round of national drug negotiations have been released 17 anticancer drugs, such as azacytidine and cetuximab, were included in the category B scope of the national health insurance catalog and determined the payment standard of health insurance after achieving an average price reduction of 56.7% through negotiations Hu Jinglin, director of the National Health Insurance Bureau, said in an interview with CCTV that the institutional reform has created good conditions for the negotiation The integration of the medical insurance system makes the national medical insurance bureau have greater strategic purchasing power, and then we have a stronger voice in the negotiation, which can better achieve the purpose of "volume for price" In fact, with the development of medical insurance access negotiations, more and more anticancer drugs will be cut sharply in the future, so that the curative effect is clear, more patients will benefit from the drugs necessary for clinical use, and the burden of medical insurance payment will be reduced Although the price of anti-tumor drugs has been greatly reduced this time, the implementation of the landing still needs many details According to the notice on including 17 kinds of drugs into the category B scope of the national basic medical insurance, work injury insurance and maternity insurance drugs catalogue, the centralized procurement of drugs in all provinces (districts and cities) should be implemented by the end of November According to the Bureau of health and knowledge, 10 of the 17 cancer drugs in this negotiation are new ones that were only listed in 2017 No matter multinational pharmaceutical companies or local enterprises will actively occupy the market Once they take the lead, there will undoubtedly be huge profit return As the winner of this medical insurance negotiation, ibital ® has been listed in China for more than 10 years, but it is also the only precise targeted treatment drug for colorectal cancer in China, which has significant therapeutic effect on ras wild-type patients and is necessary for the treatment of metastatic colorectal cancer in China The successful inclusion of medical insurance can make precision treatment reach more patients, greatly reduce the burden of patients, and make patients get benefits Yuan Zezhi, senior director of China Cancer business division of Merck, said that up to now, we have seen a multiple growth in the number of new diseases After the gradual implementation of national supporting policies, we have seen a significant increase in product consumption The company is actively communicating with medical institutions to ensure that there are enough drugs to supply patients and enable patients who really need to use them " The current negotiation price is far higher than the authorized Price issued by the headquarters Therefore, in the negotiation process, we need to keep communicating with the headquarters, and the result of the negotiation is that the price of drugs has been reduced from 4200 yuan to 1295 yuan " The formulation of this price is repeatedly demonstrated by domestic pharmacoeconomics experts, which conforms to the therapeutic value of this variety in Chinese population At the same time, it can also meet the needs and potential of the domestic market, which well reflects the firm confidence of the manufacturers in the national health insurance policy and its implementation Yuan Zezhi said that Merck China should be the lowest price in the world Through this health care negotiation, Merck can let the common people get the application by exchanging price for quantity, which is a good thing for the common people in China It is well known that cancer is a serious threat to human health and has a serious impact on family and social stability However, targeted drugs are not effective for all cancer patients At present, many provinces and cities in China have included cancer treatment targeted drugs into the payment scope of special drugs for serious illness insurance However, as the target gene detection of cancer drugs "quasi star", patients still need to pay for it at their own expense, which brings greater burden to cancer patients and families Many patients choose "blind eating" because of this, which will not only delay the treatment and affect the treatment effect, but also hinder the popularization of precision treatment, and cause great waste to the medical insurance fund Zhang suzhan, director of cancer center of the Second Affiliated Hospital of Zhejiang University Medical College and director of Cancer Research Institute of Zhejiang University, appealed in an interview with the Bureau of health and knowledge that clinical practice has proved that targeted gene detection is the basis and premise of targeted drug treatment, which is inseparable from targeted drugs and directly affects the therapeutic effect of drugs Therefore, targeted gene detection should be included in the medical insurance as a basic medical insurance diagnosis and treatment project "Universal targeted tumor gene screening is the best way to standardize the use of anti-tumor drugs in the future." Zhang suzhan said that the former makes the treatment more targeted and more economical than the latter Taking colorectal cancer as an example, a simple ras gene test can make clinicians better recommend follow-up treatment for patients At the same time, Zhang Su Zhan believes that because the targeted gene detection only needs one time, the general physical condition of patients can be known, and there is no need to repeat the examination, especially entering the medical insurance catalog will effectively curb the abuse of examination costs in medical institutions As a matter of fact, the targeted gene examination, which is often thousands of yuan or even tens of thousands of yuan, is obviously a high cost that cannot be reimbursed by the current medical insurance system, and its cost is far higher than the scope that the country can bear, even higher than the cost of drug treatment Therefore, if the targeted gene test wants to enter the medical insurance, it must reduce the cost Han Sheng, an international research center of pharmaceutical management at Peking University, once said publicly that to judge whether a new health technology is worth promoting, we should analyze it from the perspectives of direct cost, direct medical cost, indirect cost and the corresponding extended invisible cost According to Japanese research, the benefit of cancer gene detection is that for every additional patient's life year, the detection fee needs to be increased by 3.38 million yen (about 206000 yuan), while Japan's willingness to pay is about 50000 US dollars, about 5-6 million yen (305000-366000 yuan), so Japan is allowed to reimburse this fee Up to now, from the perspective of China's medical insurance, the focus is on drug treatment, not involving gene detection When it comes to precise treatment, it is necessary to target gene detection and use them together, or the effectiveness of tumor drugs will be greatly reduced, Zhang called.