Medical insurance catalogue will be published! "Life saving medicine" into the medical insurance was opposed!

I'm afraid the answer to how many kinds of high-value drugs can be included in the medical insurance catalog is coming According to the work plan for 2019 national medical insurance drug catalog adjustment issued by the state health insurance bureau, the regular catalog will be released in July, August to September will be the negotiation stage, and September to October will be the negotiation access catalog Now, the time has entered the middle of August, the industry is looking forward to the medical insurance directory is still "out of contract." It is believed that the existing medical insurance catalogue is very complex, and there are many differences among the review experts, resulting in the "dystocia" of the catalogue However, this "overdue" also indicates that the health insurance catalog may be released at any time, and the issues concerned by the industry may be disclosed at any time How many kinds of high-value drugs can enter the medical insurance is probably the most concerned problem of the industry and even the insured Since its emergence, this issue has been the focus of people's attention, and even triggered social debate It's hard to enter the medical insurance catalog! Should high-value drugs be included in medical insurance? It's a question of emotion and reason Generally speaking, the high-value drugs that may be included in the medical insurance, most of which are the treatment drugs for major diseases such as cancer and rare diseases, as well as the high-cost specific drugs The reason why this kind of medicine can cause controversy is that "the curative effect is superior, but the price is extremely high" For example, in the field of non-small cell lung cancer treatment, the third generation lung cancer targeting drug oxitinib (trade name: Teresa), has clear efficacy and good safety However, before being included in the medical insurance, the treatment fee for one month will be 51000 yuan As a result, the debate began to emerge The voice of support thinks that these high-value drugs with significant curative effect are "life-saving drugs" and "emergency drugs" for the common people It is very reasonable to enter the medical insurance, which is equivalent to expanding the welfare of the common people Although the price is very expensive, the price can be solved through price negotiation This is an important initiative being implemented by the state at present In June 2018, the National Health Insurance Bureau, the Ministry of human resources and social security, the national health and Health Commission, the Ministry of Finance and other departments launched special negotiations on the access of anti-cancer drugs to medical insurance outside the catalog After negotiation with enterprises, 17 drugs were successfully negotiated Compared with the average retail price, the payment standard of negotiated drugs decreased by 56.7% on average The "tirissa" mentioned above is one of the 17 drugs negotiated by these countries After the negotiation, the cost of one month's treatment will be reduced from 51000 yuan to 15000 yuan At the same time, thanks to the reimbursement of medical insurance, the drug burden of patients will be further reduced However, there are also some objections Opponents believe that at present, the health insurance fund is facing a tense dilemma, including more high-value drugs into health insurance, how to prevent drug abuse? How to control the medical insurance fund? In addition, the high price and the excessive use of funds are also concerns Someone once calculated an account After the negotiation of "tirissa" medical insurance, the price was 15000 yuan per box, and the premium of local new rural cooperative medical insurance was 220 yuan per person per year In his province, the health insurance fund needs to pay about 100000 yuan a year for a patient taking "tirissa", which is equivalent to the premiums of 454 new rural cooperative insurance participants The opposing voices believe that the national health insurance is a inclusive system, which is to "protect the basic", so that more people can benefit If high-value drugs occupy too many health insurance funds, the loss or protection of a larger area of people Therefore, high-value drugs should enter the medical insurance catalog, be considered and reviewed by many parties, combined with clear efficacy and pharmacoeconomic analysis, balance the relationship between budget and value, and ensure fairness and accessibility In a word, it is more complicated for high-value drugs to enter the medical insurance catalogue It's hard to get into the medical insurance catalog! At present, the national negotiation of drugs into medical insurance has entered the stage of implementation, but there are still some problems exposed Not long ago, media reported that anti-cancer drugs "disappeared" after being included in the medical insurance Because the amount of medical insurance fund used by the hospital is limited every year, "drug proportion" also has strict requirements If more anti-cancer drugs are prescribed, the whole medical insurance fund quota of the hospital will be squeezed Therefore, some hospitals are not willing to prescribe negotiated drugs Therefore, some regions have adopted the "two channel" mode of designated medical institutions and designated retail pharmacies to supply national medical insurance and negotiate anticancer drugs For example, if the drug supply problem of designated medical institutions cannot be solved immediately, the designated retail pharmacies should be started to supply drugs and settle accounts in time However, there is still a point worth exploring and exploring If the designated hospitals can't bear this, what about the designated pharmacies?