(Reporter Qiu Yue, Health Times) “The adjustment of the National Medical Insurance Catalogue this year is about to begin again. Our company’s newly launched Gaucher disease treatment drug, Vipril, also intends to impact medical insurance.” June 14, Takeda China staff told Health Times.
On June 13, the National Medical Insurance Administration released the “2022 National Basic Medical Insurance, Work Injury Insurance and Maternity Insurance Drug Catalog Adjustment Work Plan” and related documents for public comment.
More drugs will benefit patients with rare diseases
Although it is still in the stage of soliciting opinions, a reporter from Health Times noticed that in the “Adjustment Plan”< strong>The drugs for the treatment of rare diseases are listed separately, and the time interval for drug listing is relaxed, It is proposed that “before June 30, 2022, drugs for the treatment of rare diseases approved by the State Food and Drug Administration can be declared in the 2022 Drug List. Adjustment.
Hu Shanlian, a professor at the School of Public Health of Fudan University, believes that this undoubtedly reflects the national medical insurance’s concern and protection for rare disease groups, and also gives enterprises a clear signal – whether it is high value Or non-high-value rare disease treatment drugs, can be actively declared. “I estimate that the number of applications for rare disease drugs this year should be quite large. ”
In addition to appropriately relaxing the application conditions for rare disease treatment drugs, there is another item in the plan that deserves attention: During the period from January 1, 2017 to June 30, 2022, approved by the State Food and Drug Administration Drugs with significant changes in approvals, indications, or functional indications.
“This is also important. “Hu Shanlian pointed out that in the past, many drugs that were originally in the medical insurance catalog also had the function of treating rare diseases, but the medical insurance may not have included the indication in the scope of reimbursement, and drug companies in this situation may also take the initiative to apply for adjustment of medical insurance. This policy will also allow more drugs to benefit more rare disease patients.
Developers Photo courtesy of Takeda China
More high-value rare disease drugs may be negotiated
December 3, 2021, National Medical Insurance The bureau officially released the “Notice on the National Basic Medical Insurance, Work Injury Insurance and Maternity Insurance Drug Catalogue (2021)”, two high-value rare disease drugs: Nosinagen Sodium Injection and Agalsidase Alpha Injection Concentrated Solution appeared in This is the first high-value rare disease drug to be included in the list since the 2016 NRDL access negotiation.
Whether there will be more high-value rare disease drugs this year What about competing for medical insurance negotiations?
Health Times reporters found that as early as before the announcement of the adjustment plan for the medical insurance catalogue in 2022, there were some ways of actively reducing prices in advance to seek opportunities to enter the medical insurance catalogue. Roche’s spinal cord Muscular atrophy (SMA) rare disease drug Risprom is one of them.
On June 9, an announcement issued by the Shandong Provincial Pharmaceutical Equipment Centralized Purchasing Platform showed that Roche’s drug for the treatment of spinal cord The drug Risprolan for muscular dystrophy (SMA) voluntarily applied for a price reduction, and the adjusted price was 14,500 yuan per bottle. The previous retail price of risprom in China was 63,800 yuan per bottle.
Hu Shanlian believes that there may be more high-value rare disease drugs applied for medical insurance this year, but the final negotiation result is still uncertain at present, but the medical insurance department has created a great deal for these drugs to enter the medical insurance. Good environment and opportunities. “We certainly hope that more high-value drugs can enter the medical insurance, but after all, the medical insurance fund is limited, and it is unrealistic to rely solely on the medical insurance for protection, and it still needs multi-party financing. “
Hu Shanlian said that in recent years, we have been calling for the establishment of a special fund for rare diseases in the medical insurance fund, so that the medical insurance fund can be planned and used in a more scientific and standardized manner to ensure sustainable Benefit more rare disease patients.