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Health insurance + research and development, expected to use the new drug difficulty

Source:Traditional Chinese Folk Medicine Research and Development Association
2018年04月13日



Health insurance + research and development, expected to use the new drug difficulty "dimensionality"
Health newspaper


Innovative anticancer drugs, such as tumor targeting drugs and biological agents, have brought good news to some cancer patients. Our country has greatly reduced the price of some high-value innovative anti-cancer drugs through national price negotiations, and incorporated these drugs into the national health insurance directory. But the impact of these highly effective, high-value, innovative drugs on health care has been a worry for managers everywhere. Experts say the inclusion of high-value drugs in health care is not the same as "Wolf", but it is based on price negotiations and accurate estimates of health care policy.
1
"Special medicine" is good for health insurance.
The implementation of fine management of innovative anticancer drugs, such as small molecular targeted drugs, in appropriate form, may bring positive changes to fund expenditure. As early as 2012, the medical insurance department of Qingdao city, shandong province, formulated the special medicine special assistance policy for some serious diseases under the framework of the medical assistance system for major diseases. Under the premise of strict patient access, the system of responsible doctors should be carried out, and the patient should choose the hospital where the doctor is responsible for the medical treatment. The insured patients who have obtained the qualification of special treatment of special drugs should choose one of the special pharmacy that has the supply condition to be used as their designated drug store, in principle, no change will be made in the medical year.
In non-small cell lung cancer drug kay beauty, its ehrs - 2 positive breast cancer drug herceptin, for example, health administrative departments, according to the survey data of Qingdao apt to the treatment of patients with special material assistance system significantly improves the efficiency, reduces the economic burden of patients, selected patients with single per capita hospitalization days from 15.57 days respectively, 9.97 -to 9.74 days and 6.25 days, since the expense ratio by 65.83%, 80.84% to 65.83% and 65.83% respectively.
While benefiting patients, it is also obvious that the special drug policy can control medical expenses reasonably and reduce the pressure of fund expenditure. According to the data, the proportion of the total expenditure of breast cancer related health insurance funds in Qingdao was reduced from 1.6% to 1.4% before and after the policy was carried out. The total expenditure of breast cancer insurance fund in 2015 was about 20.53 million yuan compared with the previous year. The per capita annual medical expenses of patients with NSCLC also decreased from 1507 million yuan before the policy development to 110,700 yuan in 2015.
2
High requirements for refined management.
The purchase channel in the health insurance policy is not free, only the hospital reimbursement... Although the new medical insurance directory of innovative cancer drugs in some places has met some problem, but the tongji medical college huazhong university of science and technology and drug policy and management research center, said Tony for the improvement of anticancer drug accessibility, should be held to an optimistic attitude.
Tony, 2017 national drug price negotiations of the measurement show that the negotiations medicine into the health care spending will have 5 billion yuan of new fund, not to the medical insurance fund can ill afford to impact the overall security, "the new national health insurance directory adjusted, country is still in the follow up the process of implementation, national negotiations anti-cancer drug reimbursement will further this year be born".
Betta Pharmaceuticals Co., Ltd, senior vice President of Wan Jiang advice, for tumor targeted drugs such as part of the drug in countries with high price negotiations, health administrative departments of the patients with strict regulatory future indications audit under the premise of clinical behavior, such as by patients on prescription purchase at the designated drugstore that decide a dot, can dissolve the public hospital for medicine proportion, the structure of the health care costs and so on all sorts of concerns, also facilitate at the same time, sales channels is concentrated supervision work. Experts point out that, whether public hospital sales or specific pharmacies are sold, high-value drugs such as innovative anticancer drugs will have higher requirements for refined management of medical insurance departments.
"The reform of government institutions in progress has brought about the return of health care functions, which is undoubtedly a good news." Tony said the health care level of function integration and management system, national policy, improve the level of a serious illness insurance tilt will be beneficial to improve from the perspective of security "buyer's ability to pay" innovative anti-cancer drug accessibility.
Tony said the health care sector leading drug price negotiations, at the same time regulation into the coverage of medical institutions related service and medical expenses, etc., can completely for innovative cancer drugs, and other countries to negotiate drug more refinement to pay for health care policy. Realize the basic medical insurance, serious illness insurance, medical treatment and other functions of highly integrated, the national health insurance bureau may establish special disease in larger scale pharmacy, in under the premise of fixed-point, medicine, ChuFangQuan, undertake specific anti-cancer drug sales, expenses, such as policy, crack innovative anti-cancer drugs currently attainable hospital, pharmacy is difficult to quote the worries of patients, "zhejiang province special drug program on negotiation of a serious illness insurance, Qingdao relief apt, material project of a serious illness, have accumulated a good exploration experience".
3
The original medicine is flourishing.
In recent years, our country made a series of reforms in the field of drug approval for examination and approval, greatly accelerate the speed of drug approval listed, and a lot of anti-cancer drug for major disease areas, innovative drugs, such as "identity", have entered the fast channel of examination and approval. According to the general statistics of the reporter, in 2017, China has approved five new anticancer drugs, such as renal cancer, pazolone, arafinib, and regofenib. In China at present, the first filing of PD - 1 monoclonal antibody drugs, independent research and development of many tumor targeting of nearly 10 kinds of anticancer drugs, have priority for examination and approval, is expected to be listed on the approved this year.
In the clinical trial stage, the vigorous development of domestic anticancer drugs can confirm Chen hao's judgment. Promulgated by the administration of the state food and drug supervision and administration of drug approval report "for 2017, according to our country 2017 review of the approved drug innovation medicine clinical trial application, 399, has doubled in number in 2016. Of the 170 varieties involved, 72 were antitumor drugs, accounting for 42% of the total.
The accessibility of innovative cancer drugs in the future China, the China association of enterprises with foreign investment market access to drug research and development industry committee director zhu bo said, in addition to the drug approval for examination and approval of major reform to speed up the innovation in the field of medicine, our country has to end in 2017 medicine medicine, all the public medical institutions to cancel the drug addition, it largely reduce the sales price of innovative cancer drugs in the hospital. Signs "the favorable policies and the present tax reform, we have reason to believe that, by speeding up registration approval, cancel the hospital markups, reduce tariff and value-added tax and a series of reform measures, innovative anti-cancer drug accessibility greatly improve can be expected."




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