The first independent innovation of the second-generation antipsychotic long-acting injection in China was included in the medical insurance directory

There are about 6.5 million registered schizophrenia patients in China, and the total number is estimated to reach about 16 million. For a long time, patients with schizophrenia have low medication compliance, and recurrent attacks have become a major difficulty in treatment. From January 1, 2022, the National Basic Medical Insurance, Work Injury Insurance and Maternity Insurance Drug Catalogue (2021) will be officially implemented, and the first self-developed second-generation antipsychotic long-acting injection risperidone microspheres (II.) for injection in China are also included. This means that the first independent and innovative second-generation anti-schizophrenia long-acting injection in China that is included in the new version of the medical insurance catalogue through national negotiations will benefit more patients.

Schizophrenics: Do not know that they are sick

Schizophrenia is a recurrent chronic prolonged disease that is one of the top ten causes of disability in the world, and the vast majority of patients lack the ability to work and require long-term medication and monitoring.

Professor Jia Fujun, director of the Guangdong Provincial Mental Health Center, said that the prevalence of schizophrenia in China is about 5.6 ‰, and the international prevalence rate has been maintained at about 1% for a long time. At present, there are more than 6.5 million registered patients in the country, and the actual estimate is about 16 million patients. In Guangdong, for example, there are about 560,000 registered patients with severe mental disorders, which is expected to account for only one-third of the actual number of patients. "At present, there are six major diseases included in the management of serious mental disorders in China, of which schizophrenia accounts for about 70%."

Professor Jia Fujun

In the Korean drama "It's Okay, It's Love", the tall and handsome male actor plays a schizophrenic patient, leaving a deep impression on the public. But in fact, schizophrenia may not be as "beautiful" as it seems.

Professor Jia Fujun pointed out that unlike mental diseases such as depression, which are greatly affected by psychosocial factors, the occurrence of schizophrenia is mainly due to biological factors, that is, the patient's brain has organic changes, and psychological activities such as cognition, emotion, and volitional behavior have been fully abnormal. "People with schizophrenia often have cognitive and emotional impairments such as auditory hallucinations and delusions. Such patients will show emotional indifference, loss of ability to learn and socialize, gradual loss of social functioning, and some even aggressive behavior. A clear feature is that people with schizophrenia usually do not have 'self-awareness', and they are often unaware that they are sick, which brings difficulties to treatment. ”

Poor compliance becomes a difficult point of treatment

"Patients with schizophrenia have poor treatment compliance, cannot take the initiative to take medication, and even reject medication because they do not admit that there is a disease, resulting in difficulty in treatment to maintain continuity, resulting in repeated attacks of disease, which is the biggest difficulty in current treatment."

Professor Jia Fujun introduced that the traditional oral drug treatment plan, compliance is generally poor, many patients will reduce or stop the drug after the symptoms improve after discharge, resulting in the disease going back to the road.

A national survey shows that the current standardized treatment rate of schizophrenia patients in China is less than 40%, and the difference between urban and rural areas is obvious. "Repeated seizures, patients are prone to recession, become more and more isolated, unsociable, self-care ability, housework ability, learning and work ability, etc. will decline comprehensively with the increase in the number of relapses."

Data show that 60% of patients with first-onset schizophrenia have poor medication adherence, and the recurrence rate within 5 years exceeds 80%. Other studies have shown that poor adherence is a major risk factor for patients to relapse or readmission. Multiple recurrences lead to prolongation of the course of the disease, increase the difficulty of treatment, and also greatly increase the cost of treatment, bringing a greater burden to the family and society.

With the advent of long-acting injections, this conundrum is being solved. Long-acting antipsychotic injections significantly improve patient compliance compared with oral formulations and are an important treatment strategy for preventing recurrence. At present, the expert consensus has adopted long-acting injections as a first-line treatment strategy for patients with acute and maintenance schizophrenia.

The first independent innovation of the second generation of long-acting injections in China was included in the medical insurance directory

On December 3, 2021, the National Medical Security Bureau announced the Catalogue of Drugs for National Basic Medical Insurance, Work Injury Insurance and Maternity Insurance (2021), and 74 drugs were added to the catalogue. The first self-developed second-generation antipsychotic drug long-acting injection risperidone microspheres (II.) (trade name "Rehintol") for injection in China has also been included in the new version of the medical insurance catalogue through national negotiations, which is used to treat acute and chronic schizophrenia and other obvious positive symptoms and obvious negative symptoms of various psychotic states, which can alleviate the emotional symptoms related to schizophrenia.

Professor Jia Fujun pointed out that long-acting injections greatly improve the patient's medication compliance problem, and ultimately achieve the result of improving the overall efficacy. However, due to price factors, many patients cannot afford the long-term financial burden. The clinical application of antipsychotic long-acting injections in China is low, and compared with the use rate of about 13% in the United States, the use rate of domestic long-acting injections is still less than 3%. It is expected that the inclusion of Ruixinto in the medical insurance directory will bring benefits to more clinical patients, and the cost burden of patients will be greatly reduced.

It is reported that Ruixinto was included in the priority review procedure by the Drug Evaluation Center of the State Drug Administration in December 2019, and was approved by the State Drug Administration on January 12, 2021. Resinto injections are given every two weeks, significantly reducing the frequency of medication in patients, effectively avoiding missed medications, and significantly improving the problem of poor medication compliance prevalent in patients with schizophrenia of oral antipsychotics. In addition, after the first injection of resintal, there is no need to supplement oral preparations at the same time to maintain blood concentration, the onset of action is rapid, the patient's psychotic symptoms can be quickly controlled, and the rapid clearance after stopping the drug is more conducive to the doctor's flexible adjustment of the treatment plan according to the patient's condition.

[Reporter] Yan Huifang

【Author】 Yan Huifang

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