Today (January 1), the new national medical insurance drug list was officially implemented, with a total of 2860 drugs in the list, covering all therapeutic areas. 74 new drugs were added, the average price of drugs fell by more than 60%, and 7 rare disease drugs entered the new catalogue through negotiation.
At present, the number of people insured by basic medical insurance in China is 1.36 billion, and the participation rate is stable at more than 95%. The direct settlement of hospitalization expenses across provinces has covered all provinces, all kinds of insured persons and major outgoing personnel in the country.
In 2021, the state will continue to implement a free treatment policy for patients with new crown pneumonia, and the cost of new crown virus vaccines and vaccinations will be borne by medical insurance and finances. The average price of "centralized procurement" of drugs has been reduced by more than 50%, and the average price of high-value medical consumables "collection and procurement" has been reduced by more than 80%, and the cumulative burden on the masses has been reduced by more than 250 billion yuan.
New biologics enter Medicare
A boon for 6 million psoriasis patients
Ms. Gu, a citizen of Nanjing, suffered from "psoriasis" two years ago, and a large-scale rash appeared on her skin, accompanied by white scales falling off, which had a great impact on her body and mind.
"When I wake up in the morning, I can see this kind of dander on the sheets, the skin is very painful and dry, and at night I have to keep applying wet ointment. When I was sick, I was very tormented, and I wondered why I got this disease, and I didn't want others to see this side of me. ”
In the past, psoriasis was an extremely difficult skin disease to treat. But with the advent of biologics in 2019, it has become a "chronic disease" that is easy to treat.
Zhang Ruili, deputy chief physician of the Department of Dermatology of the Second Affiliated Hospital of Nanjing Medical University, said, "In the past, drugs such as methotrexate were used, and the efficiency was only about 50% or 60%, and it was impossible to completely eliminate them." But now with this biologic, it can be completely eliminated, and the effect is still very significant compared to traditional treatment. ”
After more than a year of treatment, the clinical symptoms of Ms. Gu's psoriasis have completely disappeared. However, because patients may recur due to irregular diet, work and rest, etc., they still need to continue to take drugs. The monthly treatment fee of more than 4,000 yuan is not a small pressure for Ms. Gu. "Because I felt that there was no dandruff or anything like that, I originally wanted to ask the director if he would not be cured, and it would cost a lot of money a year, but then the director said that he was going to enter medical insurance."
In the new version of the national medical insurance directory, Ms. Gu is using the ezizizizumab injection and another biological agent for the treatment of psoriasis, and the monthly treatment fee after reimbursement is only a few hundred yuan.
This is not only for Ms. Gu, but also for the more than 6 million "psoriasis" patients across the country, it is good news, "In the past, others were helping us, and now it feels as if we as a group of people can get out of the predicament and let us work normally." ”
For the first time, high-value medicines were included
SMA Rare Disease Drugs Offer "Civilian Price"
In addition, the high-profile "high-value" rare disease drugs for the treatment of spinal muscular atrophy are also included in medicare for the first time. At the time of listing, nearly 700,000 yuan a shot of "Nocinasin Sodium Injection" was negotiated to only 33,000 yuan a shot, a drop of up to 95%.
Mr. Bao, the parent of the child, told reporters, "We felt in our hearts that our children could finally continue to use medicine in the future. ”
In 2019, Mr. Bao's son Lele (pseudonym) was diagnosed with spinal muscular atrophy, a rare disease caused by the degeneration of "anterior horn motor neurons of the spinal cord" that leads to muscle weakness and muscle atrophy, with an incidence of about 1 in 10,000. If treatment is not intervened as soon as possible, the child generally does not live to be 2 years old and requires lifelong medication.
For the sake of the children, Mr. Bao's family has insisted on 9 injections of medicine, of which 6 injections are provided free of charge by the China Primary Health Care Foundation, in addition, the provincial charity and other foundations have rescued more than 600,000 yuan. Even so, the amount of self-payment of Mr. Bao's family is still as high as 1.95 million yuan.
In July 2021, spinal muscular atrophy was included in the first batch of rare disease drug protection objects in Jiangsu Province, and the reimbursement was 70,000-80,000 yuan for one year after reimbursement. Immediately after December, "Northinal sodium injection" was included in the national medical insurance, and after negotiations, the "sky-high drug" was also offered at a civilian price.
"We also feel that what the national health care negotiations say is that we will not give up every small group. When we hear this, we can also deeply feel the concept of people's lives first. We also tell the child to face up to his illness, as long as he continues to treat, he can also go to school and run and play with other children. ”
The price of 67 negotiated drugs has been reduced by more than 60%.
The benefits reached 21 clinical groups
After the adjustment of the national medical insurance drug list in 2021, a total of 74 kinds of urgently needed clinical drugs are "sent in the snow", involving 21 clinical groups.
In addition to 7 kinds of drugs for rare diseases, it also includes 18 kinds of tumor drugs, 20 kinds of chronic disease drugs, 15 kinds of anti-infective drugs, as well as 2 kinds of new crown pneumonia treatment drugs, 12 kinds of drugs in other fields, and patients benefit a wide range.
The average price of 67 exclusive drugs successfully negotiated by the national medical insurance was 61.71%, and the price reduction reached a record high. Among them, 66 were the drugs listed last year, and the inclusion of new drugs reached 99%.
Gu Hai, director of the Public Health Management and Medical Security Policy Research Center of Nanjing University, said: "It reflects that the introduction of medical insurance policies in recent years to some new drugs with relatively high clinical value, which are not strong in substitution, and have exclusive treatment effects have been strengthened in recent years. This also reflects the principle that the party and the state, including the medical security system, can better meet the health needs of the people. ”
"Dual Channel" helps the new version of the catalog land
Improve access to medications
In order to ensure the smooth landing of drugs negotiated by medical insurance and solve the problems of "difficulty in entering the hospital" and "difficulty in using drugs" for insured patients, the National Medical Insurance Bureau issued the "Guiding Opinions on Establishing and Improving the "Dual Channel" Management Mechanism for Drugs Negotiated by National Medical Insurance in April 2021, which includes designated retail pharmacies in the scope of negotiation drug supply guarantee, and forms a "dual channel" for negotiating drug reimbursement together with designated medical institutions.
When the hospital cannot guarantee the medication of inpatients in time, the doctor can prescribe the medicine through the "dual channel" system and distribute it to the hospital by the pharmacy.
"In this regard, the relevant state departments are considering whether it is more convenient for the people to buy drugs, and after such a policy is implemented, the people are not afraid of not being able to buy drugs, and the level of guaranteed treatment he enjoys is the same as that of medical institutions when they buy drugs, and medical insurance is the same in terms of payment policies." Gu Hai introduced.
For detailed reports, please pay attention to Jiangsu Public News Channel
Jiangsu Radio and Television General Station Rong Media News Center reporter / Wang Xuetong
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