Text/ Xin Ying Zhao Tianyu
Editor / Wang Xiao
Photo/pixabay
New crown antigen detection reagents and new crown treatment drugs have been included in medical insurance.
This is an important content conveyed by the National Medical Insurance Bureau on March 21, 2022, the Notice on Effectively Doing a Good Job in the Medical Security Work of the Current Epidemic Prevention and Control (hereinafter referred to as the "Notice").
The "Notice" requires that all provinces temporarily include "new coronavirus antigen testing" in the basic medical insurance catalogue in accordance with procedures, including testing reagents and corresponding testing items. At the same time, individuals who purchase COVID-19 antigen testing reagents at designated retail pharmacies can use medical insurance personal accounts to pay.
In addition, the new therapeutic drugs added in the "Diagnosis and Treatment Plan for Novel Coronavirus Pneumonia (Trial Ninth Edition)" - nematvir tablets / ritonavir tablets, are purchased by medical institutions in accordance with the price communicated between enterprises and relevant departments, and the medical insurance department pays according to regulations.
In addition to antigen reagents and new crown drugs, medical insurance will also support the normal operation of medical institutions in areas with serious epidemics, and if necessary, part of the new crown treatment funds can be prepaid according to procedures.
At present, the domestic new crown pneumonia epidemic is divergent in many places, the epidemic prevention and control is in a critical stage, and the medical insurance fund is an important guarantee for the fight against the epidemic. The National Medical Insurance Bureau has made this move to serve the current needs of epidemic prevention and control and further strengthen the medical security of the prevention and control of the new crown pneumonia epidemic.
The market for primary medical institutions is about to open the floodgates
Six days ago, on March 15, the National Medical Insurance Bureau issued a letter agreeing that Henan and Chongqing would temporarily increase the charge of 5 yuan per time for the new coronavirus antigen testing service, and the total charge for a single antigen testing service and reagents (including sampling devices) would not exceed 15 yuan.
The National Medical Insurance Bureau requires provinces to refer to this standard and continue to standardize and optimize price policies. On March 22, the announcement of the collection of new crown antigen detection reagents in Shaanxi Province was directly limited, and the maximum effective declaration price was not higher than 10 yuan per person. Previously, in the collective procurement organized by Shandong Province, the price of new crown antigen detection reagents has dropped to 7.9 yuan per person, and the highest price is 9 yuan.
From the approval of the State Food and Drug Administration for listing, to the entry of collection and inclusion in medical insurance, the speed of antigen detection is like a rocket.
"Expected, but it was a bit of a surprise that it came so quickly." Zhang Mingdong, chief scientist of Shanghai Liangrun Biomedical Technology Co., Ltd., said. The company's antigen kit is undergoing domestic registration declaration, and seeing the news of entering medical insurance, this is his first reaction.
As of March 22, 17 models of new crown antigen detection reagents have been approved for domestic marketing. Antigen detection is the detection of antigens by the binding response of antigens and antibodies, and is characterized by rapid and simple.
Related listed companies whose antigen kits have been listed and used in China have experienced a brief stock price increase at the beginning of the approval, and generally fell on March 22. As of the close of the day, Wanfu Bio (300482. SZ) closed down 9.14%, heatscape bio (688068. SH) fell 7%, Novizan (688105. SH) fell 6.95%, Matilda Bio (002932. SZ) fell 6.71%, BGI Gene (300676. SZ) fell 5.73%.
Compared with the nucleic acid testing that is also included in the medical insurance catalog, the main revenue of the enterprise comes from government procurement, that is, the use of nucleic acid testing for the whole people, but this part is not within the scope of medical insurance payment." The current big order for antigen testing is also from regional screening, which is limited by Medicare payments. A medical industry insider analyzed.
Unlike nucleic acid testing, the market gates for primary medical institutions and home testing that medicare can pay for have been opened.
Antigen testing can be used to self-test community residents. This time, the National Health Insurance Bureau provides support for individual purchases – individuals who purchase COVID-19 antigen tests at retail pharmacies can be paid for using their personal Medicare accounts.
Medical insurance payments have always brought a large number of customers to designated pharmacies, and according to public data estimates in 2019, nearly half of the income of retail pharmacies comes from payments from employees' medical insurance personal accounts.
In the online kit sales of Alibaba Health on March 14, Nanjing Nuoweizan's antigen detection home kit was 486 yuan for 20 people, an average of 24.3 yuan per copy; the pre-sale product of Jinshengda Pharmacy in Jiangxi Province was launched on the day of Meituan's drug purchase, which was 32.8 yuan.
At the same time that antigen testing is included in medical insurance, the National Medical Insurance Bureau also requires provinces to carry out special price monitoring of the prices of antigen testing reagents sold at retail terminals such as online platforms and social pharmacies, and actively provide unfair high price clues from different channels to price supervision and inspection law enforcement departments.
"Individuals who buy antigen test kits are mostly unplanned, and may temporarily find themselves passing through a risk area, and will choose the nearest offline pharmacy to buy." The above-mentioned pharmacy industry insider said.
Younger consumers may prefer the convenience of buying drugs online, and Medicare personal account payments may not be enough to change consumer habits. However, also on the e-commerce platform, the price will still be the most important for consumers.
"The county has begun to purchase antigen detection reagents, and plans to use them in pilot health centers next month." The person in charge of a township health center in Shaanxi Province expects to be able to use antigen testing and screening as soon as possible to receive "non-new coronavirus" patients.
According to the "Application Plan for The Detection of Antigens of the New Coronavirus (Trial)", primary hospitals will first conduct nucleic acid testing for those who are accompanied by respiratory tract, fever and other symptoms and have symptoms within five days, and those who do not have nucleic acid detection capabilities will be tested for antigens.
In economically developed areas, nucleic acid testing in primary medical and health institutions is easier to complete, such as Beijing Municipality requires primary medical institutions to receive the above patients, first of all, to cooperate with hospitals or institutions for nucleic acid sampling, and antigen detection can be carried out at the same time.
However, the grass-roots market that does not have the conditions for testing is larger, and according to the requirements, all general hospitals above the second level must have nucleic acid sampling and testing capabilities. Therefore, primary medical institutions with nucleic acid testing capabilities are still a minority. By the end of 2020, there are more than 970,000 primary medical and health institutions nationwide.
Huaan Securities pointed out that the new crown antigen test can solve the difficulty of nucleic acid testing in remote and grass-roots areas, and the market size of diagnosis and treatment testing needs of grass-roots medical and health institutions is about 5.5 billion yuan.
According to the "Finance and Economic Health" understanding, at present, grass-roots medical institutions in many places have not yet begun to obtain antigen detection reagents, and medical personnel have begun to prepare for training and so on.
The new crown drug stocks rose for 17 consecutive days
On March 16, the new coronavirus treatment drug nematvir tablets/ritonavir tablets combination packaging (i.e. PAXLOVIDP) arrived at Shanghai Pudong Airport.
On March 19, the first batch of PAXLOVID cooperated between China Pharmaceutical and Health Industry Co., Ltd. (hereinafter referred to as "China Pharmaceutical") and Pfizer arrived at China Pharmaceutical Daxing Logistics Center.
Two days later, on March 21, the Notice included it in medical insurance, stipulating that medical institutions should purchase according to the price agreed between enterprises and relevant departments, and the medical insurance department should pay according to regulations.
According to Pfizer's official website, PAXLOVID is an oral small molecule new coronavirus treatment drug for the treatment of mild to moderate novel coronavirus pneumonia patients with mild to moderate new coronavirus pneumonia with high risk factors for progression to severe disease, such as patients with high risk factors for severe disease such as advanced age, chronic kidney disease, diabetes, cardiovascular disease, and chronic lung disease. Based on the results of the research novel COVID-19 oral antiviral candidate PAXLOVID study published by Pfizer in 2021, the interim analysis showed that the drug reduced the risk of hospitalization and death in high-risk COVID-19 patients by 89%.
As of now, the price of the drug in China has not been publicly disclosed. According to public information, Pfizer PAXLOVID is priced in the United States as a five-day course, and the U.S. government needs to pay about $530 (about 3367 yuan).
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China Pharmaceutical said that at present, the company has received an urgent order for urgent protection of drugs, and all drugs are being quickly transported to the front line of the national fight against the epidemic.
The "Notice" requires that medical security departments at all levels should refine and improve work measures in accordance with the requirements of the "Notice of the National Medical Security Bureau and the Ministry of Finance on Doing a Good Job in Medical Security for the Pneumonia Epidemic Caused by the Novel Coronavirus Infection" (National Medical Insurance Electricity [2020] No. 5) and other documents, and continue to implement policies such as comprehensive protection for the medical expenses of confirmed patients. Support the normal operation of medical institutions in areas with severe epidemics, and if necessary, they can advance part of the new crown treatment funds in accordance with procedures.
According to the statistics of Cypress Blue, there are some new drugs in the "Diagnosis and Treatment Plan for Novel Coronavirus Pneumonia (Trial Ninth Edition)", such as ampavirinumab/romizumab injection, dexamethasone, methylprednisolone, interleukin 6 (IL-6) inhibitor tocizumab, low molecular weight heparin, unfractionated heparin and other products.
The "Notice" requires that the provincial medical security departments refer to the relevant requirements to temporarily include them in the scope of payment of the medical insurance fund in their provinces; for drugs that are transferred out and are not in the basic medical insurance directory, medical insurance payments should be stopped on the date of the release of the "Diagnosis and Treatment Plan (Trial Ninth Edition)".
China Pharmaceutical has signed an agreement with Pfizer to be responsible for the commercial operation of Pfizer Ritonavir tablets in the Chinese mainland market in 2022. On March 22, China Pharmaceutical announced that ritonavir tablets have not been included in the national medical insurance. If included in the national health insurance, it may have an impact on the sales price.
According to past data, as products are included in the new crown diagnosis and treatment plan and become recommended drugs, it will effectively promote the sales and revenue performance of varieties involving pharmaceutical companies, and even directly enhance the company's performance and market impact. On the closing day of March 21, China Pharmaceutical rose again, and since March 2, the company's stock price has risen by nearly 230%. From February 25 to March 21, China Pharmaceutical rose for 17 consecutive trading days. On March 22, the company closed down 4.35%.
With the development of the epidemic, it is expected that more approved new coronavirus drugs will be included in medical insurance in the future.