Text/Yangcheng Evening News all-media reporter Zhang Hua
Photo/Visual China
The results of the sixth batch of national drug collection (insulin special) selection will be implemented in May this year. "After the implementation of insulin collection, the price of drugs will come down, which can allow more diabetic patients to have more choices, which is bound to have a certain impact on the choice of insulin treatment options for diabetic patients." Recently, Qin Guijun, director of the Department of Endocrinology of the First Affiliated Hospital of Zhengzhou University, said.
Volume-for-price collection brings real benefits to patients
According to the global diabetes map (10th edition) released by the International Diabetes Federation (IDF) at the end of 2021, there are more than 140 million diabetics in China, accounting for about one-tenth of the country's total population.
Insulin therapy is an important means of diabetes treatment. Patients with type 1 diabetes mellitus (T1DM) require lifelong insulin therapy. Patients with type 2 diabetes mellitus (T2DM) gradually decline in islet function as the course of the disease is prolonged, and some patients also need to be treated with insulin.
The average price of the selected drugs in the insulin collection was reduced by 48%, and the highest reduction was more than 70%, of which the lowest price of the single selected single of the three generations of insulin was Eli Lilly Pharmaceutical's sperm protein zinc recombinant lispro insulin mixed injection (25R), which was only 18.89 yuan.
Volume-for-price collection allows patients to use high-quality drugs at lower prices, bringing real benefits to patients. Qin Guijun introduced that from the implementation of the first five batches of national drug collection, the price of drugs after the collection has dropped sharply, and the selected varieties are drugs with good efficacy and excellent quality, and patients have really benefited, and at the same time, they have also improved the situation that there are many varieties of drugs and disorderly competition before, optimized the varieties of clinical drugs, saved medical expenses, and continuously improved the level of rational use of drugs in hospitals.
"The hospital has begun to strengthen in-hospital training, deepen doctors' understanding of the collection policy, mobilize the enthusiasm of doctors to take the initiative to implement the collection policy, and will further improve the management of the hospital's drug catalog, guide and strengthen the use of collected drugs through performance appraisal, ensure the priority use of selected drugs, and ensure the rational use of patients." Qin Guijun said.
Rational use of insulin, personalized administration is the key
With the advancement of technology, insulin drugs are constantly changing. The purity of second-generation insulin is significantly higher than that of first-generation animal insulin, but the peak of action after second-generation insulin injection takes 2 to 4 hours, and the medication time may not match the meal time, and there is a risk of hypoglycemia in patients. The biggest advantage of third-generation insulin (insulin analogues) compared to second-generation insulin is a significant reduction in the adverse reactions of hypoglycemia.
The Guide states that for HbA1c≥9. 0% or fasting blood glucose ≥11. Patients with newly diagnosed type 2 diabetes mellitus with 1 mmol/L with significant hyperglycemia may be considered for short-term (2 weeks to 3 months) intensive insulin therapy. In addition, insulin therapy may be considered when type 2 diabetes mellitus is still substandard after 3 months of glycosylated hemoglobin (HbA1c) after 3 months of adequate oral hypoglycemic therapy.
In terms of body shape, it is generally believed that patients with thin body size are more suitable for insulin therapy, which can not only control blood sugar levels, but also improve appetite and avoid further weight loss. For patients with obesity and severe insulin resistance, more attention should be paid to weight loss and increase insulin sensitivity during treatment.
Collection promotes the upgrading of insulin therapy regimens
Before the collection, the annual cost of using three generations of insulin is about 2,000 to 3,000 yuan, which is a greater economic pressure for diabetic patients.
"Taking a single sperm protein zinc recombinant lispro insulin mixed injection (25R) priced at 18.89 yuan as an example, according to the use of 3 insulins per month, the daily treatment cost is now less than 2 yuan, which is lower than the price of many oral hypoglycemic drugs." Qin Guijun said that the sixth batch of national drug collection has further narrowed the price difference between third-generation insulin and second-generation insulin, which is conducive to promoting the upgrading of insulin treatment programs and benefiting more patients.
Some diabetics are concerned that changing insulin medications will affect the effectiveness of treatment and disease control. In this regard, Qin Guijun explained: "On the basis of relatively stable blood glucose control, the same type of insulin acts in the same way and can replace each other. Patients who use insulin for a long time should also change the drug regularly to avoid the production of antibodies. If the drug is changed, during the transition period of 3 to 7 days of drug conversion, the patient needs to cooperate with the doctor to do a good job of blood glucose monitoring. To replace insulin, the drug in the body to go through a process of accumulation, in the process of blood sugar will fluctuate slightly, the patient does not have to worry. (For more news, please pay attention to Yangcheng Pie pai.ycwb.com)
Source | Yangcheng Evening News Yangcheng Pie
Editor-in-charge | Cui Wencan