1.2 million injections of anti-cancer drugs may miss medical insurance

At present, the three-day national medical insurance negotiations have officially ended on November 11
.
It is worth noting that from November 10 until the end of the medical insurance negotiations, the representative of Fosun Kate, a manufacturer of "sky-priced anti-cancer drugs" with a high price of 1.
2 million yuan per injection, has never been seen
.
According to data, the number of cancer patients in China is huge, and because such drugs are often expensive, in each round of medical insurance negotiations, the anti-tumor drug PD-1 monoclonal antibody is the focus of the industry
.
In the previous rounds of medical insurance negotiations, Hengrui Pharma's carrelizumab, Cinda Biosintilizumab, BeiGene tislelizumab, and Junshi Bio-Treprizumab accounted for 85.
21% respectively.
, 63.
73%, 79.
60%, 70.
82% of the decline has been included in the medical insurance catalog, the overall decline reached 60-85%
.
In this medical insurance negotiation, based on the list of drugs reviewed in the preliminary form, a total of 15 domestically-made innovative drugs participated in the national talks for the first time, including Ensatinib from Betta Pharmaceuticals, Obritinib from Nuocheng Jianhua, and Yixing from Dongyang Sunshine.
Metavir et al
.
These drugs are all new drugs approved for marketing within the past three years, and 9 drugs are new drugs that have been marketed this year
.
Among them, it is worth mentioning that among these 15 domestically-made innovative drugs, there is also a heavy CAR-T product, that is, 1.
2 million injections of anti-cancer drug-Achilles
.
It is understood that Fosun Kate is a cell therapy product based on Yescarta, a CAR-T cell therapy product imported from Kite Pharma, and is authorized to locally produce cell therapy products in China
.
On June 10, 2021, the product is used to treat relapsed or refractory indolent non-Hodgkin's lymphoma (r/riNHL) after receiving second-line or above systemic treatment, including follicular lymphoma (FL) and marginal zone Lymphoma (MZL) was approved by the State Drug Administration for clinical trials
.
On June 22, 2021, the product is used to treat adult patients with relapsed or refractory large B-cell lymphoma after receiving second-line or above systemic treatment, including diffuse large B-cell lymphoma (DLBCL) non-specific (NOS) ), primary mediastinal large B-cell lymphoma (PMBCL), high-grade B-cell lymphoma, and follicular lymphoma transformed DLBCL have been approved by the State Food and Drug Administration
.
As the first approved CD19 CAR-T cell therapy drug in China, the approval of Akirensai opened a new chapter in the treatment of patients with relapsed and refractory large B-cell lymphoma after systemic treatment in China
.
However, although the patient only needs one infusion to achieve complete remission, the product is very expensive due to the need for individual customization.
The current price is as high as 1.
2 million yuan per bag
.
Judging from the degree of inclusion of oncology drugs and the extent of price reductions in the previous rounds of medical insurance negotiations, the industry is very much looking forward to the good results of Akirensai in this medical insurance negotiation
.
However, some analysts have pointed out that the possibility of Akirensai entering the medical insurance catalog is relatively small, because it is unrealistic for high-value drugs of up to one million to be included in the medical insurance
.
Judging from the conclusion of the current negotiations and the fact that Fosun Kate’s representative has not been seen on the scene, this prediction may have become a reality.
After all, Akilunsai injection will not be eligible for medical insurance.
The industry hopes that its hopes for a substantial price reduction may have been emptied.

.
In fact, a drug that has passed the preliminary formal review does not mean that it has entered the medical insurance catalog.
It only means that the drug has been reviewed and meets the corresponding application requirements and has initially obtained the qualification to participate in the next review
.
According to public information, Fosun's Kate Akilunsai injection was only approved on June 23 this year.
Although it is stuck before the drug declaration node of the medical insurance negotiation, the clinical efficacy and pharmacoeconomic data of the drug's real listing are not yet complete.
, May not be enough to support the subsequent entry into the medical insurance negotiation stage
.
In addition, Akilense injection requires hundreds of research supports from R&D to market, which also creates high R&D costs
.
For example, the research and development cost of Akirensai injection, which only does the bridging test, is as high as 675 million yuan.
Therefore, it is impossible to significantly reduce the price for medical insurance when considering the cost recovery and economic benefits.

.
In short, the medical insurance negotiations in 2021 have come to an end
.
Based on the experience of previous years, perhaps the results of the negotiations will be announced this month or December, when all speculations and assessments will be announced
.
Regardless of the result, pharmaceutical companies can only respond to changes and actively prepare for war
.