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On April 26, the Jiangsu Provincial Medical Security Bureau issued the "Notice on Adjusting the "Dual Channel" Management and Separate Payment of Some Guotan Drugs" (for details, please click to read the original text ), and 8 Guotan drugs such as Trastuzumab Injection were issued.
In addition to Jiangsu Province, Hunan and other places have also established a "dual-channel" management drug dynamic adjustment mechanism
1 A variety of star drugs are listed
Judging from the adjustment requirements of "dual-channel" management drugs in Jiangsu Province: First , the trastuzumab injection, bevacizumab injection, adalimumab injection, raltitrexed injection, erlotinib oral normal release For 6 drugs, including the dosage form and the oral normal-release dosage form of deferasirox, the separate payment list was called up, and the "dual-channel" management was continued
Among them, the most attention is the monoclonal antibody drugs
Judging from the market situation, in 2021, Qilu Pharmaceutical will be listed in the top 10 in terms of sales of in-hospital medicines with an increase of 28%, and bevacizumab injection is a major driving force for Qilu Pharmaceutical's sales growth
According to statistics, the sales of Qilu Pharmaceutical’s bevacizumab injection in the first year (2020) will reach 1.
Bevacizumab, rituximab, and trastuzumab are known as Roche's "troika".
2 The medical insurance policy is the first pilot area
This adjustment is based on the "Notice on "Dual Channel" Management and Dynamic Adjustment of Individual Payment Lists issued by the Jiangsu Provincial Medical Insurance Bureau last week
Zeng Shixin pointed out that the "dual-channel" management catalogue of Jiangsu Province includes separate payment catalogues.
For those drugs and innovative drugs with long use cycles and high treatment costs, the Jiangsu Provincial Medical Insurance Bureau can implement separate payment according to the affordability of its medical insurance funds, but only if The drug must first be included in the "dual-channel" drug catalog, and then select the drug with a long use cycle and a high cost of treatment for separate payment
.
Jiangsu Province also requires that for the negotiated drugs that are not successfully renewed in the national medical insurance drug list after the expiration of the "Guotan Drug" agreement, the "dual-channel" management and separate payment drug list should be simultaneously transferred; the "Guotan Drug" agreement expires The original "Guotan Drugs" that were later transferred to the regular catalogue and belonged to the drugs within the scope of the current "dual-channel" management and separate payment list in Jiangsu Province, withdraw from the separate payment and retain the "dual-channel" management
.
The carding found that as of now, in addition to Jiangsu Province, Hunan and other places have issued a notice on the dynamic management of "dual-channel" drugs in the country
.
In addition, since the beginning of this year, Jiangxi, Shanxi and other places have adjusted the scope of "dual-channel" drugs respectively
.
As of the end of January this year, the Shanxi Provincial Medical Insurance Bureau will add 36 drugs such as icatibant acetate injection among the newly negotiated drugs in the state in 2021, and eltrombopag ethanolamine tablets, ava maleate among the negotiated drugs during the agreement period.
Eight drugs, including Tropopa tablets and riluzole in the Class B list of medical insurance, are included in the scope of provincial special drugs
.
Some experts said that the "dual channel" and separate payment policies are decided by the provinces under the coordination of the state
.
Which drugs are included, reimbursed by hospitals or paid separately, each region has a certain discretion
.
Taking Eltrombopag as an example, Novartis learned that Haitrombopag is likely to enter the medical insurance list as an innovative drug after it is launched, so it chose to actively request to participate in the medical insurance negotiation from the conventional category B list, in order to obtain the negotiating drug corresponding to the competitive product.
Eligibility to obtain "dual channel" and separate payment eligibility in some provinces and cities
.
Judging from the results of the negotiation, these two drugs have entered medical insurance through price reduction, which is a good result for patients
.
"In fact, the policy adjustment of the 'dual-channel' management of drugs in various regions needs to be based on the understanding of each region's policies
.
Jiangsu, Zhejiang and other places have more medical insurance balances, and relevant departments are more willing to be pilot areas for the new policy
.
Therefore, it is possible to use These places are regarded as the pilot areas of the national medical insurance policy
.
" The above- mentioned experts said
.