China News Service, Beijing, September 14 (Reporter Li Yanan) In order to improve the fairness of China's anti-cancer drug medical insurance resource sharing and help improve the health of cancer patients, experts have recently sponsored the "Three-medicine Interaction Medical Insurance System Construction" The “Seminar” called for the continuous increase in the number and types of innovative anti-cancer drugs in the medical insurance catalogue, fairness should be included in the drug value evaluation dimension, and the availability of high-quality innovative drugs should be improved to help the "Healthy China Action (2019- 2030) The goal that the overall cancer 5-year survival rate by 2022 will not be less than 43.3% will be realized soon.
Leng Jiahua, director of the Medical Insurance Service Department of Peking University Cancer Hospital, said that in recent years, my country's medical insurance reforms and innovations in the field of anti-cancer have greatly increased the protection of cancer patients.
In 2017, the form and value of medical evidence for national negotiations were introduced through innovation. 36 new innovative drugs were added to the medical insurance catalogue. In 2018, the anti-cancer drug special negotiations added 17 new specific drugs. The 2019 medical insurance catalogue added clinical medicine at one time. 97 kinds of necessary innovative drugs.
Among them, there is no lack of blockbuster anti-cancer drugs such as trastuzumab and crizotinib, which have raised the national health insurance coverage of breast cancer and lung cancer to a new level.
"The country has made great reforms in the medical insurance reimbursement of anticancer drugs in recent years. It turned out that the oncology drugs needed for a course of treatment for patients cost hundreds of thousands of yuan. After medical insurance negotiations, it was reduced to around 100,000 yuan and some were even lower. After medical insurance reimbursement, patients only bear about tens of thousands of yuan, which reflects the government's care for the people. At the same time, it is necessary to actively promote the establishment of a medical insurance dynamic adjustment mechanism to ensure the fairness and rationality of the use of medical insurance funds, and allow more innovative anti-cancer Drugs are included in the scope of medical insurance reimbursement," said Zhong Mingkang, director of the Department of Pharmacy, Huashan Hospital, Fudan University.
Ma Fei, chief physician of the Cancer Hospital of the Chinese Academy of Medical Sciences, cited breast cancer as the number one high-incidence cancer in women and pointed out that the current situation of advanced breast cancer diagnosis and treatment in China is still very severe. Compared with developed countries, China’s available innovative drug treatment options are still insufficient. Rich, innovative drugs that have been approved in China still face the problem of being expensive and unaffordable.
Zhai Qing, the director of the Cancer Hospital of Fudan University, also said that the introduction of new targeted drugs with clear curative effects into medical insurance can not only reduce the burden on patients, but also improve patient compliance, thereby improving the quality of life and survival rate of cancer patients.
As each hospital focuses on different disciplines, medical insurance drugs entering the hospital's clinics will have large differences. The scientific drug evaluation and selection system also affects the availability and fairness of medical insurance drugs for cancer patients.
Zhao Zhigang, director of the Department of Pharmacy of Beijing Tiantan Hospital affiliated to Capital Medical University, said that the release of the latest version of the "Quick Guide for Drug Evaluation and Selection of Chinese Medical Institutions" provides a scientific, fair and just way for drugs to enter hospitals after the announcement of the National Medical Insurance Catalogue. Let medical insurance drugs be quickly used in clinical practice.
When talking about rare diseases, Liu Junshuai, vice president of Beijing Association of Rare Disease Diagnosis, Treatment and Protection, said that fairness guarantee, as the core issue of rare disease drug protection, should be reflected in multiple levels such as ethics and efficiency.
From the perspective of system construction, compared with universal health insurance, rare diseases (including rare diseases in different contexts) should have a relatively priority and relatively independent medication guarantee mechanism, and the universal system of preferences and priority policies should be combined. Promote the continuous improvement of the availability of medicines as much as possible, so as to achieve a more valuable and efficient high-level fair guarantee; at the same time, it is also necessary to further improve the guarantee between various systems on the basis of the establishment of an innovative multi-level guarantee system Structure, and form a multi-party co-payment, co-payment, co-governance, and sharing model.
Leng Jiahua suggested that the medical insurance fairness evaluation of anti-cancer drugs can be combined with the current medical insurance's emphasis on "clinical necessity, safety and effectiveness, and reasonable price" evaluation criteria, and the second step of screening after the treatment method meets the safety and effectiveness.
After referring to the dimension of fairness in the field of medical security, the absolute clinical benefit of a single drug may no longer be a passport to access.
Realize the fairness and coordination of medical security, give play to the strategic purchasing role of medical insurance funds, and promote the high-quality coordinated development of medical security and medical services.
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