Is specialty drug insurance worth it?

  "Insure the bottom line, pay for the sky-high anti-cancer drug" "Although CAR-T (chimeric antigen receptor T cell) immunotherapy is good, the high cost has also discouraged many patients"... With the 1.2 million injections of anti-cancer drugs Cancer drugs swiped, and insurance companies began to sell related insurance.

  CAR-T cell immunotherapy insurance is on fire!

Wang Meng (pseudonym), a senior insurance agent, told the Beijing News Shell Finance reporter: "95% of the new orders opened this month are for this product. We don't sell it, only give it away, 5,000 yuan. There is one insurance quota for the 10-year regular payment of Yuan premium, and 3 insurance quotas for the 10-year regular payment of 10,000 premium.”

  What kind of product is this?

Simply understand, CAR-T cell immunotherapy insurance belongs to special drug insurance, and the main protection responsibility is CAR-T cell immunotherapy insurance money.

The Beijing News Shell Finance reporter noticed that in the promotion of insurance companies, the annual premiums vary from a few yuan to more than 100 yuan depending on age, and some products are even as low as 4.9 yuan per year.

  Is specialty drug insurance worth it?

What problems should you pay attention to when purchasing?

  Special effect insurance sales hot: one-year premium as low as 4.9 yuan

  A reporter from Shell Finance found that as of now, many insurance companies such as Taikang Life, Ping An Life, Xinhua Insurance, PICC Life, and Ping An Annuity have launched CAR-T cell immunotherapy insurance, most of which are cheap and relatively simple.

  Shell Finance saw in the promotion of Ankangfu CAR-T cell immunotherapy insurance under Ping An Annuity Insurance that only 4.9 yuan is required to obtain a maximum insurance amount of 2 million.

The coverage includes drug fees, inspection fees, bed fees and other expenses, and people without medical insurance can also buy it.

  The main responsibility of this product is the CAR-T cell immunotherapy insurance premium of 2 million yuan, and there are two gift responsibilities, namely the CAR-T cell immunotherapy medical treatment arrangement service and the medical treatment fee advance service.

The publicity content shows that the waiting period for CAR-T cell immunotherapy insurance liability is 30 days, which includes 5 subdivided responsibilities, namely cellular immunotherapy medical insurance, transportation expense insurance, accommodation expense insurance, and one-time hospitalization. The subsidy insurance money and the illness death insurance benefit during the treatment period, the contract is terminated when the total amount of various insurance benefits actually accumulatively paid reaches 2 million yuan during the insurance period.

  From the perspective of insurance conditions, the age range for the first insurance application is 18 to 70 years old, and there are 4 health notices in total, mainly asking whether a doctor recommends a bone marrow biopsy or/and further blood cytology; whether the insured has ever suffered from malignant tumor Tumors, etc., if one of the items does not meet the requirements, you cannot apply for insurance.

Also, insurance companies do not accept coverage if they are waiting for a checkup diagnosis.

  In terms of price, taking a 30-year-old consumer with medical insurance as an example, the one-year premium for Baoan Kangfu CAR-T cell immunotherapy insurance is only 8.6 yuan, but if the age is older, the product price is not cheap, such as 70 The insurance premium for the elderly with medical insurance also needs to be 113.7 yuan per year.

  Shell Finance reporters noticed that in the publicity of insurance companies, the latest anti-cancer technology CAR-T cell immunotherapy is often linked to "special drugs" and "high prices", and also claims to be precise in anti-cancer, and the whole process is worry-free.

  "1.2 million one-shot anti-cancer magic drug" is available, can you buy insurance to buy peace of mind?

  A consumer who has purchased the product told Shell Finance reporter: "This kind of insurance is really cheap. It costs more than ten yuan to buy an ice cream, and the insurance policy is only a few yuan a year, so you can feel at ease when you buy it."

  The reason why CAR-T cell immunotherapy insurance is "hot" is due to the fact that the product is cheap and the guarantee is clear.

On the other hand, it is related to the better anticancer efficacy of CAR-T.

  According to public information, known by netizens as the "1.2 million anti-cancer magic drug", since June 2021, China's first commercialized CAR-T cell therapy product, Yikaida, has been officially approved for marketing in China, and has been launched nationwide. More than 80 hospitals have treated more than 200 patients.

  The Everbright Securities Research Report pointed out that because some patients fail to respond to treatment or are more likely to relapse due to drug resistance, traditional treatment options cannot cure tumor diseases.

Clinical studies have shown that CAR-T cell immunotherapy can overcome the above difficulties through its mechanism of action, and is expected to completely eradicate the unresolved cells expressing tumor-associated antigens, including tumor cells and tumor stem cells, thereby producing curative effects.

Therefore, CAR-T cell therapy can be an effective treatment option for patients who have failed previous treatments.

  However, this cutting-edge technology is not suitable for all patients, and medical resources are relatively scarce.

Taikang Life Insurance mentioned in a publicity last year that the first CAR-T cell immunotherapy drug in China, Akilence Injection (trade name: Yikaida), will be launched in June 2021. Hospitals, pharmacies and Experts are still in short supply.

There are nearly 50 hospitals with CAR-T qualifications in the country, accounting for only about 3% of the national top three hospitals.

In addition, only more than 60 specific pharmacies across the country are qualified to order such drugs.

  It is worth mentioning that last year, "Shanghai's 1.2 million one-shot anticancer drug was launched" was widely circulated on the Internet.

The switchboard of Shanghai Jiaotong University School of Medicine once received hundreds of inquiries, all asking if they could come for CAR-T treatment.

In this regard, the relevant departments in Shanghai have refuted the rumors, and the expression "1.2 million yuan for an injection, the cancer cells will be cleared in 2 months" has not been recognized by professional doctors.

  In fact, the emerging cell therapy represented by CAR-T cell immunotherapy is the most cutting-edge research field in the medical field, but its clinical use is still in its early stages, and not all patients are suitable for this treatment.

  Regarding this type of insurance, Zhu Junsheng, research director of the China Insurance and Pension Research Center of the PBC School of Finance, Tsinghua University, told Shell Finance reporter that because this is a single special drug insurance, although the coverage is high, the probability of occurrence is very low, so the premium is relatively high. It's cheaper.

  Is it necessary to purchase insurance separately for CAR-T therapy?

  On the one hand, there are high medical expenses, and on the other hand, CAR-T cell immunotherapy has been pushed to the "altar". It is undoubtedly an option to transfer risks through highly leveraged insurance.

However, is it really necessary for consumers to purchase a separate CAR-T cell immunotherapy insurance?

  Shell Finance reporters learned that it is not only the purchase of CAR-T cell immunotherapy insurance to enjoy this kind of compensation. The millions of medical insurance purchased by some consumers before also includes CAR-T cell immunotherapy related responsibilities.

  For example, a million-dollar medical insurance with guaranteed renewal for 6 years, the insurance liability is divided into general medical insurance liability and major disease medical insurance liability, including inpatient medical expenses, special outpatient expenses, outpatient surgery expenses, Outpatient and emergency medical expenses for 7 days before hospitalization and 30 days after discharge (including the day of admission and discharge).

For the cost of CAR-T cell immunotherapy, as long as it is a medical expense that meets the insurance responsibility during hospitalization (or treatment) in a hospital recognized by the insurance company, it can be reimbursed.

  E Xiangnu-Medical Care One Million Medical Insurance (20 Years)-Personal Edition also clearly stated in the product introduction page that it covers special drug protection such as CAR-T, with a maximum annual reimbursement of 2 million.

  In addition, some Huimin Insurance also has this responsibility. For example, Beijing Jinghui Insurance included CAR-T cell immunotherapy in its coverage in October 2021, and completed the first CAR-T therapy claim settlement on February 17 this year. Compensation to 1 million yuan.

  Zhu Junsheng said that the price of CAR-T cell immunotherapy is relatively high, which generally requires millions of yuan. If there are tumor patients who want to receive CAR-T therapy, the medical cost is a relatively large burden. If consumers have purchased CAR-covered CAR -T therapy liability million medical insurance and other products, then there is no need to buy such a product separately.

However, many million-dollar medical insurance, Huimin Insurance, etc. do not include relevant responsibilities. It is indeed possible to consider purchasing such products, which are cheaper and more targeted.

  Yang Zeyun, a teacher in the Department of Finance of the School of Management of Beijing Union University, told Shell Finance reporters that for individual consumers, they should be optimistic about the relevant terms when purchasing products.

In fact, there are also some Huimin Insurance products on the market that include the responsibility of CAR-T cell immunotherapy.

In terms of price, although Huimin Insurance is more expensive than a single CAR-T therapy insurance, it has more insurance responsibilities, is more comprehensive and more practical.

When purchasing, it also depends on the guarantee amount of CAR-T therapy in Huimin Insurance. Some products only have a quota of 500,000, which may not be enough for the use of CAR-T therapy.

  "Some million-dollar medical insurances can also reimburse the treatment costs of CAR-T cell immunotherapy, depending on the terms. For consumers, the million-dollar medical insurance with CAR-T therapy liability is better than monotherapy insurance. ." Yang Zeyun said.

  Regarding the issues that should be paid attention to when purchasing insurance such as CAR-T cell immunotherapy, Zhu Junsheng said that in addition to paying attention to the responsibility of the product itself, you can also pay attention to additional services, such as whether there is a green channel for medical treatment and other resources that can be connected, because CAR-T Medical resources for cellular immunotherapy are relatively scarce, if some resources can be connected.

For consumers, insurance can not only solve the problem of medical expenses, but also solve many medical problems.

  Shell Finance reporters noticed that many insurance companies have focused on the resources connected to their products in their publicity. For example, a certain product claims to have direct access to CAR-T qualified hospitals and experts. Currently, it has covered a network of 105 CAR-T qualified hospitals. Help customers find the right hospital, and at the same time, directly connect to CAR-T qualified hospital wards, provide hospitalization assistance arrangements, etc.

  Beijing News Shell Finance reporter Pan Yichun

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