Is it possible that the imported drugs of "700,000 yuan per shot" will be included in medical insurance at a significant price cut?
□Jiang Jingjing
Recently, the drug "700,000 yuan per injection of Noxinassen Sodium Injection" for the treatment of spinal muscular atrophy has attracted attention. The staff of the Letters and Visits Office of the National Medical Insurance Bureau said in an interview with the media that the price of Noxinagen Sodium Injection is set by the pharmaceutical companies themselves, so the price of the drug in each country has certain discrepancies, "except for the raw materials and R&D costs of the drug. Pharmaceutical companies will also consider profit issues. In addition, the drug is currently monopolized in the domestic market, and the price has been high.” Relevant pharmaceutical companies responded, “Always maintain active communication with relevant national and local government departments. Call for the establishment of a multi-party co-payment mechanism."
Noxinagen Sodium Injection is an imported drug and a "monopoly drug." In terms of absolute price, the domestic "700,000 yuan per piece" can be called a sky-high price; and from a global horizontal comparison, the price is relatively not too outrageous. Roughly speaking, the price of this drug in various countries is in the range of "a few hundred thousand yuan per shot". The only difference is that some countries have included it in a "welfare security plan", public finances have paid the bulk of the price of medicines, and patients' out-of-pocket expenses have been greatly reduced.
Previously, there was a saying that "the domestic price of Nocina sodium is as high as 700,000 yuan, and the price in Australia is only more than 200 yuan". The confusion between the price of medicine and the patient's out-of-pocket expenses after the reimbursement of medicine has caused quite a misunderstanding. Under the clarification of facts and the fermentation of public opinion, the voice calling for "noxinagen sodium injection to be included in the medical insurance catalogue" once again occupied the public opinion field-from the perspective of responsibility ethics and humanitarianism, it should be the case; however, given that the medical insurance fund "receives The actual situation of "stretching balance" and the mission function positioning of "guaranteeing basics" may be a bit reluctant to pay for such high-priced rare disease drugs!
It should be said that now is a delicate time node. A new round of medical insurance catalog adjustments will be launched in September and will be announced from November to December 2020. There are various signs that related functional departments and pharmaceutical manufacturers are also interested in negotiating with regard to Nosina Sodium Injection. In spite of the difficulties, there is still hope for the inclusion of Nosinagen Sodium Injection in the medical insurance list after the price drop.
With reference to past market laws, orphan drugs basically adopt a typical liposuction pricing strategy, that is, position the price at a higher level when the product just enters the market, and then gradually reduce the price over time. In addition, as drug patents are gradually approaching expiration, as other companies have the right to imitate, the strong pricing advantage of "monopoly drugs" will also be diluted, and lower prices are a general trend... Everyone knows the truth, both parties have the capital to bargain. , It depends on the art of specific negotiation.
Concerning commercial interests, market incentives, public morality and national responsibility, "orphan drugs" for rare diseases has always been a complicated and heavy topic. The more so, the more we should seek common ground while reserving differences, and the more we should seek the best solution with patience and wisdom.