Paxlovid medical insurance negotiations failed, and these drugs can still be reimbursed, with a wide variety!

　　China News Service, January 9th (China News Finance Zhang Nizuo Yuqing) On the 8th, after a few days of "soul bargaining", the 2022 National Medical Insurance Drug Catalog negotiation work officially ended.

According to the news from the National Medical Insurance Administration, Paxlovid, a new crown treatment drug that has attracted much attention from the outside world, failed to negotiate due to high quotations, while Azvudine Tablets and Qingfei Paidu Granules successfully negotiated.

Bid too high, Paxlovid health insurance talks fail

　　According to the person in charge of the Medicine Management Department of the National Medical Security Administration, this year, a total of three new crown treatment drugs, Azivudine Tablets, Naimatevir Tablets/Ritonavir Tablets Combination Packaging ("Paxlovid"), and Qingfei Paidu Granules, passed the approval. Participated in the negotiations through procedures such as self-declaration, form review, and expert review by enterprises.

Among them, Azivudine Tablets and Qingfei Paidu Granules were successfully negotiated, but Paxlovid failed due to the high quotation of the manufacturer Pfizer Investment Co.,

Ltd.

Screenshot from the official website of the National Medical Insurance Bureau

　　The above-mentioned person in charge also stated that although Paxlovid failed to be included in the medical insurance catalog through negotiation, according to the recent "Related Policies on Optimizing the Treatment Expenses of New Coronavirus Infected Patients after the Implementation of "Class B and B Controls" jointly issued by the National Medical Insurance Administration and relevant departments All therapeutic drugs in the "Diagnosis and Treatment Program for Novel Coronavirus Infection (Trial Version 10)",

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During this period, insured patients infected with the new coronavirus can enjoy the medical insurance reimbursement policy when using these drugs.

Competing products approved, domestic drugs on the way Paxlovid is not the "only option"

　　my country has a huge elderly population and people suffering from underlying diseases. Therefore, whether Paxlovid and other new crown treatment drugs can be covered by medical insurance has always been highly concerned.

　　Although Paxlovid failed to be shortlisted this time, with the approval of the drug regulatory department and the acceleration of domestic drug research and development, patients will have more diverse choices in the future.

　　Not long before this negotiation, in December 2022, the State Food and Drug Administration had conditionally approved the import registration of Merck’s new coronavirus treatment drug, Monogravir Capsules.

In a community health service center in Beijing, medical staff are putting the delivered cold medicine into the medicine rack.

Photo by China News Agency reporter Yi Haifei

　　According to media reports, on March 17, 2022, the Medicines Patent Pool (MPP) in Geneva announced that it had signed agreements with 35 pharmaceutical companies, allowing them to produce Nematevir, one of the components of Pfizer’s new crown oral drug Paxlovid APIs or preparations.

Among them, five Chinese pharmaceutical companies are Shanghai Desano, Huahai Pharmaceutical, ProPharm, Fosun Pharma, and Jiuzhou Pharmaceutical.

　　At the same time, the development of domestically produced new crown therapeutic drugs is also accelerating.

In addition to Real Bio’s Azvudine Tablets, which have been approved for marketing in China, Junshi Biotech’s VV116, Ascletis Pharmaceutical’s new crown oral drug polymerase inhibitor ASC10, and CSPC’s new crown oral drug SYH2055 have entered clinical trials.

　　Some industry analysts believe that with the increase in the number of approved drugs, there will be pressure on the future pricing of Paxlovid.

　　The National Medical Insurance Administration also introduced that after Azivudine Tablets and Qingfei Paidu Granules were included in the National Medical Insurance Drug List after this negotiation,

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At the same time, in order to meet the treatment needs of patients infected with the new coronavirus in various places, the medical insurance departments of various places have recently incorporated a batch of new crown symptomatic treatment drugs into the scope of medical insurance payment in the region in light of the operation of local medical insurance funds.

The official reimbursement policy clearly states that these expenses can be reported!

　　Aiming at the issue of reimbursement of treatment expenses for the new crown that patients are most concerned about, the policy has also been clarified.

　　The "Notice on Relevant Policies for Optimizing Treatment Expenses for Patients with Novel Coronavirus Infection after the Implementation of "Class B and B Controls" recently issued by four departments including the National Medical Insurance Bureau requires that the occurrence of new coronavirus infection patients in all medical institutions shall meet the requirements The inpatient medical expenses of the new coronavirus infection diagnosis and treatment plan formulated by the health and health department shall implement the early-stage expense protection policy. After the basic medical insurance, serious illness insurance, medical assistance, etc. are paid in accordance with the regulations, the part of the personal burden shall be subsidized by the finance, and the required funds shall be provided by the local government. The finance will pay in advance, and the central finance will subsidize 60% of the actual expenses incurred.

The policy is calculated based on the patient's admission time and will be implemented until March 31, 2023.

　　From a local level, Beijing recently made it clear that the insured patients who have a new type of coronavirus infection and 11 types of suspected symptoms (fever, dry cough, fatigue, sore throat, loss of smell/taste, nasal congestion) , runny nose, conjunctivitis, myalgia and diarrhea) related outpatient and emergency expenses are implemented with special protection, there is no deductible line and cap line, and the reimbursement rate is 90%, which will be implemented until March 31, 2023.

　　The Yunnan Provincial Medical Security Bureau and other departments also jointly issued the "Notice", clarifying the continued implementation of the policy of full reimbursement of hospitalization expenses and the implementation of special guarantees for outpatient and emergency treatment expenses.

　　In response to the issue of drug pricing, the person in charge of the Medical Management Department of the National Medical Insurance Bureau also stated that the Office of the National Medical Insurance Bureau recently issued the "Guidelines for the Formation of Drug Prices for New Coronary Treatment (Trial)" to provide new antiviral drugs for the prevention and treatment of new coronavirus infections. ,

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