"Effective medicine 550,000 yuan per injection" calls for a shared mechanism for the treatment of rare diseases
Recently, a bill for hospitalization charges was spread online, causing netizens to question it.
The bill shows that in the Pediatric Neurorehabilitation Ward of the Second Affiliated Hospital of Xi'an Jiaotong University, a 1-year-old girl spent a total of more than 550,000 yuan in hospitalization for 4 days.
The hospital responded that the treatment is scientific and there are no sky-high charges. This kind of special medicine is so expensive and is not in the medical insurance catalog.
The family members stated that the medication was given their informed consent and the hospital did not overcharge.
(See Health Times on September 5)
It can be seen that "harvesting patients", "arbitrarily charging, overcharging" and other situations are not true.
Relevant information shows that the girl was diagnosed with spinal muscular atrophy, a rare genetic disease, and "Nosinagen Sodium" is the world's first specific drug for precise targeted treatment of this disease. The drug is in February 2019. Introduced to China in January, the price was 700,000 yuan per needle at that time, and it was reduced to 550,000 yuan per needle in January this year.
In foreign countries, its price is also expensive.
An injection of 550,000 yuan will cost as much as 4 million yuan in the first year, and about 2 million yuan in subsequent years. This is obviously unbearable for the patient’s family.
From the perspective of pharmaceutical companies, the high price is mainly due to the huge investment in new drug development and the limited demand for rare diseases.
On the one hand, the high price has its rationality and inevitability, and on the other hand, it is a heavy reality that most patients cannot afford.
Especially under the current medical insurance system, rare disease specific drugs have not been included in the medical insurance reimbursement list.
From the perspective of the management of the medical insurance fund, "after the rare disease drugs are included in the medical insurance catalogue, for underdeveloped regions, the fund used to pay for high-priced rare diseases may affect the protection of other underlying diseases, and it may also cause local economic pressure in the future. ".
How to resolve this contradiction so that medical insurance can more share the burden of personal medical care and achieve social mutual aid is indeed a problem.
For example, according to the use of medical insurance funds in various regions, a certain proportion of reimbursements for special drugs is given, "what can be shared is a little"; through major illness medical mutual assistance supplementary insurance and other social commercial insurance channels, etc.
In fact, similar approaches are being tried in some places.
For example, Chengdu, Sichuan, has launched a rare disease drug protection policy, including 7 rare disease drugs, including Noxinagen sodium, included in the city’s critical illness medical mutual assistance supplementary insurance coverage; Zhejiang has also piloted a rare disease special fund protection model. A basic medical insurance participant established a special fund for rare disease drug protection at a payment standard of 2 yuan per year, and the maximum reimbursement ratio can reach 90%... This joint force sharing mechanism not only effectively reduces the burden on patients, but also takes into account the basic medical insurance. Affordability.
It is worth noting that some local medical insurance funds appear to be overwhelmed and are also related to some medical waste.
Such as the phenomenon of over-prescribing and inspection caused by unreasonable medical compensation methods.
If these phenomena can be effectively curbed, then the expenditure pressure of the medical insurance fund is expected to be alleviated.
Using precious medical insurance funds and "life-saving money" as much as possible on the blade of "medicine treatment" to benefit more patients and the public is the direction of the efforts of relevant departments.
Zhang Guifeng