Imatinib, commonly known as "Glinin", is a drug for the treatment of leukemia and also the "protagonist" in the movie Dying. There is a line in the movie: "There is only one disease in the world, poor disease." This sentence once stung the hearts of many leukemia patients. Li Yong (pseudonym) is such a patient. 20 13, diagnosed as chronic myeloid leukemia. The monthly treatment cost is about 30 thousand yuan, which requires lifelong medication. In the same year, his child was born. Faced with high medical expenses, as an ordinary working class, Li Yong felt that he had dragged down the whole family and once wanted to give up treatment.
In 20 17, imatinib began to enter the medical insurance catalogue, and the cost per tablet was reduced to 170 yuan. In 20 18, the national medical insurance bureau started centralized drug bidding, and the number of imatinib was reduced to1each in 4 yuan; In the second year, the national collection work resumed, and each department only needed 9.8 yuan. Li Yong said that he only needs 350 yuan to buy medicine every month now, and the desperate dilemma of not being able to afford medicine at the beginning no longer exists.
Imatinib listed in China's medical insurance catalogue is a generic drug produced in China. Can the efficacy of generic drugs entering medical insurance be the same as that of original drugs? In order to answer this question that many patients are concerned about, 20 Beijing medical institutions, including Beijing xuanwu hospital, conducted real-world research on the clinical efficacy and safety of imatinib 14 generic drugs under the guidance of the National Medical Insurance Bureau and entrusted by the Beijing Municipal Health and Health Commission. More than 1 10000 cases were collected in this study. The results show that 14 generic drug is equivalent to the original drug in clinical efficacy and use.
Li Yong said that after learning the news, he strengthened his confidence in medication. In fact, the domestic generic drug imatinib also produced the expected curative effect. Li Yong's illness is now under control and his life is basically no longer affected.
In a hospital in Sichuan, patients are reimbursing medical expenses. Liu Yurong/photo
National centralized procurement promotes the optimization of drug use structure.
According to Jiang, China has conducted six national centralized drug purchases, and the average price of drugs has dropped by about 53%. Jiang said that the national centralized drug bidding work is "purchasing by quantity, exchanging price by quantity". National centralized procurement, give play to the strategic procurement role of medical insurance fund. "Therefore, the national centralized drug procurement is also figuratively compared to the national' drug group purchase'.
National centralized drug procurement has a great influence on drug procurement in China. According to the data released by China Medical Insurance Research Association, one year after the centralized procurement results of the nine drugs investigated were implemented, compared with the previous year, the total annual procurement amount of selected generic drugs increased by 265. 19%. Accordingly, the total annual purchase of generic drugs that were not selected decreased by 80.79%, and the total annual purchase of drugs that were not selected for original research decreased by 46%. The selected generic drugs have obvious substitution effect on the original drugs that have not been selected.
According to Jiang's analysis, in the prescription drug market in developed countries, the number of patented drugs accounts for about 20%, the amount of drugs accounts for about 80%, and the amount of generic drugs accounts for 80% and 20%. Patents have a patent protection period of 20 years, which is very expensive. After the patent protection period ends, many cheap generic drugs will replace patented drugs, which is an international practice.
It is worth mentioning that generic drugs, not patented drugs, need to pass the drug consistency evaluation before they can be listed. Due to the late development of drug consistency evaluation in China, the quality of generic drugs is uneven, people's trust in generic drugs is low, and there are some "excessive superstitions" on generic drugs
Drugs purchased centrally by the state are urgently needed in clinic. Hu Xin, chief physician of the Pharmacy Department of the Third Hospital of Beijing Medical University, said at the press conference that the national centralized procurement not only replaced the original drugs with generic drugs, but also instigated the drug use structure of medical institutions, making the "tiger balm" drugs with low clinical value and "broad spectrum" indications fade out of clinical use, increasing the use of drugs with high clinical value and sufficient evidence. At the same time, the utilization rate of medical insurance fund has been improved, and the drug use structure in China is closer to international practice.
In addition, the national centralized procurement work has also played a good baton role for pharmaceutical companies. Wang Nannan, the administrative manager of the market access department of Zhejiang Jingxin Pharmaceutical Co., Ltd., said at the press conference that the purchasing policy with quantity makes it easier for enterprises with guaranteed production quality to give full play to their scale advantages and return to the essence of manufacturing operation with reasonable price guarantee, which further promotes the transformation and upgrading of their business strategies. In the research and development of new drugs, the company has continuously increased investment in innovation and promoted the development of more new products with more innovative value and more in line with clinical needs.
Improve the accessibility of medicines for ordinary people.
After the generic drugs that passed the consistency evaluation replaced the original drugs, the people became the ultimate beneficiaries. In Hu Xin's view, improving patients' availability of drugs is the greatest benefit of drug concentration in China.
Statistics from the National Cardiovascular Center show that the number of dyslipidemia in China has exceeded 400 million. Atorvastatin is a commonly used drug to treat hyperlipidemia. In the centralized procurement organized by the National Medical Insurance Bureau in 20 19, Qilu Pharmaceutical Atorvastatin Calcium Tablets was selected, with a decrease of 78%.
A grass-roots doctor at Ji 'nan Heshili Community Health Service Center said that atorvastatin is a commonly used drug at the grass-roots level, and the national centralized procurement work changed atorvastatin from a box of original research drugs in 40 yuan to a box of Qilu pharmaceutical generic drugs in 1.68 yuan. "Price reduction can greatly improve the compliance of patients with medication. In order to save the cost of medicine, some patients may reduce their medication at will, but after the price drops to more than one yuan, this situation is greatly reduced. "
The national collection involves many chronic diseases. During the period of 165438+ 10, the sixth centralized procurement in China was mainly insulin, and the average price of the products to be selected was reduced by 48%. According to the news released by the National Medical Insurance Bureau, this centralized procurement not only reduced the inflated price, but also achieved a high degree of matching with the actual clinical needs. Taking insulin glargine commonly used in clinic as an example, the average cost of insulin glargine is 1.80 yuan/branch, which is reduced to about 70 yuan/branch, and each patient can save about 4,000 yuan every year.
Tylenol, a drug for treating hepatitis B.
In Fu Wei, the price of each tablet before collection was 10.6 1 yuan, and the annual treatment cost was 3,800 yuan. After collection, the price dropped to an average of 0.38 yuan per tablet, a decrease of 96%, and the annual treatment cost was 137 yuan. The average annual treatment cost of first-line drugs entecavir and tenofovir disoproxil fumarate fumarate also decreased from 5,500 yuan and 600 yuan to 70 yuan, about 1.50 yuan, respectively. The reduction of the cost of hepatitis B drugs in China has been highly praised by the World Health Organization.
Hu Xin cited the data of Beijing Hospital to illustrate how centralized procurement can improve people's access to medicines. 243 kinds of drugs were selected in the first five batches in China, and Beijing Hospital purchased 160 kinds. From 20 19 to 1-9, the per capita drug expenditure of hospitals in Beijing was 332.33 yuan, down by 22.46% year-on-year, and dropped to 257.7 yuan from 2002 1-9.
Hu Xin said that in the outpatient treatment of hospitals in Beijing, the per capita medical insurance reimbursement is 20,000 yuan each year, including medicines and examinations. This amount is at a high level in all provinces in China, but for the elderly suffering from multiple diseases at the same time, 20,000 yuan is obviously not enough. After the amount exceeds, many elderly patients will stop taking drugs and reduce their drugs without authorization. Now that the cost of drugs has been reduced, the compliance of patients will be greatly improved.
Note: A drug has two names: generic name and trade name. Generic name is the legal name of drugs, that is, the generic name of drugs with the same composition or formula in China. A trade name is a product name determined by a pharmaceutical manufacturer and approved by the pharmaceutical supervisory and administrative department. It is proprietary and cannot be copied. Under a common name, there may be multiple commodity names due to different manufacturers. For example, compound paracetamol and amantadine capsules (or tablets) are common names for cold medicines, while Gai Ke, Kuaike, Kuaikang, Tektronix and Wang Gan are trade names.
Related Q&A: In the movie Dying, gliadin is a generic drug for the treatment of chronic myeloid leukemia, which is a fiction for the movie. In real life, this drug for treating leukemia is called imatinib, which is a molecular targeted drug of tyrosine kinase BCR-ABL developed and produced by Novartis in Switzerland. It is the first-line treatment choice for patients with chronic myeloid leukemia at present, and the treatment effect is very good, of course, its price is also very expensive.
It is reported that the cost of a "miracle" drug like Gleevec may be less than 1,000, but the price has also increased due to the huge manpower, material resources and funds required for early research and development.
In fact, Glenin in the film is based on this drug, and the whole film is also described around this drug. In the film, the price of Grenin starts at 10,000 yuan, which is really unbearable for ordinary families. In addition to this Swiss-made Granin, India also has a generic Granin, which is cheaper than Swiss-made Granin and the effect is not much worse. So in the movie, Yong Cheng began to promote this drug, but this generic drug in the movie is not allowed to be sold in China, because it has not obtained the sales license of imported drugs, even if it is effective for leukemia, it is not recognized.