On January 18, the 2022 medical insurance catalog was officially announced, and the new version of the catalog will be implemented on March 1, 2023.
According to the new version of the catalog, 111 new drugs have been added to the national medical insurance drugs, and 3 drugs have been transferred out. After adjustment, the total number of drugs in the national medical insurance drug catalog is 2,967, including 1,586 Western medicines and 1,381 Chinese patent medicines. There are still 892 types of traditional Chinese medicine pieces.
The National Medical Insurance Administration introduced at the press conference on the adjustment of the medical insurance drug catalog on January 18 that in this round of adjustment of the national medical insurance catalog, the National Medical Insurance Information Platform*** received 537 pieces of enterprise declaration information, involving 490 drugs. , 344 drugs passed the preliminary formal review, with a passing rate of 70%. Judging from the negotiation and bidding situation, 147 drugs outside the catalog participated in negotiations and bidding, and 121 drugs were successfully negotiated or bid, with an overall success rate of 82.3%.
“A small step further can benefit more patients” “Our purpose is the same” From January 5 to 8, 2023, at the medical insurance negotiation site at the National People’s Congress Conference Center in Beijing, The Paper The news noted that many negotiators mentioned such statements. Ten days later, as the dust of the 2022 version of the medical insurance catalog settled, the results of the 2022 national medical insurance drug negotiations were officially announced.
The negotiation for two new coronavirus oral drugs was successful
Huang Xinyu, deputy director of the Pharmaceutical Service Management Department of the National Medical Insurance Administration, said that for the third consecutive year, the National Medical Insurance Administration has included new coronavirus treatment drugs in the medical insurance catalog. Conditions, two drugs including Azivudine Tablets and Qingfei Paidu Granules will be officially included in the national medical insurance drug catalog through negotiation and price reduction. Among the 25 marketed drugs involved in the tenth edition of the new coronavirus infection diagnosis and treatment plan, 21 varieties have been officially included in the national medical insurance catalog.
Previously, three types of Azivudine tablets from Real Biotechnology, Pfizer’s nematvir tablets/ritonavir tablet combination packaging, and Qingfei Paidu granules from the Institute of Clinical Basic Medicine of the Chinese Academy of Chinese Medical Sciences COVID-19 treatment drugs participated in the negotiation of the National Medical Insurance Catalog.
According to media reports, the result of the negotiation for Azivudine is that the price of 3mg specification is reduced by about 35%, and it is included in medical insurance at a price of 11.58 yuan/tablet. Azivudine is mainly used to treat COVID-19 in 1mg format. According to the drug price comparison specification, the price of this specification should also be reduced to 4.99 yuan/tablet, that is, the price of Azivudine used to treat COVID-19 should be reduced from 270 yuan/bottle. About 175 yuan/bottle.
The person in charge of the Pharmaceutical Management Department of the National Medical Insurance Administration introduced on January 8 that the negotiations for Azivudine Tablets and Qingfei Paidu Granules were successful, while Paxlovid failed due to the excessive price offered by the manufacturer Pfizer. The person in charge said that although Paxlovid failed to be included in the medical insurance catalog through negotiation, according to the "Notice on Optimizing Medical Insurance Related Policies for the Treatment Costs of New Coronavirus Infected Patients after the Implementation of "Category B and B" jointly issued by the National Medical Insurance Administration and relevant departments recently, ” requires that all therapeutic drugs in the “New Coronavirus Infection Diagnosis and Treatment Plan”, including Paxlovid, Azivudine Tablets, Monolavir Capsules, Sanhan Huashi Granules, etc., will be temporarily paid by medical insurance until March 2023. March 31st.
In addition, after Azivudine Tablets and Qingfei Paidu Granules were included in the National Medical Insurance Drug Directory through this negotiation, there are more than 600 types of drugs in the National Medical Insurance Drug Directory for treating COVID-19 symptoms such as fever and cough.
Domestic PD-1 adds two new indications
The PD-1 negotiation that has attracted much attention. Currently, four domestic PD-1 products have been included in medical insurance. This medical insurance negotiation The main focus is on new indications. Up to now, 13 PD-1 antibodies have been approved in China, entered into the preliminary review list, and participated in negotiations to increase the indications of varieties in the catalog.
Previously, some media stated that the above-mentioned 4 domestically produced PD-1s have a total of 12 indications that are not included in the medical insurance, involving nasopharyngeal cancer, esophageal squamous cell carcinoma, esophageal cancer, esophageal squamous cell carcinoma, gastric cancer Or 6 cancer types: gastroesophageal junction adenocarcinoma and non-small cell lung cancer. Among them, esophageal squamous cell carcinoma is an indication declared by four companies in this negotiation on the medical insurance catalog.
Judging from the published medical insurance catalog, The Paper noted that Innovent Biologics’ sintilimab was included in two new first-line treatment indications for gastric cancer and esophageal cancer this year. This time, it was included in the medical insurance. Sintilimab has become the only PD-1 inhibitor with all five first-line indications included in the national medical insurance catalog.
Professor Shen Lin, director of the Department of Gastrointestinal Oncology at Peking University Cancer Hospital, said that in recent years, immunotherapy has played an increasingly important role in the field of tumor treatment. Clinical studies have found that, overall, patients with esophageal cancer can benefit from immunotherapy in terms of overall survival regardless of the expression level of PD-1 antibodies, which undoubtedly gives clinicians more treatment options. Indications such as esophageal squamous cell carcinoma are included in the new version of the national medical insurance catalog, and patients’ medication burden will be further reduced.
The sky-high price of anti-cancer drugs has not been included in the medical insurance catalog
It is worth mentioning whether the "one-million-shot" CAR-T therapy can be successfully negotiated in this adjustment to the medical insurance catalog attracted much attention from the outside world. This year, WuXi Junuo's Ruijiolanzai injection was on the negotiation list, but failed to enter the medical insurance directory through negotiations.
In addition to CAR-T therapy, in the field of tumor treatment, ADC drugs are known as "intelligent biological missiles" and "magic bullets". In recent years, this type of drugs has become a research and development hotspot in the pharmaceutical field.
Up to now, there are 5 ADC drugs approved for marketing in my country, including Roche’s Trastuzumab, Takeda’s Vibutuximab, and Pfizer/Wyeth’s Orbituximab. Plus itolizumab, Rongchang Biotech's vedicituzumab and Genting Xinyao's gosatuzumab. In 2021, vedicituzumab was successfully negotiated to enter the national medical insurance directory; the negotiation for velbutuximab failed, and Enmei trastuzumab was not included in the preliminary review list.
According to the new version of the National Reimbursement Directory, in this negotiation, Roche’s trastuzumab, Takeda Pharmaceutical’s vibutuximab, and Rongchang Biologics’ vedisituximab were successfully negotiated. In the medical insurance directory.
Seven rare disease drugs have been included in the medical insurance catalog
The National Medical Insurance Administration press conference introduced that a total of 24 domestically produced major innovative drugs were included in the negotiations, and in the end, orebatidine Negotiations were successful on 20 drugs including Nigeria. At the same time, 7 drugs for rare diseases, 22 drugs for children, and 2 essential drugs were successfully included in the catalog, further improving the level of drug protection in key areas.
In 2021, seven rare disease drugs, including the SMA treatment drug nosinaxin sodium, were successfully negotiated to enter the national medical insurance, with an average price reduction of 65%. There are 19 rare disease drugs entering the preliminary review list in 2022, including Sanofi's type I Gaucher disease treatment drug imiglucerase for injection, Fabry disease drug agalsidase beta for injection; Takeda's treatment Hereditary angioedema drug lanariumab and Gaucher disease treatment drug velaglucerase alfa for injection; Roche's SMA treatment drug lisopran oral solution in powder, etc.
According to reports, my country’s medical insurance catalog currently includes 52 rare disease drugs, covering 27 rare diseases. Among them, since the establishment of the National Medical Insurance Administration, 26 new rare disease drugs have been added to the catalog through negotiation, with an average reduction of 53%. The price reduction is combined with medical insurance reimbursement, effectively reducing the burden on insured patients.
On January 18, Huang Xinyu said that as long as the price of rare disease drugs can be negotiated, the medical insurance catalog is very positive and wants to include rare disease drugs in the catalog, and in the early review and subsequent calculation process , all pay great attention to the use of drugs for rare diseases.
According to the new version of the reimbursement directory, hereditary angioedema treatment drug lanariumab, adult relapsing multiple sclerosis drug ofatumumab, spinal muscular atrophy treatment drug lixirumab Prolan oral solution powder appears in the medical insurance catalog. In terms of domestic innovative drugs, many are included in this round of negotiations. Among them, Hengrui Pharmaceuticals’ AR inhibitor revelutamide tablets and two products from Zai Lab are also included in the reimbursement drug catalog.