Since March this year, the medical insurance department of the mainland has reduced the price of innovative drugs with high price and included them in the medical insurance catalog, including anti-cancer drugs, a total of 119 kinds of drugs, but now it is rumored that some people responded that the drugs included in the medical insurance can be seen but not touched, so that the good intention of the policy is greatly compromised. The picture shows that doctors at Hunan Cancer Hospital are picking up drugs for patients. (China News Service)
The mainland’s medical insurance department has reduced the price of clinically urgent and expensive innovative drugs and included them in the medical insurance catalog since March this year, including a total of 119 kinds of drugs, including anti-cancer drugs, but now it is rumored that some people respond that the drugs included in the medical insurance can be seen but not touched, so that the policy’s good intentions are greatly compromised. Medical experts pointed out that hospitals must go through a relevant selection process for the use of new drugs, which takes some time, and called for the policy to be further loosened to provide support for medical institutions to use negotiated drugs in order to increase hospitals’ willingness to use new drugs.
According to the statistics of the Chinese Pharmaceutical Society on 1,420 sample hospitals, the proportion of innovative oncology drugs included in the national medical insurance catalog from 2018 to 2019 that entered hospitals was about 25%. Why is it difficult for negotiated drugs to enter hospitals? Cao Zhuang, deputy researcher of the National Institute of Medical Security of Capital Medical University, said that at present, hospitals are the main channel to guarantee the landing of negotiated innovative drugs, but whether medical institutions use negotiated drugs and how much the utilization rate directly affects the implementation effect of the negotiated drug policy, and hospitals need a process to dispense new drugs.
Zhao Bin, deputy director of the pharmacy department of Peking Union Medical College Hospital, said that when the negotiated drugs enter the hospital, they will first go through drug selection, which is the responsibility of the hospital’s internal organization “Pharmacy Management and Pharmacotherapeutics Committee”. It takes a long time to accumulate enough evidence before a drug is qualified for marketing and doctors can get detailed information about the effectiveness and safety of the drug.
Zhao Bin said that when a doctor confirms the submission of a drug application, his or her clinical department will organize an initial selection of experts, and then submit the results to the Pharmacy Management and Pharmacotherapeutics Committee for review, and the hospital will hold regular drug selection meetings. That is, the frequency of the pharmacy management and pharmacotherapeutics committee to decide the time and speed of new drugs into the hospital. It is understood that most hospitals on the mainland convene pharmacy committees less frequently, with large hospitals generally convening once a year, once every six months, and individual hospitals convening once every few years. And the negotiated drugs into the medical insurance catalog is valid for 2 years, which means that some negotiated drugs have passed the agreement period before entering the hospital.
Cao Zhuang said, to ensure that all the negotiated drugs in the short term for the people to use to, the chances are not good, there are still regions will be negotiated drugs into the drug ratio, cost increases and other assessment indicators range, which affects the public hospitals equipped with drugs, especially the higher cost of innovative drugs, hospitals are not willing to take the risk. He suggested that the policy should be further unbundled to provide support for medical institutions to use the negotiated drugs.
It is understood that more than 20 provincial medical insurance departments on the mainland have issued corresponding policies to implement a “dual-channel” protection policy for some of the negotiated drugs, i.e., the use and reimbursement of some of the high-priced or special drugs for the participants, the implementation of medical institutions and designated pharmacies to jointly protect the approach. Song Ruilin, executive chairman of the China Association for the Promotion of Pharmaceutical Innovation, said that this solves the supply problem caused by the inability of negotiated drugs to enter hospitals.
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