Should a dose of 700000 yuan be covered by medical insurance?

• by EVOMT
• 2020-08-10

The 700000 injection of "Nosenazone Sodium Injection" has recently received media attention

Recently, media reported that a couple in Hunan found their son unable to clench their hands and exercise their legs when he was full moon. After going to the hospital for examination, they learned that the child was diagnosed with Spinal Muscle Atrophy (SMA)

The doctor told them that to treat this disease, they can only use a specific drug called "Nosenazone Sodium Injection". The problem is, the price for an injection is 700000 yuan!

This is not the entire treatment cost. After the four injections are completed, they will need to be injected again every four months

Such huge treatment costs are difficult for many families to bear

According to media reports, the price of a single injection of Nosenazone sodium in China is 700000 yuan, but in Australia, it only costs $41, and in Japan, it is even nearly free

A stone stirs up a thousand waves, and many netizens wonder why the price difference between China and foreign countries for this drug is so large

Ouyang Chunlan, a mother in Guangdong, submitted an information disclosure application to the State Drug Administration, hoping to learn about the procurement method and domestic pricing basis of the 700000 yuan per injection of Nosenazone sodium injection, a drug for treating spinal muscular atrophy

There are also netizens who shout that the relevant departments should give an explanation

The Health Insurance Bureau responded to this matter

According to the "Red Star News" report, on August 5th, a staff member of the Letters and Calls Office of the National Health Insurance Bureau stated in an interview with a reporter that the price of Nosenazone Sodium Injection is set by pharmaceutical companies themselves, so there are certain differences in the price of the drug in each country. "In addition to the raw materials and research and development costs of the drug, pharmaceutical companies will also consider the issue of profit. In addition to the current market monopoly situation of the drug in China, the price has also remained high."

It is understood that Nosenazone sodium injection was developed by Bojian Company of the United States and was first approved in the United States on December 23, 2016. It is the world's first SMA targeted treatment drug. On February 22, 2019, Nosenazone sodium injection was officially approved by the National Drug Administration, becoming the first drug for the treatment of spinal muscular atrophy (SMA) in China

In fact, Nosenazone sodium injection is not only a "sky-high priced drug" in China. In the United States, Nosenazone sodium injection is $125000 per injection. In Australia, Nosenazone sodium injection is not the reported injection of $41, with the issuance price reaching $110000, just because the majority of medical insurance reimbursement

Another netizen said that this drug is almost free in Japan, but it is also due to the inclusion of medical insurance, which pays for it, and the strict application conditions that only minors are reimbursed

The staff interviewed above said that since the introduction of Nosenazone Sodium Injection in 2019, it has been included in the medical insurance negotiation agenda. The country hopes to negotiate with relevant drug companies to reduce the drug price, thereby meeting the needs of SMA patients "Since last year, the country has been negotiating with pharmaceutical companies, with expert groups studying pricing, and it is unclear how much specific pricing will be. However, the inclusion of medical insurance has not been discussed, as drug prices have not come down, so it has never been possible to enter the medical insurance catalog," said the above-mentioned staff member

Because the health insurance catalog developed by the National Health Insurance Bureau is applicable to all parts of the country, it is necessary to ensure that the drugs entered into the health insurance catalog are affordable everywhere "Once such rare disease drugs are included in the medical insurance catalog, for underdeveloped regions, other basic diseases may not be guaranteed after the fund is used to pay for high-priced rare diseases, and subsequent economic pressures may also be caused. Therefore, the most fundamental solution is for the country and drug companies to negotiate and negotiate the price."

In response to these reports, Bojian Biotechnology responded today that Nosenazone Sodium Injection is currently a self funded drug in China. According to relevant national regulations, drugs participating in the 2019 national health insurance negotiations must be approved before December 31, 2018. Nosenazone Sodium Injection was approved in February 2019, which does not meet the conditions for participating in the 2019 national health insurance negotiations, Therefore, the company has not participated in the 2019 national health insurance negotiation. The company has been actively communicating with relevant national and local government departments, calling for the establishment of a multi-party payment mechanism to further improve the drug availability of Chinese SMA patients.