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刚需药是怎样“谈”进医保的

2017-08-07 03:31:36   中国青年网

看到名单里的“曲妥珠单抗”,陈俊(化名)心里的一块石头落了地。

陈俊的母亲罹患乳腺癌,需要注射曲妥珠单抗,即俗称的赫赛汀。此前在中国,这一由跨国药企罗氏生产的药品,一支的零售价格就高达2万多元。而在一个治疗周期里,患者至少要注射14支。对患者而言,即便可以通过医保部分报销,同样是一笔难以承受的巨大支出。

日前,人力资源和社会保障部对外公布36种药品进入医保目录后的价格谈判结果,并同步确定了这些药品的医保支付标准,赫赛汀名列其中。经过谈判,每支药品支付标准降到7600元,降幅近七成。

被纳入《国家基本医疗保险、工伤保险和生育保险药品目录(2017年版)》乙类范围的药品,大多都是患者热盼的肿瘤靶向药,以及治疗心血管病、血友病等重大疾病的药品。与2016年平均零售价相比,谈判药品平均降幅达44%,最高降幅达70%。

这是中国药品医保准入的首次国家谈判。对患者而言,刚需药降价入医保无疑是一场“甘霖”;而对医保基金和药企而言,也能从中收获共赢。

药价大降 患者受益

申请签证、购买机票、兑换货币、交涉砍价、冷链运输……1年前,曾有一名网友在网上分享了自己去印度新德里购买赫赛汀的经历。为了购买几支药品,一路折腾、心力交瘁。即便如此,买药的成本也比国内购药低。有好几名网友回复称,看完买药“攻略”,自己也打算去印度买药。

陈俊说,自己也曾有这样的念头,但害怕买到假药或药物过期失效,担心回国后医生不给注射,因此并未成行。

而此次纳入医保目录后,赫赛汀的单只售价降到7600元,按照参保患者最低自付比例二成计算,患者每支药品最低只需花费1500元,相当于一张去新德里的单程机票。

像赫赛汀这样的药品,属于治疗肿瘤的“靶向药”。所谓靶向药,是指能够“瞄准”特定的病变部位,并在目标部位蓄积或释放有效成分的药品。由于药效高、毒副作用小,靶向药成为治疗癌症的理想药品。

长期以来,部分癌症患者必须依靠进口靶向药以及某些创新药延续生命。然而,这些药品囿于专利限制,往往价格极高,且不能通过医保报销。面对“用钱买命”的负担,不少人选择放弃,有的被迫加入“购药大军”,到印度等周边国家采购进口药品或低价“仿制药”。

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