You need to look at government plans.

In 2018, the medical insurance payment standard for Tagrisso was 510 yuan (80mg/tablet), which is 15,300 yuan/box/month; the latest medical insurance price of Tagrisso in 2021 is 5,580 yuan/box (80mg*30 tablets) in 2020

Medical insurance negotiations are settled!

Negotiations were successful on 119 types of drugs, with an average price reduction of 50.64%.

During this negotiation, more than 50 anti-tumor drugs were included in medical insurance.

Among them, the approved drugs related to lung cancer patients include osimertinib, amitinib, anlotinib, crizotinib, alectinib, ceritinib, erlotinib, and afatinib8

There are two targeted therapy drugs, camrelizumab and bevacizumab, two immunosuppressive drugs.

Targeted drug 1. Osimertinib: Osimertinib has attracted much attention as the first-line treatment of lung cancer and has been included in the medical insurance.

Data from the Phase III clinical study FLAURA show that for lung cancer patients with EGFR-sensitive mutations, the progression-free survival of first-line treatment with osimertinib is as high as 18.9 months, which is much higher than the 10.2 months of first-generation targeted drugs.

Osimertinib is currently the only targeted drug with overall survival (OS) data exceeding 3 years.

Studies have confirmed that osimertinib has a good effect when entering the brain and can reduce the risk of brain metastasis progression by 52%.

The results of this medical insurance negotiation show that the scope of medical insurance payment for osimertinib is: 1. Locally advanced or metastatic non-small cell lung cancer with epidermal growth factor receptor (EGFR) exon 19 deletion or exon 21 (L858R) substitution mutation

First-line treatment for adult patients with NSCLC; 2. Patients who have previously experienced disease progression during or after epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) treatment, and have been confirmed to be EGFRT790M mutation positive

Treatment of adult patients with locally advanced or metastatic non-small cell lung cancer.

In the past, only second-line use of osimertinib for lung cancer patients could be reimbursed by medical insurance. In the future, patients using osimertinib as first-line treatment can be reimbursed by medical insurance.

2. Crizotinib: Crizotinib is included in medical insurance for the first-line treatment of advanced lung cancer. Crizotinib is a tyrosine kinase receptor inhibitor developed by Pfizer. The corresponding targets include ALK, HGFR (c-Met), ROS1 (c

-cos) and RON, which belong to the ALK generation targeted drugs.

Crizotinib was launched in China in 2013 and entered the Class B National Medical Insurance Catalog in October 2018. The payment standard is 260 yuan/250mg tablets and 219 yuan/200mg tablets.

Crizotinib is mainly suitable for the treatment of patients with anaplastic lymphoma kinase (ALK)-positive locally advanced or metastatic non-small cell lung cancer or patients with ROS1-positive advanced non-small cell lung cancer.

It has been confirmed in clinical trials to show high activity in patients with ALK mutations in lung cancer.

The effective rate of crizotinib in treating lung cancer can reach over 65%, and the median progression-free survival (PFS) is 8-10 months.

This medical insurance negotiation shows that the scope of medical insurance payment for crizotinib is: limited to patients with anaplastic lymphoma kinase (ALK)-positive locally advanced or metastatic non-small cell lung cancer or patients with ROS1-positive advanced non-small cell lung cancer.

3. Alectinib: Aletinib is a second-generation ALK inhibitor for the first-line treatment of advanced ALK-positive lung cancer. It was approved for marketing in China in August 2018.

Research data confirms that after ALK-positive non-small cell lung cancer (NSCLC) patients receive first-line treatment with alectinib, the median progression-free survival (PFS) is as long as 34.8m, which is significantly better than other options and has better safety.

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Legal basis: Article 28 of the "Social Insurance Law of the People's Republic of China" that meets the basic medical insurance drug catalog, diagnosis and treatment items, medical service facility standards, and emergency and rescue medical expenses shall be deducted from the basic medical insurance fund in accordance with national regulations.

Pay.

Article 29 The part of the medical expenses of the insured persons that should be paid by the basic medical insurance fund shall be settled directly between the social insurance agency and the medical institution and pharmaceutical business unit.

The social insurance administrative department and the health administrative department should establish a settlement system for medical expenses in other places to facilitate insured persons to enjoy basic medical insurance benefits.

Article 30 The following medical expenses are not included in the payment scope of the basic medical insurance fund: (1) Those that should be paid from the work-related injury insurance fund; (2) Those that should be borne by a third party; (3) Those that should be borne by the public health department

; (4) Seeking medical treatment abroad.

Medical expenses should be borne by a third party in accordance with the law. If the third party fails to pay or the third party cannot be identified, the basic medical insurance fund shall pay first.

After the basic medical insurance fund has paid in advance, it has the right to recover compensation from the third party.