China Extends Insurance Coverage for High-End Drugs - Sixth Tone

China extended state insurance coverage to 74 new medicines in an update to the country's medical insurance catalog. 11 were eliminated after being deemed ineffective, leaving a total of 2,860 medicines.

The newly-added drugs include antibiotics, cancer drugs, and gynecological drugs, among others. Seven highly specialized drugs for rare diseases were also added.

According to the National Healthcare Security Administration, the addition includes 67 medicines made by a single company. In the absence of competition, the government set prices through negotiations, winning an average reduction of 62% compared to previous market prices.

One of the biggest price reductions was for nusinersen, a drug used to treat spinal muscular atrophy (SMA), a rare inherited condition that reduces muscle strength and movement in infants, children, and adults. It was first brought to China in 2019 at the sky-high price of 697,000 yuan (nearly $110,000) per injection. A patient needs six injections in the first year of treatment and then three each year for the rest of their life.

SMA affects slightly fewer than 30,000 patients in China. Charities currently cover the costs for some patients, but the father of a 4-year-old who was diagnosed with SMA at the age of 9 months told domestic media he had to pay over half a million yuan per year even after this aid.

"From no medication to 700,000 yuan each injection to 550,000 yuan for a whole year to getting included in the medical insurance, I can't describe my feelings now except by saying that I'm so grateful," the father, named Ma Hengxiang, said.

After eight rounds of negotiations, the manufacturer, Biogen China, agreed to charge the government 33,000 yuan per injection, down from an opening offer of 53,680 yuan, reported China Central Television.

A drug known as dalfampridine or Ampyra used to treat the rare disease multiple sclerosis (MS) has also been included in the catalog for the first time. MS is an autoimmune disease that affects the central nervous system, leading to physical and cognitive disabilities.

Due to the country's limited knowledge and widespread unawareness of the disease, it has been under-recognized and under-treated. It was estimated in 2019 that MS affected around 30,000 people in China, or 0.002% of the population. "Because of the rising awareness and the progress of diagnostics, this number is now estimated at between 50,000 and 80,000," says Yao Yao, an MS patient and online spokesperson for China's MS community.

"Our fellow patients were thrilled to hear the news and have contacted us asking where they can buy the drug and at what price, but everything about it will remain unknown to us until the release of the medicine at the beginning of 2022," Yao told Sixth Tone.

This year's update also covers China's first original drug for Alzheimer's disease. Since the approval and release of the drug — known as Sodium Oligimannate GV-971 — in 2019, other researchers have questioned the evidence of its effectiveness. Meanwhile, the drug's makers claim that it is able to significantly improve patients' cognitive performance. The drug is currently in Phase III trials in the United States.

Editor: David Cohen.

(Header image: People Visual)