Disclaimer: The content of this article is written with authoritative information combined with personal opinions, and the source of the literature and screenshots have been marked at the end of the article, please be aware.
Regarding the issue of sky-high drugs, many people must be very nervous. After all, once you unfortunately have a rare disease, the sky-high price of drugs becomes a little desperate. Every medical expense is facing bankruptcy.
No, the drug I'm going to talk about today is nusinersen sodium worth 700,000 shots, just looking at this number can make people collapse mentally.
Domestic 700,000, Macao 200 yuan, 凭啥?
The most important thing is that drugs like this one are not effective all at once. At least 5-6 injections a year are required to have a therapeutic effect. The sum of the front and back is 300-4 million, and with such a high price, you can top a luxury house.
However, as far away as Australia, the drug costs only 200 yuan, which is about the same as the price of a meal.
After learning this information, many netizens asked: "Is this price discrimination?" Or do some businesses want to make black money? That's why the price of nusinersen sodium is so high."
At this time, some people will ask, having said so much, what is this so-called nusinersen sodium treating? Why is it so expensive?
Judging from the relevant information, nusinersen sodium is a drug developed by Biogen in the United States, which specializes in the treatment of a disease called spinal muscular atrophy.
It is an inherited neurological disorder. After birth, muscles and nerves atrophy, breathing and swallowing become more and more difficult, and the patient has to rely on ventilators and tubes to transport nutrients. Because of this, most patients do not live to be 2 years old.
According to current statistics, there are more than 30,000 patients with spinal muscular atrophy in China and 500,000 in the world, which is a rare disease in the disease category.
Because of this, the drug nusinersen sodium for its treatment has become an "orphan drug".
Medical insurance has made a great contribution
Is there some hidden secret hidden here?
Strictly speaking, this so-called "orphan drug" often requires billions of dollars to be developed and a finished product can only be obtained after countless trial and error in the early stage.
But in the end, because of the small market and the small number of patients, it only sold tens of millions of sales. In this case, many pharmaceutical companies have no incentive to develop it.
In order to compensate for the R&D expenses in the early stage and return cash flow, pharmaceutical companies can only sell nusinersen sodium so expensive.
And this kind of expensive is expensive without discrimination. Take the United States side as an example, a shot is 125,000 US dollars, which is equivalent to 860,000 yuan, which is more expensive than ours.
As for why nusinersen sodium in Australia is so cheap, it is mainly because they have medical insurance.
According to Australia's health insurance policy, Australian citizens with an annual income of more than 20,000 Australian dollars need to pay 2% of their income as medical insurance premiums. Converted to 2,000 yuan, there is no cap.
The most critical thing is that Australia has targeted reimbursement for the drug nusinersen sodium, with a total investment of 250 million US dollars. In this case, isn't Australia's nusinersen sodium incredibly cheap?
Speaking of which, many people may ask, in this case, why doesn't the mainland include this drug in medical insurance?
First of all, the mainland's medical insurance cannot withstand such a large rate of consumption. Although the people of our country only pay 300~550 yuan of medical insurance every year. And the amount consumed is also very large, after all, the number of drugs used by patients every year is so large.
In addition, with the aging of the population and the expansion of flexible employment, fewer and fewer people will pay for health insurance in the future.
As early as 2018, there was an imbalance between the income and expenditure of medical insurance in mainland China. For example, the income growth of employee medical insurance is 10.3%, but the expenditure has reached 13.1%. There is also the income of residents' medical insurance, the growth is 23.3%, but the expenditure is 26.7%.
In 2020, the average hospitalization fee of the national employee medical insurance reached 12,657 yuan, an increase of 6.5% over the previous year. It can be seen that the "income-expenditure" item of mainland medical insurance is widening every year in a small gap.
As expenditures gradually outstrip income, the resources of health insurance will not be able to cover everyone's head in the future. In this case, isn't it difficult to use medical insurance money to cover nusinersen sodium?
Should sky-high drugs be included in medical insurance?
What's more, most of the "orphan drugs" really can't be included in the medical insurance. After all, "orphan drugs" are too expensive. In the case of nusinersen sodium, one shot alone costs 1,400 insured people.
What is this concept? You must know that 700,000 is equivalent to the price of 700 azacitidine injections and 43,000 afatinib tablets.
Moreover, the therapeutic range of these drugs is no less than that of nusinersen sodium, and they are used in leukemia patients and lung cancer patients, respectively. Everyone's life is precious, and it is impossible to ignore the life and death of patients with spinal muscular atrophy without regard to the life and death of patients with other diseases, right?
Maybe it cost 700,000 yuan to buy sky-high drugs here, and a few dollars of penicillin over there can save your life. In this case, how should the health insurance bureau choose?
In other words, the money paid by medical insurance is limited, is it to save the minority or the majority? The answer to this question must be self-explanatory.
In short, this dilemma is the same logic as the dilemma of saving people by rails. There are 5 people lying on one track and 1 person lying on the other, if you can only control the train in one direction, how will you drive?
This is also why in the movie "I Am Not the God of Medicine", a classic line is said: "There is only one disease in this world, and that is the disease of poverty".
Of course, in response to the problem of sky-high drug prices, in fact, our country has been trying to overcome it. For example, the National Medical Security Administration has been negotiating with those pharmaceutical companies for a long time.
On December 3, 2021, Zhang Jinni, the negotiator of the National Health Insurance Administration, directly demonstrated her ability to "bargain with her soul". After several tuggings with representatives of pharmaceutical companies at the negotiation site of the drug catalog, nusinersen sodium was finally taken down at an annual price of 33,000 yuan and included in the medical insurance.
During this period, she cut the price of many sky-high drugs by 30-80%. Some sky-high drugs used to be 50,000 boxes at their own expense, but after they were included in the medical insurance, they directly became 5,000 boxes. In this case, the financial pressure on the patients is diluted a lot.
In short, there have been difficulties and obstacles in the issue of sky-high drug prices, but at the same time, there are also continuous efforts of relevant staff. As long as things develop in a good direction, I believe that one day, patients will remove the dark cloud of sky-high drug prices on their heads and usher in a new life.
Information sources:
Red Star News [The truth behind the rare disease of "700,000 yuan per injection] How far is the sky-high price drug into the medical insurance? 】
Health Knowledge Bureau [National Health Insurance Administration's response: particularly expensive products cannot be included in medical insurance]
Global Network [700,000 to 33,000 "life-saving medicine" started! ] The "small group" was not abandoned......]
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