[Bright Time Comment] Pay more attention to the medicines "not commonly used"

【Light Review】

Recently, the State Medical Insurance Bureau issued an announcement that the "Working Plan for Adjustment of the National Basic Medical Insurance, Work Injury Insurance and Maternity Insurance Drug Catalog" (hereinafter referred to as the "Work Plan") and related documents were publicly solicited from the society. This year, on the basis of continuing to support the treatment of new crown pneumonia therapy and innovative drugs, it fully reflects the attention of rare disease treatment drugs and children's medication. Pharmaceuticals that have been approved for listing and incorporated into the application of children's medicines "before June 30, 2022 are clearly included in the application conditions, and the level of drug guarantee in the relevant population is expected to further improve.

The main expenditure of medical insurance funds is the treatment cost of various diseases. Common diseases with high incidence and huge cases of cases are the scope of medical insurance first. In the case of this basic requirement, medical insurance must further cover rare diseases, severe illnesses, and medication for women and children. This is not only the function of medical insurance, but also an indispensable part of the people's health appeal.

Related to it, in recent years, the State Medical Insurance Bureau has implemented a trial of paying a state -of -the -paid national group (DRGS) in many cities across the country, exploring the establishment of the DRGS paid system, and vigorously promoting DRGS to implement in more cities. The implementation of DRGS can make the National Medical Insurance Bureau's use of accurate distribution of medical insurance expenditures and reducing unreasonable and unscientific medical insurance funds, and continues to focus on tumors, chronic diseases, rare diseases, and medication for women and children.

The characteristics of rare diseases are low incidence and small number of cases. The high cost of developing drugs for biomedical companies is often borne by less patients. In addition, less competition in remote fields is more likely to form monopolies. Therefore, the treatment of rare diseases is often "sky -high". In December 2021, a special effect medicine Nosnina sodium injection of spinal muscle atrophy in the medical insurance category was negotiated. The price of this drug was 700,000 yuan/needle before incorporating the medical insurance directory. After the negotiations, the price reduction has been significantly reduced, and it has reached the scope of more patients.

There are still many "sky -high medicines" specializing in the treatment of rare diseases. These patients and their diseases may not be familiar with us, but their health should also be guaranteed. The National Medical Insurance Bureau released the "Work Plan", continued to pay attention to the rare disease treatment drugs, and publicly solicited opinions from the society. I believe that we can hear the voices of more patients with rare diseases.

Children's medication is different from rare disease treatment drugs. The huge differences between children and adults in terms of growth and development, physiological activities, drug metabolism, and important organs have led to the difference in medication between the two. For example, adults commonly used by adults, which are prohibited in principle in pediatrics. Similar examples also exist in many fields such as sedatives and antiepileptic drugs. The National Medical Insurance Administration's release of the "Work Plan" also strives to make the list of drugs included in the medical insurance directory more in line with the characteristics of children's medication and better protect the health of children's patients.

However, during the treatment process, there are still some cases of medication demand that conflicts with existing policies. For example, in the treatment of nerve -derived bladder caused by congenital deformity diseases, one type of drugs that can relieve the symptoms of urinary tract need to be used, and most of these drugs are recommended to use more than 18 years of age. In many medical guidelines and expert consensus in my country, children are not recommended to use such drugs. This has caused clinicians and family members of children. On the one hand, clinicians are risked by clinicians who take the risk of unprepared medicine to prescribe medicine for children; on the other hand Imported drugs. Similar situations show that in areas such as rare diseases, serious illnesses, and medication for women and children, they should give more and more wider attention.

We can't ignore them because some medicines are not commonly used. Sometimes, uncommon medicine is also a life -saving medicine. In the process of public soliciting opinions from the "Work Plan", the relevant departments should listen to the voices of all parties in the society, and it is also necessary for the clinical line to understand the actual needs and difficulties of patients. Essence

(Author: Huang Mingliu, an urology doctor of the Children's Hospital Affiliated to Suzhou University)

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