诺华心衰创新药经谈判纳入2019医保目录,报销比例**达90%

2019-11-28 不详 美通社

2019年11月28日,国家医疗保障局公布了2019国家医保目录谈判结果,又有70种药品纳入《国家基本医疗保险、工伤保险和生育保险药品目录(2019年版)》(以下简称医保目录),并确定了这些药品的医保支付标准。新增药品涉及慢性病、癌症、罕见病等领域,此次公布的名单还纳入了治疗慢性心力衰竭的诺华创新药诺欣妥®(沙库巴曲缬沙坦钠片),作为医保目录乙类药品各地可报销70%-90%。2019年11月28日

2019年11月28日,国家医疗保障局公布了2019国家医保目录谈判结果,又有70种药品纳入《国家基本医疗保险、工伤保险和生育保险药品目录(2019年版)》(以下简称医保目录),并确定了这些药品的医保支付标准。新增药品涉及慢性病、癌症、罕见病等领域,此次公布的名单还纳入了治疗慢性心力衰竭的诺华创新药诺欣妥®(沙库巴曲缬沙坦钠片),作为医保目录乙类药品各地可报销70%-90%。

2019年11月28日,国家医疗保障局公布了2019国家医保目录谈判结果,又有70种药品纳入医保目录,此次公布的名单还纳入了治疗慢性心力衰竭的诺华创新药诺欣妥(R)(沙库巴曲缬沙坦钠片),作为医保目录乙类药品各地可报销70%-90%。

这也意味着我国超千万的心衰患者拥有了长期规范治疗的基础保障。在医保和创新药的助力下,心衰患者的住院和死亡风险有望进一步下降,生活质量有望更上一层楼。

千万国人遭受心衰威胁,疾病诊疗任重道远

我国已经成为世界上拥有最大心衰患者群的国家之一,成年人心衰患病率高达1.3%[1],至少有一千万的患者人群。而作为所有心血管疾病的终末阶段,心衰也有着庞大的“后备军”,高血压、冠心病、瓣膜性心脏病、糖尿病、慢性肾病等都是心衰的诱发因素,随着老龄化的日趋严重,这些“潜在”高危人群或将面临心衰困扰。

然而,心衰诊疗现状却不尽人意:约有50%心衰患者在诊断5年后死亡[2,3],生存率低于多种癌症。此外,由于心衰导致反复住院,给患者、患者家庭和社会造成沉重的经济负担。数据显示,我国患者平均每年住院2.4次,约69%的患者都有1年内再住院的经历[4],直接治疗费用高达3.9万元,超越我国年人均可支配收入近两倍[5]。提升心衰综合诊疗水平,重视并加强疾病长期管理势在必行。

北京安贞医院刘宇扬教授表示:“心衰并不是绝症。如果患者在发现一些比较明显的心衰症状如:活动后容易疲惫,平躺时感到呼吸困难,下肢水肿、尿量减少等症状,就及时前往距离最近的心衰中心或正规医院心内科就诊,做到早发现早治疗。同时,心衰治疗需要长期管理。患者即使症状好转也需谨遵医嘱,规范用药,不要随意停药、减药,以降低住院率、提高生活质量,并获得更好的治疗结局。”

这些症状要上心
这些症状要上心

创新药纳入医保报销,为心衰患者减负、实现规范治疗

近年来,在医学界科学家、学者和专家的共同努力下,我国心衰领域在规范推进及治疗方法创新等方面取得了许多进展。根据2018年10月更新的《2018中国心力衰竭诊断和治疗指南》,创新药血管紧张素受体脑啡肽酶抑制剂(ARNI)被列为一类推荐。这一更新主要基于ARNI药物突出的临床表现:根据一项临床研究显示,在心衰标准化治疗的基础上(ARNI替代现有的标准治疗方案),其使心衰患者心血管死亡和心衰住院风险降低20%[6]。

沙库巴曲缬沙坦钠片进入医保目录,是关乎民生的重大利好消息。作为近20年来治疗慢性心衰的突破性创新药,沙库巴曲缬沙坦钠片也是全球首个ARNI类药物,用于慢性心力衰竭(NYHA II-IV级)患者的治疗,于2017年获国家药监局优先审评上市,上市两年已惠及70万中国心衰患者。

医保省钱更开心
医保省钱更开心

“此次,沙库巴曲缬沙坦钠片成功被纳入医保目录,进一步证实了国家医保准入政策更加注重于药物治疗所带来的多维度价值获益,例如:药物的创新性、是否满足了临床上未被满足的需求;并从药物经济学综合考虑药物的性价比等。” 北京安贞医院刘宇扬教授评价“同时,这对于广大心衰患者也是一大福音。用药负担的减轻,不仅会促使患者及时接受规范的药物治疗,更可以让更多治疗中的患者遵循指南完成规范化治疗,获得更佳治疗效果。”

创新机制更放心
创新机制更放心

自今年8月医保目录确定拟谈判药品,经过3个多月的谈判周期,沙库巴曲缬沙坦钠片进入国家医保目录,并按医保目录乙类药品可报销70%-90%。根据此次国家文件要求,各地市应于2020年1月1日执行谈判结果,各地市具体执行时间及报销政策参见地方具体执行细则。期待随着新医保目录的落地执行,创新药可尽快造福更多心衰患者。

[1] 2018年中国国际心力衰竭大会 http://www.chinahf.org/portal.php?mod=view&aid=278

[2] Xu Y, et al. Exp Ther Med. 2013 Dec;6(6):1437-1442.

[3] Zeng H, et al. Int J Cancer. 2015 Apr 15;136(8):1921-30.

[4] Huang et al. J of Medical Economics20:5, 549-553, DOI:10.1080/13696998.2017.1297309.

[5] Zeng H, et al. Int J Cancer. 2015 Apr 15;136(8):1921-30.

[6] McMurray JJ, Packer M, Desai AS, et al. Angiotensinneprilysin inhibition versus enalapril in heart failure[J]. N Engl J Med, 2014, 371(11): 993-1004. DOI: 10.1056 /NEJMoa1409077.

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