When is Pralsetinib expected to be included in medical insurance reimbursement in China?

Pralsetinib is a targeted drug for RETfusion-positive non-small cell lung cancer (NSCLC) and some thyroid cancers. It has been officially approved for marketing in China, but it has not yet been included in the medical insurance reimbursement system. Due to the high price of drugs, the cost of a single box of conventional packaging specifications such as 100mg 60 pills or 100mg 120 pills may reach more than 20,000 yuan, or even as high as 60,000 yuan in some areas, which brings a greater financial burden to patients. Therefore, the inclusion of platinib in medical insurance is of great significance for reducing patient medication costs and improving accessibility.

There is currently no official timetable for when platinib will be included in domestic medical insurance. Usually, the entry of drugs into the medical insurance reimbursement catalog requires centralized negotiation or evaluation organized by the National Medical Insurance Bureau, including multiple factors such as the clinical efficacy of the drug, cost-benefit analysis, and the size of the patient population. Given that platinib is an innovative targeted drug, its clinical value has been recognized, but the price is relatively high. The medical insurance negotiation and approval process may take some time, and it is still necessary to wait patiently for its official inclusion in the short term.

The price of platinib in overseas markets is higher. The price of a box of 60 tablets of the original drug fluctuates between 40,000 and more than 100,000 yuan. Some countries have developed generic drugs, such as 120 tablets produced in Laos, which cost about more than 3,000 yuan. The difference between overseas drug prices and domestic medical insurance policies also provides a reference for domestic medical insurance negotiations. With the advancement of generic drug research and development and the accumulation of clinical use data, the possibility of Platinib being included in medical insurance will gradually increase.

In the future, after platinib enters medical insurance, it will significantly reduce patients’ financial pressure and improve treatment compliance and accessibility. At the same time, domestic medical institutions may also further improve the coverage of RET genetic testing so that more patients who meet the indications can receive precise treatment in a timely manner. Prior to this, if patients needed medication, they needed to purchase the medication through formal channels and arrange a reasonable treatment plan based on the guidance of a doctor.

Reference materials:https://www.drugs.com/