Ceritinib/ceritinib payment amount after medical insurance reimbursement

Since its launch, Ceritinib has played a key role in the treatment of ALK-positive non-small cell lung cancer (NSCLC) as a second-generation ALK inhibitor. With its official approval in China and its inclusion in the national medical insurance directory, patients' drug accessibility has been significantly improved and the economic burden has been significantly alleviated. Under the current medical insurance policy, ceritinib has become an important part of the treatment path for many ALK-positive lung cancer patients, and its payment structure also reflects China's medical insurance reform's systematic adjustment strategy for high-priced targeted drugs.

First of all, ceritinib is suitable for patients with ALK fusion gene-positive locally advanced or metastatic non-small cell lung cancer, especially those who have developed resistance or progression after previous treatment with crizotinib. For such patients, the continuity of targeted therapy is crucial, and treatment cost is often the core issue that affects patients' continued medication. Fortunately, since the drug was included in the national medical insurance, its price has dropped significantly, making it from once "unattainable" to a "sustainable drug" realistic choice.

The common specification of ceritinib currently on the market in China is 150 mg The actual payment amount is affected by multiple factors such as the regional medical insurance reimbursement ratio, the deductible and whether the patient has completed outpatient procedures for major diseases. In most provinces, after meeting the indications and completing medical insurance registration, the out-of-pocket proportion of ordinary insured persons is approximately 15% to 25%.

In terms of payment mechanism, some cities have also included ceritinib in local special drugs or major disease protection plans. Once patients are included in the "cancer outpatient reimbursement scope", they can also enjoy a higher proportion of outpatient reimbursement. Some hospitals even provide pharmaceutical company assistance or drug purchase exemption policies to further expand patient affordability.

Reference materials:https://go.drugbank.com/drugs/DB09063