Detailed explanation of the medical insurance negotiation results and reimbursement coverage of teclistamab

Teritolumab (Teclistamab) is a new bispecific Tcell connector (BiTE antibody) that mainly targets BCMA (B cell maturation antigen) and CD3 molecules for the treatment of relapsed or refractory multiple myeloma (RRMM). The drug was developed by Johnson & Johnson (Janssen) and is one of the important developments in the field of BCMA targeted therapy in recent years. At present, teritusumab has been approved for marketing in many countries and regions, and will be introduced into the Chinese market in 2024, marking my country's further opening up in the field of high-end tumor immunotherapy.

Although teritolumab has been successfully marketed in China, it has not been included in the national medical insurance directory so far. This means that patients have to bear all the costs themselves when using the drug, which puts great financial pressure on them. Because it is an innovative immunotherapy with significant efficacy and is suitable for people with refractory multiple myeloma who have extremely limited treatment options. It has strong clinical value and is therefore expected to become a key drug candidate in the next one to two rounds of medical insurance negotiations. However, due to the current high price, whether it is successfully included in medical insurance still depends on the profit margin of the enterprise and the cost-effectiveness evaluated by the National Medical Insurance Bureau.

According to overseas public information, the research version of Teritusumab (specification153mg/1.7ml) sells for more than 50,000 yuan per box, and the cost of a complete course of treatment is very expensive. Although there are already marketing channels in China, the price still poses a large burden to most ordinary patients. Some patients may consider purchasing drugs overseas or participating in clinical trials to obtain drug support, but these approaches have limitations in terms of accessibility and safety. Therefore, before medical insurance covers it, the clinical promotion of teritusumab is still severely restricted by price factors.

As the country attaches increasing importance to the inclusion of innovative anti-cancer drugs in medical insurance year by year, biological drugs with "breakthrough efficacy" such as teritusumab have strong potential for medical insurance access in the future. If companies make sufficient concessions during medical insurance negotiations, they are expected to achieve coverage in the next round of adjustments to the national medical insurance catalog. Prior to this, patients are advised to pay attention to hospital clinical research, charitable drug donation projects or auxiliary reimbursement mechanisms. At the same time, a reasonable treatment plan should be formulated under the guidance of a professional doctor by weighing the efficacy and cost. The medical insurance trends of teritusumab also deserve continued attention from patients and the industry.

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