Is Apelvis included in medical insurance? Medical insurance payment scope and patient reimbursement process

As of now, Alpelisib has not been officially launched in my country, so it has not yet been included in the national medical insurance directory. Since it is not on the market, domestic medical institutions cannot prescribe the drug, nor can it be reimbursed through medical insurance. If patients need to use the drug, they can only obtain the original drug or generic drugs through overseas channels, which also means that they have to bear the cost of the drug out of their own pocket.

Because it is not included in the medical insurance catalog, Apelvis does not have the scope of medical insurance payment, and there is no reimbursement policy or process related to medical insurance payment. At present, domestic medical insurance policies mainly cover drugs that have been approved for marketing by the State Food and Drug Administration and included in the medical insurance catalog through negotiation. Apelis is still in the overseas sales stage, so it does not have any preferential medical insurance treatment.

From a price point of view, the price of the Indian version of Apelis' original drug is about more than 3,000 yuan per box, while the generic drug produced by a Lao pharmaceutical factory is more affordable, with each box costing more than 1,000 yuan. Since these drugs are currently only available through overseas pharmacies or agent channels, patients need to carefully identify the channel qualifications when choosing to ensure that the source of the drugs is legal and safe.
Generally speaking, if domestic patients currently want to use Apelvis for treatment, they need to contact overseas channels to purchase it themselves and bear all the cost of the drug. It is recommended that patients consult a professional doctor before considering using this drug to see if it is suitable for their condition. At the same time, they should pay close attention to the domestic marketing progress of this drug and future changes in medical insurance policies, so that it can be incorporated into a more standardized medication management and financial support system as soon as possible when conditions are ripe.
Reference: https://www.piqray.com/