Is Tucatinib included in medical insurance? Medical insurance coverage and reimbursement process

Currently, the original drug Tucatinib (Tucatinib) has not been officially launched in the Chinese market, so it has not been included in the domestic medical insurance system. This means that domestic patients are currently unable to purchase the drug through medical insurance reimbursement. Since the drug is still in the overseas market circulation stage, patients need to purchase it through other channels, such as through foreign pharmacies or regular international pharmacies.

Although tucatinib has not yet been launched in China, there are already original drugs and generic drugs in overseas markets for patients to choose from. Taking the European market as an example, the European version of the original Tucatinib in 150 mg 84 tablet format can be sold for more than 40,000 yuan per box, which is a considerable expense for patients. In comparison, the price of the generic version of tucatinib produced by Lao pharmaceutical companies is more affordable. The price of the generic version of tucatinib in 150 mg and 60 tablets is about more than 2,000 yuan. Generic drugs are basically the same as the original drugs in terms of drug ingredients, so generic drugs have become the choice of some patients.

Since the original drug of tucatinib has not yet been marketed in China, it does not meet the conditions for inclusion in medical insurance and therefore cannot enjoy medical insurance reimbursement. However, if the drug is launched in China and included in medical insurance in the future, patients can receive a prescription through the hospital and enjoy reimbursement according to the medical insurance policy in their region. The medical insurance reimbursement process usually includes steps such as the doctor issuing a prescription, the pharmacy checking the drug information and submitting it to the medical insurance system, and the patient paying the reimbursed fee. The specific reimbursement ratio and patient out-of-pocket portion will vary from region to region, and patients can consult their local hospitals.

For those patients who need to use tucatinib, although it is not available directly in China for the time being, generic versions of the drug are available overseas. The price of generic tucatinib in 150mg*60 tablets produced by a Lao pharmaceutical factory is about more than 2,000 yuan. Compared with the high price of the original drug, the generic drug is obviously more cost-effective. Patients can choose to purchase generic drugs through formal channels, but they still need to choose the purchasing channel carefully to ensure the quality and legality of the drugs.

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