Is margetuximab included in medical insurance? What are the conditions and proportions of medical insurance reimbursement?

As of now, Margetuximab (Margetuximab) has not been included in medical insurance in China. Since the drug has been on the market for a short time in China, the relevant medical insurance reimbursement policy has not yet been determined. As a targeted treatment drug for HER2 positive breast cancer and gastric cancer, margetuximab has a high market price, so patients often face greater financial pressure during treatment. Because it is not yet covered by Medicare, patients are required to pay the full cost, which means many patients may not have easy access to the drug.

The specific price of macituximab in China has not yet been determined, but according to the price in the international market, the common specifications are 250mg/10ml*1 bottles/ boxes, and the price is about more than 30,000 yuan. This high price is a significant burden for most patients. Therefore, patients may want to consult the hospital pharmacy to learn about the latest drug prices and possible payment options when choosing treatment. If the drug is included in medical insurance in the future, it is expected that the burden on patients will be greatly reduced, but the specific reimbursement ratio and conditions still need to be in accordance with the relevant policies of the medical insurance department.

The price of margetuximab is usually higher overseas, especially the selling price of the original drug in Europe and Japan. Although pricing varies from country to country, margetuximab is generally more expensive, which is one of the reasons why it has not been rapidly popularized in the country. Patients wishing to purchase the drug overseas may be required to bear additional shipping costs and customs duties, making such cross-border purchases an expensive and complex option.

Currently, there are no generic versions of margetuximab on the market. Due to the high R&D and production costs of the drug and its short time to market in the country, the development and production of generic drugs is still in its early stages. The absence of generic drugs leaves patients with no choice but to choose original drugs, which further increases the cost of treatment. As the drug market develops, relevant generic drugs may appear in the future, but this option has not yet been realized. Therefore, patients should fully understand relevant drug information during treatment, communicate with doctors and pharmacists, and choose the most suitable treatment plan.

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