Is cimepilimab covered by medical insurance? What are the proportions and conditions of medical insurance reimbursement?

Cemiplimab (Cemiplimab), as a new type of immune checkpoint inhibitor, is currently not available in the domestic market and has not been included in the scope of medical insurance. Therefore, patients still need to bear all the costs for domestic drug purchases. Since this drug has not yet been included in medical insurance, the reimbursement ratio and conditions for medical insurance are not yet clearly defined. When patients purchase cimepilimab in China, they need to bear higher out-of-pocket expenses, and the purchase channels are relatively limited.

The price of cimipilimab is relatively high in overseas markets, especially in the United States and Europe. The common 350mg/7mL (50mg/mL) specifications are sold for about 40,000 to 100,000 yuan. Specific prices may fluctuate due to exchange rate effects. For some patients, purchasing overseas becomes an option, but high prices remain a challenge. In addition, there are currently no generic drugs of cimepilimab on the market, making its treatment more expensive.

Although cimepilimab has not yet been included in domestic medical insurance, with the market popularity of the drug and the gradual increase in clinical application, it may be included in the medical insurance list in the future. After entering the medical insurance, the price of drugs may be effectively controlled, and the treatment burden on patients will be reduced. However, the specific time and conditions for a drug to enter medical insurance still need to be approved by relevant departments, and usually involve multiple evaluations, including the clinical effect, cost-effectiveness and other factors of the drug.

Currently, Cemiplimab (Cemiplimab) is not included in medical insurance, and patients need to bear higher drug costs. In terms of price, the selling price in overseas markets is usually between RMB 40,000 and RMB 100,000, and since there are currently no generic drugs, the price is relatively expensive. It is hoped that this drug will be included in medical insurance in the future to reduce the financial burden on patients.

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