Can Cemiplimab be reimbursed by medical insurance and the reimbursement rate

Cemiplimab (Cemiplimab) is a PD-1 antibody drug that has attracted attention in the field of global tumor immunotherapy. It is mainly used for indications such as cutaneous squamous cell carcinoma, basal cell carcinoma and some non-small cell lung cancer. In China, patients are very concerned about their medical insurance situation. However, the original product of this drug has not yet been officially launched in mainland China, so it has not entered the national medical insurance negotiation catalog. Naturally, there is no reimbursement ratio or local medical insurance supplementary reimbursement policy. In other words, China currently has no way to purchase original drugs through formal channels, and there is no medical insurance payment standard that can be checked. The price also lacks clear figures because it has not been listed, and it is in the status of "unannounced, not included, and not priced".

Nevertheless, as PD-1 drugs continue to consolidate their position in international clinical treatment, whether cimepilimab can be introduced into the domestic market in the future has been a matter of continued concern in the industry. Many materials mention that the application of this drug in locally advanced or metastatic cutaneous squamous cell carcinoma has changed the treatment strategy. However, domestic treatment options for the same type of disease are relatively limited, so it has potential value in entering the Chinese market. If it enters the domestic market in the future, in accordance with the basic trend of national medical insurance negotiations, it will usually refer to factors such as the pricing logic of similar immune drugs, the indication needs of the domestic population, and the update cycle of the medical insurance catalog. Whether to be included in medical insurance is usually closely related to the cost-effectiveness assessment and clinical value of the drug, and this step usually requires the drug to be officially launched before it can be promoted.

Before the drug is launched, some patients will pay attention to the possibility of international purchase, clinical trials or in-hospital filing, but these methods cannot be linked to medical insurance reimbursement. Therefore, the most important thing at present is to confirm the three key points of "not listed in the country, not in the medical insurance catalog, and not covered by reimbursement". The reimbursement policy will be clarified only if there is progress on the market or updates to the National Medical Insurance Directory in the future.

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