Looking at the report that the reimbursement of insulin analogues has been cancelled abroad, do you

Insulin analogues have been on the market for a relatively short period of time, and it remains to be seen whether they have significant advantages over human insulin as a new class of insulin. At present, human insulin is the most widely used insulin, and from this point of view, the cancellation of analogues into medical insurance is also to maximize the protection of the majority of diabetic patients using insulin.

At present, there are only two types of human insulin and insulin analogues on the foreign market. The hypoglycemic effect of analogues and human insulin is comparable, and the safety needs to be confirmed by long-term evidence. The cancellation of analogues in Germany and Canada is also analyzed by pharmacoeconomic studies.

We usually think that abroad, especially developed countries such as Germany and Canada, should have more and better drugs in the medical insurance list than China. But this time the cancellation of reimbursement for insulin analogues abroad was really unexpected.

But in fact, this problem is very easy to explain, because the medical resources of any country need to be reasonably allocated, and the medical insurance catalogue usually gives priority to those drugs that are in line with pharmacoeconomics. The cancellation of insulin analogues in medical insurance indicates that although it is a relatively new product, it is not cost-effective compared to human insulin.

As far as I know, in the case of comparable effectiveness and safety, the medical insurance catalogue gives preference to cheaper drugs. What's more, analogues have a shorter time to market, and the only advantage that can be seen so far is that analogues can be injected more flexibly, for example, ultra-short-acting insulin can be injected immediately before meals, while short-acting human insulin needs to be injected half an hour earlier. However, there is a lack of direct evidence for the hypoglycemic effect and the prevention of diabetic complications.

In particular, the safety has yet to be confirmed.

Animal insulin belongs to Class A medical insurance, and human insulin and insulin analogues belong to Class B, and the liquidation ratio is different according to the medical and health economic situation in various places, usually around 70. However, insulin analogues are high and their use is usually limited to patients with hypoglycemia, type 1 diabetes, and fragility diabetes. The medical insurance system covers all users in urban areas, including enterprises (state-owned enterprises, collective enterprises, foreign-invested enterprises, private enterprises, etc.), institutions, private non-enterprises and their employees, who must participate in basic medical insurance.

Whether or not township enterprises and their employees, owners of urban individual economic organizations and their employees participate in basic medical insurance shall be decided by the people of all provinces, autonomous regions and municipalities directly under the Central Government. Insulin is within the scope of agricultural reimbursement, but the policies vary from place to place. Generally, if the insulin reimbursed by the agricultural cooperative system, if it is class A, class A refers to some animal insulin, such as ordinary insulin, protain zinc insulin, etc., which can be reported about 80%.

If it is some class B insulin, such as Novore, Humula 25 and recombinant insulin glargine, insulin glargine, insulin detemir, etc., the reimbursement ratio of these standards is relatively low, which is about 50%. The following medical expenses are not covered by basic medical insurance**:

1) It should be paid out of work-related injury insurance**;

2) It shall be borne by a third party;

3) It should be borne by public health;

4) Seeking medical treatment outside the country.

[Legal basis].Social Insurance Law of the People's Republic of China

Article 28 In line with the basic medical insurance drug list, diagnosis and treatment items, medical service facility standards and emergency and rescue medical expenses, in accordance with the provisions of the state from the basic medical insurance ** payment.