Cancer prevention and treatment, medical protection guide丨From imatinib to daratumumab——a list of medical insurance targeted drugs for blood tumors

The 2018 movie "Dying to Survive" brought chronic myeloid leukemia, a blood tumor, into the public eye. In addition to chronic myeloid leukemia, various types of leukemia, lymphoma, and multiple myeloma that we often hear about are all blood tumors. Unlike solid tumors, blood tumors cannot be removed by surgery. Targeted therapy and immunotherapy play an important role in the treatment of malignant blood tumors. According to experts, the prototype of the anti-cancer drug "Glenin" in the movie is the real-life targeted drug imatinib, a highly specific tyrosine kinase inhibitor. This is also one of the earliest tumor targeted drugs on the market in the world. Its appearance has increased the 5-year survival rate of patients with chronic myeloid leukemia from 30% to more than 80%.

In recent years, targeted drugs and immunotherapy drugs have been increasingly used in the treatment of hematological malignancies, and have achieved very good results. Rituximab, zanubrutinib, tislelizumab, ixazomib, limplicept, siltuximab, daratumumab... More and more targeted drugs for hematological malignancies have been gradually launched and included in the national medical insurance drug catalog.

Before it was included in the medical insurance drug list, targeted drug treatment was expensive and many patients could not afford it. The National Medical Insurance Administration accelerated the pace of medical insurance negotiations and promoted the inclusion of a large number of exclusive anti-tumor drugs in the medical insurance list, so that new drugs can benefit patients faster, allowing them to benefit from breakthrough innovative treatments in a timely manner, and effectively reducing the burden of drug costs for patients. In September 2019, Daratumumab was launched in China. This was the world's first and China's only CD38 monoclonal antibody at the time. CD38 is highly expressed in cancer cells and is an important target for immunotherapy of multiple myeloma. Due to its precise target and dual mechanisms of killing myeloma cells and activating immunity, Daratumumab has brought about a significant improvement in efficacy and safety, bringing the 5-year survival rate of multiple myeloma patients to 66.7%, bringing new hope. But at that time, Daratumumab was priced at 20,000 yuan per unit. Although it was lower than that in European countries such as Germany and Italy, the annual treatment cost was still around 1 million yuan.

Mr. Yao from Anhui is a farmer. In 2020, he began to seek medical treatment and medicine because of long-term "neck and back pain", and was eventually diagnosed with multiple myeloma. One million yuan a year is an unaffordable "sky-high price" for Mr. Yao's family. The doctor had no choice but to develop a traditional proteasome inhibitor-based combination treatment plan for him. In 2021, after several rounds of arduous negotiations and communications, daratumumab was successfully negotiated and included in the national medical insurance drug list after a substantial price reduction, which gave Mr. Yao hope of life again. In 2024, daratumumab was further reduced in price after the medical insurance renewal. Compared with the original price, the negotiated price reduction and medical insurance reimbursement have reduced Mr. Yao's medication burden by 95%.
With the dynamic adjustment of the national medical insurance drug list, innovative drugs for blood system diseases are constantly expanding, and the coverage and payment level are constantly improving. The negotiation and access of medical insurance drugs have driven a significant drop in drug costs, greatly reducing the economic burden on patients' families, and enabling patients to move from "having drugs to treat" to a new era of "having drugs to insure". Under standardized and continuous treatment, Mr. Yao's condition has stabilized, and he is waiting for the hope that multiple myeloma will eventually be cured in the future.

Source: China Medical Insurance