Case Study of Icotinib on The Impact of Domestic Innovative Drugs Timely Covered by Medical Insurance

OBJECTIVE: To explore the impact of timely inclusion of medical insurance on the use of high-quality domestic innovative drugs, using the domestic innovative drug, icotinib, as an example. METHODS Province X and province Z with large difference on the timing to include icotinib in medical insurance were selected as sample provinces to compare and analyze the price, volume and expenditure changes of three targeted drugs (gefitinib, erlotinib and icotinib) for non-small cell lung cancer (NSCLC), using the sample hospital procurement data covering two provinces from 2013 to 2018 in the China Medical Economic Information Network (CMEI) database. RESULTS In two sample provinces, icotinib's daily cost had been the lowest among three sample drug's for a long time. Province Z has included icotinib in the basic health insurance since 2013. After that, the market shares of icotinib's volume and expenditure had increased rapidly from 0, and remained at about 85% for a long period of time, occupying the dominant position in province Z's market. However, province X has not included icotinib until 2016. The highest market share of icotinib's volume was only 8% in province X's market. There was little difference of sample drugs' daily cost between two provinces. After the national health insurance negotiation, the daily cost of sample drugs decreased significantly, with an overall decrease between 60% to 79%. By the second half of 2018, the daily cost of sample drugs was almost the same. CONCLUSION Timely inclusion of high-quality domestic innovative drugs in the scope of medical insurance reimbursement can greatly promote the use of high-quality domestic innovative drugs. Compared with foreign drugs with same indications, high-quality domestic innovative drugs can save money for patients, which will greatly benefit them.