Dual-channel mechanism improves patient access to affordable drugs

YINCHUAN -- Han Jiang (not his real name) has suffered from ankylosing spondylitis for nearly 20 years, but in April he finally started regular injections of the treatment drug, Secukinumab, without worrying much about the cost.

From one injection per week in the first month to one injection per month now, the medication has effectively relieved his symptoms.

"It's so much better than not having it. The pain can be reduced, and most importantly, the progression of the disease can be controlled to avoid disability and paralysis," said Han, a resident of the city of Wuzhong, northwest China's Ningxia Hui Autonomous Region.

Ankylosing spondylitis is a type of chronic rheumatic immune disease encroaching on spinal and peripheral joints, resulting in spine malformation in extreme cases.

Suffering from the illness for nearly two decades, Han had spent about 100,000 yuan (about 14,328 U.S. dollars) since 2015 on injecting Adalimumab, another medication targeting the disease. Although the medication was very effective, he had to stop using it due to the financial burden.

"The original price of Adalimumab was more than 7,000 yuan per shot. The price dropped, but it was still very expensive. Currently, the Secukinumab is available at designated drugstores, covered by the country's medical insurance programs, and costs over 300 yuan per injection, which is good news for us," he said.

Han is among the beneficiaries of a "dual-channel" mechanism launched by China's health authorities last year.

For medicines covered under the healthcare security system's price negotiation program, patients can make their purchases either at hospitals or qualified drug stores, and the two channels enjoy the same reimbursement terms, according to the National Healthcare Security Administration (NHSA).

The administration added that such measures are intended to ensure the supply of relevant drugs and meet patient needs.

Medicines that have a high clinical value, high cost, low substitutability and are in urgent demand should be made available at hospitals and qualified drugstores on the same reimbursement terms, said the administration, adding that the specific list should be determined by provincial healthcare security departments.

The NHSA and the National Health Commission issued a joint circular last year on the move to include relevant drugstores into the healthcare security system's supply chain and insurance payment system.

This year, the Ningxia Healthcare Security Administration included all the drugs covered under China's healthcare security system's price negotiation program in 2021 into its dual-channel catalog.

Meanwhile, to help patients purchase drugs nearby, Ningxia continues to increase the number of dual-channel designated medical institutions and designated retail pharmacies. Currently, 21 designated medical institutions and 96 designated retail pharmacies have been identified throughout the autonomous region.

The Wuzhong No. 2 sub-branch under Sinopharm Group is a dual-channel designated retail pharmacy, mainly for meeting the medication needs of patients suffering from chronic diseases and tumors.

Zhang Mengying, who is in charge of the pharmacy, said that between 30 and 40 kinds of dual-channel drugs are in stock, and more than 80 patients currently buy such medicines at the pharmacy, which reduces their financial burden.

Hou Zhanrui, an official with the Wuzhong medical insurance center, said that designated medical institutions and retail pharmacies have formed a supplement to ensure that patients in need both have access to the drugs and can afford them through the dual-channel mechanism.

As of mid-November, 439 patients in Wuzhong had used the direct settlement under the mechanism this year, involving 13 kinds of drugs and costing 790,400 yuan, according to Hou.

Hou added that they will continue to step up the publicity of the dual-channel work, so as to provide patients with convenient access to medical care and drug reimbursement services.

Han Jiang said that the mechanism has given him hope, and he aims to stick to the treatment to improve his quality of life.