Can PD-1 be reimbursed by Medicare? Will the price be very high?

Yes, most of them can be reimbursed by health insurance, the price is also very high, this to cooperate with the doctor's treatment can be, do not think about the problem of money health insurance reimbursement of the general formula, as follows: reimbursement amount = [the total cost of treatment - the starting line - the out-of-pocket expenses] _ reimbursement ratio (70% - 90%) Note: the starting line that the cost of treatment exceeds the minimum limit to reimbursement, the starting line of the various regions vary, the starting line of 1000-2000 yuan. The starting line varies from region to region and is generally 1000-2000 RMB. The maximum reimbursement that the reimbursement of money can not exceed the maximum limit, also varies from region to region, generally hundreds of thousands of dollars.

A, health insurance how to get reimbursed

Medicare reimbursement process:

1, the person submitting the reimbursement documents and other materials to the social security institutions acceptance;

2, acceptance of the department since the receipt of application materials, the health care center to complete the audit on the day of the settlement, payment work;

3, The social security institution reviews the materials and approves the application, and the applicant is reimbursed after receiving the reimbursement form of social health insurance medical expenses.

Legal basis:

Article 26 of the Social Insurance Law of the People's Republic of China

The treatment standards of basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with the state regulations.

Article 28 of the Social Insurance Law of the People's Republic of China

Medical expenses that are in line with the basic medical insurance drug catalog, diagnostic and treatment items, and standards of medical service facilities, as well as those for emergency and rescue, shall be paid out of the basic medical insurance fund in accordance with state regulations.

Two, PD-1

PD-1 (Programmed Death Receptor 1), also known as CD279 (Cluster of Differentiation 279) is an important immunosuppressive molecule. It regulates the immune system and promotes self-tolerance by down-regulating the immune system's response to human cells, as well as by suppressing T-cell inflammatory activity. This prevents autoimmune diseases, but it also prevents the immune system from killing cancer cells.

In December 2018, the first domestically produced PD-1 antibody drug for Hodgkin's lymphoma, sindilizumab injection, was approved for marketing. "In November 2019, Dabexu (scientific name Sindilizumab injection) was listed in Class B of the National Drug List for Basic Medical Insurance, Work Injury Insurance and Maternity Insurance (2019 Edition). (2019 Edition) Class B scope, becoming the only PD-1 anti-cancer drug to enter the national medical insurance catalog.

In December 2019, the domestic PD-1 antibody drug, Baizian (generic name: tirilizumab injection) was approved and listed on the market, and there was further development of tumor immunotherapy in China. Tirilizumab is not only the first self-developed anti-cancer drug approved and marketed in China, but also the first tumor immunotherapy drug in the world.

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