Are imported drugs for chronic diseases reimbursed?

Is the imported drug you are taking included in the medical insurance drug catalog of the country or the place where you are insured, and does it meet the corresponding reimbursement conditions?

When I helped my uncle with type 2 diabetes get medical insurance reimbursement two years ago, he had been using an imported weekly preparation hypoglycemic drug. Before it was included in the national list in 2021, one drug cost more than 900 at his own expense, and the drug cost alone was more than 20,000 per year. 202 Two years ago, this drug was negotiated to be included in the medical insurance catalog, and it happened to be within the scope of reimbursement for chronic diseases such as diabetes. After he registered for the drug, he now pays just over 100 out-of-pocket after reimbursement for each prescription. The annual drug cost has dropped to less than 2,000, which is a much lighter burden.

Of course, not all imported chronic disease drugs can be covered by medical insurance. Many patients around me have complained that the imported drugs they use cannot be reimbursed. In fact, there is no such thing as "favoring domestic drugs" here. The pool of the medical insurance fund is just that big, which is equivalent to the "public medical expenses" collected by all insured persons. Each drug must go through multiple rounds of negotiations before it is included in the catalog. The drug company must be willing to lower the price to a range that the medical insurance fund can bear while taking into account the needs of most people. There were several commonly used imported antihypertensive drugs in the past. After two or three years of negotiations, the pharmaceutical companies refused to lower the price. Naturally, they were not included in the reimbursement catalog, and patients had to pay.

If the imported medicine you use is not included in the national medical insurance, don’t panic. Many cities’ Huimin Insurance and Employee Supplementary Medical Insurance will have additional reimbursement policies. I know a patient with ankylosing spondylitis who uses an imported biological agent that is not included in the national medical insurance. The monthly drug cost is more than 6,000. Last year, the Hangzhou Huimin Insurance he participated in included this drug in the scope of special drug reimbursement. Calculated, he can reimburse nearly 30,000 a year, and the burden has been reduced a lot.

By the way, I also want to remind you of an easy pitfall. Even if the drug is included in the medical insurance catalog, if you have not registered for special outpatient diseases corresponding to chronic diseases, or if you buy the drug at a non-designated institution, you will not be able to enjoy the overall reimbursement. I once had an aunt with high blood pressure who bought imported amlodipine that was covered by medical insurance. Because she didn’t go through the registration process, she had to swipe her own personal medical insurance account every time she bought the medicine, which was equivalent to spending her own money. Later, after registering, she could reimburse 70% for each prescription, and she could save dozens of dollars every month.

The medical insurance catalog has been dynamically adjusted every year in the past two years, and more and more imported chronic disease drugs related to tumors, autoimmune diseases, and diabetes are being included. If you are not sure whether the drugs you use can be reimbursed, you can directly search the official account of the local medical insurance bureau to check the latest catalog, or just go to the hospital payment window and ask casually, so as to save you money.