By Fineline Cube Hainan Boao Lecheng International Medical Tourism Pilot Zone has released an updated special drug insurance list, allowing patients in the zone to access medicines not yet market-approved in China. The insurance scheme, first introduced in 2020, was the first government-guided provincial-level supplementary special drug insurance scheme in China. This year’s list includes 40 domestically-developed drugs and 60 overseas drugs, compared to a 25:75 ratio when the program was launched in 2020.
Enhanced Insurance Liabilities
The latest version has optimized the specific drug security contents, with increased insurance liabilities for two China-made chimeric antigen receptor (CAR)-T therapies: JW Therapeutics’ Carteyva (relmacabtagene autoleucel injection) and Fosun Kite’s Yescarta (axicabtagene ciloleucel). Additionally, Yttrium 90 resin/glass microspheres have been added for the treatment of liver cancer, leveraging the international novel drug and device special use policy.
Upgraded Insurance Plans
The insurance has upgraded its A and B plans. Members pay only an RMB 29 (USD 4.13) premium, benefiting from a maximum of RMB 1 million (USD 142,500) in coverage for specific drug expenses with zero deductible. They can enjoy 100% compensation for non-pre-existing conditions and 30% compensation for pre-existing conditions for specific tumor drugs. Other new and special drugs provide 100% compensation for non-pre-existing conditions, with pre-existing conditions not covered.
Plan B requires members to pay RMB 99 (USD 14.11) for one year of cover, with a maximum reimbursed amount of RMB 3 million (USD 427,490). The conditions include: ① An insured amount of RMB 1 million (USD 142,500) for inpatient medical expenses outside the scope of medical insurance reimbursement, with a deductible of RMB 20,000 (USD 2,850) and a compensation ratio of 60%; ② An insured amount of RMB 1 million (USD 142,500) for medical treatment at Lecheng’s designated hospitals, with a deductible of RMB 10,000 (USD 1,425) and a compensation ratio of 80%; ③ An insured amount of RMB 1 million (USD 142,500) for specific drug expenses, with no deductible. Specific tumor drugs are covered 100% for non-pre-existing conditions and 30% for pre-existing conditions, while other new special drugs provide 80% compensation for non-pre-existing conditions, with pre-existing conditions not covered.
Drug List Highlights
All 40 China-made special drugs listed are designated for tumors, while 43 of the overseas special drugs are cancer products. Other notable inclusions are rare disease drugs, such as BioMarin’s mucopolysaccharidosis type VI drug galsulfase and others in-licensed by domestic companies but not yet market-approved. For the full list, see here.-Fineline Info & Tech