The Impact Of Medical Insurance Reimbursement Policy On The Treatment Level And Disease Burden Of Patients With Rare Diseases

National health is the fundamental purpose of building a healthy China.However,the group of rare disease patients is a relatively weak group in the current medical and health system of various countries,facing the dilemma of complicated diseases,difficulties in diagnosis,few therapeutic drugs and high treatment costs.The prevention and treatment of rare diseases started late in China.In recent years,rare diseases have received increasing attention from all sides,but the accessibility and affordability of drugs for patients still need to be improved.To explore the status quo of diagnosis and treatment and disease burden of patients under the current basic medical insurance treatment,as well as the influence of differentiated reimbursement treatment on diagnosis and treatment level of rare diseases,is of great reference significance for quantitative measurement of disease burden of patients and improvement of medical insurance policies for rare patients.Hemophilia A(HA)was selected for this study.By sorting out and comparing the basic medical insurance policies in different cities,this paper describes the differential status of medical insurance treatment for HApatients in China.The diagnosis and treatment levels of patients in different cities were described by collecting patients’ visit information throughout 2018.The disease burden of patients with different medical insurance treatment was compared in terms of annual bleeding frequency,annual FⅧ dosage and annual outpatient expenses.Finally,based on the current situation,the pharmaceutical economic model is established.Assuming that the medical insurance benefits will be improved in the future,the difference in the diagnosis and treatment level and economic burden of the patient population and per capita will be predicted under the two scenarios of the improvement of treatment level and the maintenance of treatment level.The results show that patients with hemophilia A have large differences in treatment level and economic burden.From the perspective of severity,the symptoms of moderate and severe patients are more serious,and the economic burden of patients is also increased.The cost of prophylaxis treatment is higher than that of on-demand treatment.From the perspective of age,the treatment level of adult patients in China is lower than that of children.It is reflected in the amount of drugs used and the proportion of patients receiving prophylaxis treatment.From the regional perspective,there are differences in the reimbursement level of basic medical insurance in different cities,and these differences further affect the treatment level.The results of the model show that increasing the level of treatment can reduce the annual average number of bleeding and the use of medical resources,and reduce the number of missing days,but the reduced treatment costs cannot offset the increase in drug costs.Generally speaking,the treatment needs and economic burden of patients with different severity levels are quite different.The treatment level of adult hemophilia A patients should be gradually improved.The difference in medical insurance between different regions will affect the patient’s treatment level.The Improvement of treatment level leads to obvious health benefits and treatment costs.Therefore,differential treatment schemes and medical insurance levels should be formulated base on the severity.More attention should be paid to the improvement of the treatment of adult patients.Differences in medical insurance level should be narrowed The government should establish a rescue system to ease the patient cost.Enterprises should cooperate with the government to reduce patient burden.