Navigating the implementation gap for Trastuzumab’s journey from health insurance to patient access:a preliminary study in a hospital in China  

作　　者：Xingxia Yang Yufei Jia Jianhong Xu Qin Zhou Qian Long Yi Yang Yunguo Liu Juanying Zhu Xiaochen Zhang 

机构地区：[1]Department of Breast,Affiliated Women and Children Hospital,Jiaxing University,2468,East Zhonghua Road,Nanhu District,Jiaxing 314000,Zhejiang,China [2]Global Health Research Center,Duke Kunshan University,Kunshan,Jiangsu,China [3]Department of General Surgery,Affiliated Kunshan Hospital of Jiangsu University,Kunshan,China [4]Duke Global Health Institute,Duke University,Durham,NC,USA [5]Division of Social Sciences,Duke Kunshan University,No.8 Duke Avenue,Kunshan 215316,Jiangsu,China

出　　处：《Global Health Research and Policy》2024年第1期45-56,共12页全球健康研究与政策(英文)

基　　金：The research results of this article(or publication)are sponsored by the Kunshan Municipal Government(23KKSGR015)research funding.

摘　　要：Background Trastuzumab,a monoclonal antibody for breast cancer,faces global accessibility challenges,primarily due to high costs.This study examines how changes in medical insurance policies and price adjustments influence Trastuzumab utilization in China,focusing on implementation challenges and their impact on drug accessibility and affordability.Methods This retrospective study investigated Trastuzumab utilization among HER2-positive breast cancer patients at a tertiary hospital from May 2013 to December 2022 in JX,a prefecture-level city in eastern China.Patients were stratified based on their CerbB2 indicator,because those with a 2+CerbB2 status require further FISH testing to con-firm Trastuzumab eligibility.We analyzed the utilization rates of both FISH test and Trastuzumab using logistic regres-sions,identifying factors that influence their usage.Results 766 patients were included.The utilization rate of Trastuzumab among patients with CerbB23+rose from 40.40 to 77.94%in September 2017 following the expansion of insurance coverage,and further increased to 90.41%after a price reduction in 2020.The FISH test was not covered by health insurance,and it was not avail-able in the local hospital until Trastuzumab became available in JX city.For patients with CerbB22+,the proportion undergoing the FISH test increased dramatically from 8.89 to 82.08%after the price reduction in 2020.The mere inclu-sion into basic medical insurance,regardless of insurance types,significantly increased the utilization of Trastuzumab and the FISH test.However,rural patients in JX city are still facing financial burdens with Trastuzumab’s out-of-pocket cost accounting for 62.9%of their annual disposable income in 2020.Conclusions Our findings indicate that insurance coverage and price reduction significantly increased Trastu-zumab utilization.However,failure to improve the accessibility of the FISH test can pose challenges in enhancing the uptake of Trastuzumab among eligible patients.With the expiration of Trastuzumab’s patent an

关 键 词：Breast cancer Trastuzumab utilization and accessibility FISH test Basic medical insurance coverage 

分 类 号：R73[医药卫生—肿瘤]