Chinese Psoriasis Treatment Urgently Needs To Break Through Experts' Call To Speed Up The Entry Of New Drugs Into Medical Insurance

Psoriasis is a common systemic disease in Department of dermatology. It can not be eradicated and relapsed at present. Although it has not been included in chronic diseases in China, it is a chronic disease and should be managed according to chronic diseases. Recently, Professor Cui Yong, vice director of China-Japan Friendship Hospital and professor of Department of Dermatology, pointed out in an exclusive interview with the economic news reporters in twenty-first Century.

It is understood that in 1984, China conducted a nationwide epidemiological survey. The results showed that the incidence of psoriasis in China was about 0.123%. In recent years, the epidemiological survey of psoriasis has been carried out in some provinces in China. The results show that the prevalence rate of psoriasis is 0.47% in China. According to this calculation, there are about 6 million 500 thousand psoriasis patients in China.

Up to now, psoriasis is not yet completely cured, traditional treatment can not meet the needs of most patients. Therefore, psoriasis treatment urgently needs innovative therapy to seek breakthroughs. In 2019, three interleukin based psoriasis biologics were launched in China and opened the first year of the treatment of psoriasis in China.

Most clinical experts including Professor Cui Yong have pointed out that biological agents can bring higher treatment standards for psoriasis patients, but the prevalence rate is not high at present, and the biggest reason is the cost problem. According to the consensus of Chinese clinical experts, the cost of biologicals in one year is more than 100 thousand yuan, which is very heavy for the general family. "The utilization rate of biologic agents in patients with psoriasis in China is less than 1%. As clinicians hope that the disease can be included in health insurance, it is the only way for the majority of patients to be able to afford innovative drugs."

The utilization rate of biological agents is less than 1%.

It is known that psoriasis can be divided into four types: vulgaris, pustular, arthropathy and erythroderma. In addition to the common type of 90%-95%, three other types are of special type. Most patients are caused by irregular treatment, non-standard treatment or exacerbation of disease.

Cui Yong told the twenty-first Century business reporter that psoriasis is not infectious, but because psoriasis seriously affects the appearance, and there are many misconceptions about psoriasis in the public. Therefore, various pressures will still have an impact on patients' work, life, psychology and social interaction.

Depressive symptoms are very common in psoriasis patients. According to the survey report on the burden of psoriasis and the quality of life of patients in China published by the international research center of medical management, Peking University in 2018, 89% of the patients in 2017 to 2018 showed mental stress, 78% of them had experience of discrimination, and even more startling was 34% of the patients. There were suicidal thoughts in psoriasis, and 5% of the patients had committed suicide in the past year. The reason is that patients can not get satisfactory treatment results.

At present, traditional methods of treatment are mainly traditional Chinese medicine, oral medication, topical medication and physical therapy. But Cui Yong pointed out that because psoriasis pathogenesis is very complex, psoriasis treatment needs individualized treatment, while traditional treatment methods have certain disadvantages.

Oral medication for long-term use can cause side effects such as hypertension, hyperlipemia, and liver damage. The use of topical drugs alone is not effective, and the effect may gradually decrease with the increase in the use time. Physiotherapy, such as phototherapy, can improve the condition, but it is not a cure. Patches can not be completely removed. Prolonged use can accelerate the aging of skin and increase the risk of skin cancer. 。

At present, biological agents represented by interleukin inhibitors are innovative therapies for psoriasis. Cui Yong explained that the occurrence and progression of psoriasis is the result of a series of inflammatory cytokines and multiple signaling pathways. Biological agents can target the core mediating factors involved in psoriasis inflammation and progression, thus improving the skin lesions and alleviating the disease.

Cui Yong introduced the development of biologics through 3 important nodes. The first node was mainly tumor necrosis factor alpha (TNF- alpha) inhibitor. It was first used in Department of rheumatism, and it was found to improve the effect of psoriasis patients. It was gradually extended to the Department of dermatology. The second stage mainly refers to the interleukin 12/23 inhibitor (IL-12/23). Its curative effect is better than that of tumor necrosis factor inhibitor. The third stage refers to the interleukin -17A inhibitor (IL-17A). The drug can make most psoriasis patients reach PASI 90 (PASI index is the psoriasis lesion area and severity, internationally recognized criteria for treatment of psoriasis), even PASI 100, and is also effective for recurrent psoriasis patients.

However, the biological treatment of psoriasis has brought rapid breakthroughs, comprehensive clearance and safety breakthrough. However, there are not many patients in China.

"According to statistics, less than 1% of psoriasis patients using biological agents in China, it is indeed a pity that such a good medicine can not be used." Cui Yong pointed out to the twenty-first Century economic report that cost is the biggest problem for psoriasis patients to use biological agents.

Experts call for biological agents to enter health insurance

Because psoriasis needs long-term treatment, it is very easy to lead to poverty due to illness. According to Cui Yong, taking into account the cost of most patients, China's expert consensus only recommended that patients should be used for half a year, but even for half a year, the cost of drugs is still a heavy financial burden for the general family. Cui Yong continued to point out that according to foreign clinical data, 60 weeks after treatment with Yiqi Zhu monoclonal antibody, 55% patients could achieve PASI 100, and for patients with continuous medication, the skin clearance effect could be maintained for more than 5 years.

Cui Yong said that if the above biological agents can enter health insurance, the price paid by patients should be reduced through the negotiation of national health insurance, and the accessibility of medications and patients can be significantly improved. "After entering medical insurance, on the one hand, more doctors will be willing to prescribe these innovative drugs to patients, on the other hand, it will also greatly reduce the economic pressure of psoriasis patients, and achieve double promotion of drug accessibility and patient satisfaction."

As a national strategy, chronic disease management has a large amount of capital invested every year, and it will promote more and better psoriasis innovative drugs into medical insurance after being included in the chronic disease list, forming a positive cycle and maximally favorable psoriasis patients.

During the two sessions, the NPC deputies and CPPCC members were also concerned about the burden of psoriasis patients, and put forward relevant suggestions. For example, the NPC deputy and vice president of the Huaibei people's Hospital, Ren Li, drafted and submitted the proposal to speed up the improvement of the level of medical insurance for psoriasis and other diseases.

The above recommendations point out that three major immune related chronic diseases, psoriasis, specific dermatitis and vitiligo in the field of Dermatology, have more than 50 million patients in the country. Although these diseases do not directly threaten life as cancer, patients need long-term or even life-long medication, which brings heavy financial burden and psychological burden to patients themselves and their families, and further causes industry and society. Attention is the most urgent task.

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