非布司他在国内纳入医保了吗？

On June 22, 2013, the original Japanese drug febuxostat (febuxostat, feburic) for the treatment of gout was launched in China, and Astellas Pharmaceuticals (China) Co., Ltd. obtained the exclusive sales rights in the Chinese market. Is Febuxostat included in medical insurance in the country?

It is understood that febuxostat has been included in the national medical insurance catalog. The drug category is musculoskeletal system drugs > anti-gout drugs (XM > XM04), which belongs to Category B of medical insurance.

The starting dose of febuxostat (febuxostat, feburic) is 40 mg orally once daily. Since the drug-enzyme complex formed by febuxostat and xanthine oxidase is extremely stable and its uric acid-lowering effect is stronger than that of allopurinol, blood uric acid can be rechecked after 2 weeks of taking it.

If the blood uric acid level is still not less than 360umol/L after 2 weeks, it is recommended to increase the dose to 80mg, once a day. It is recommended to take the medicine for at least 6 months to prevent acute attacks of gout. If gout occurs during treatment with this drug, there is no need to discontinue the drug.

An increase in the frequency of gout attacks often occurs during the early stages of taking febuxostat. This is because blood uric acid concentration decreases, leading to mobilization of urate deposited in tissues. To prevent gout attacks during the initial stages of treatment, it is recommended to take nonsteroidal anti-inflammatory drugs or colchicine at the same time.

Febuxostat is mainly metabolized in the liver, and 49% of the metabolized inactive substances are excreted through the kidneys, 45% through feces, and some through bile. It is excreted through multiple pathways. Therefore, the dosage does not need to be adjusted in patients with mild or moderate renal failure (endogenous creatinine clearance 30-89 mL/min) and mild or moderate (Child-Pugh A and B) hepatic insufficiency.

There are currently no studies on patients with severe hepatic insufficiency (Child-Pugh C class) and severe renal insufficiency, so these patients should still be cautious when using febuxostat.