Analysis of the medical insurance reimbursement policy for enzalutamide/enzalutamide in 2024

Enzalutamide/enzalutamide (Enzalutamide), as an oral androgen receptor (AR) signaling inhibitor, has been widely used to treat castration-resistant prostate cancer (CRPC) with AR amplification or overexpression. Enzalutamide demonstrated excellent efficacy in men with metastatic CRPC. However, in addition to its remarkable therapeutic effects, many patients are also concerned about the medical insurance reimbursement policy of this drug.

The medical insurance reimbursement ratio of enzalutamide is affected by regional and specific medical insurance policies, so there are certain differences. In our country, the medical insurance system is jointly formulated by the national and local governments, resulting in different reimbursement ratios in various provinces and cities. It is important for patients to understand the specific reimbursement policies in their area.

Enzalutamide has attracted attention because of its unique once-daily oral administration, which does not require concurrent corticosteroids. Early clinical trial data suggests that enzalutamide appears to have greater efficacy than traditional antiandrogens. In a phase I/II study, most patients had metastatic disease, and about half of them had received chemotherapy. The study gradually increased the dose of enzalutamide from 30 mg to 600 mg daily to assess its safety and tolerability. The study results showed that enzalutamide exhibited antitumor activity at all doses tested, but its maximum tolerated dose was determined to be 240 mg. Of note, no additional antitumor effects were observed above this dose.

As an innovative drug, the market price of enzalutamide is relatively high, with each box of 40mg*112 tablets priced at approximately RMB 6,000. However, after medical insurance reimbursement, the actual burden on patients will be reduced to a certain extent. In addition, some regions in the country may set up special medical insurance channels, such as critical illness insurance and medical assistance, to further provide financial support to patients.