如何正确理解肝癌医保报销范围的“不能手术”

How to Understand the "No Surgery" in the Medical Insurance Reimbursement of Liver Cancer

肝细胞癌(以下简称HCC, hepatocellular carcinoma)是最常见的恶性肿瘤之一,具有起病隐匿、恶性程度高、发展速度快等特点,多数患者一经诊断便已无法手术切除。因此,非手术治疗起着越来越重要的作用。随着分子生物学、基因组学及蛋白质组学的发展,分子靶向治疗已广泛应用于肿瘤领域。索拉非尼是治疗HCC的靶向药物,在其进入医保报销目录前因价格较高,患者负担沉重,其临床应用受到限制。医保药品谈判政策旨在帮助患者进一步降低就医经济负担,普及规范化诊疗,从而使患者获益。索拉非尼纳入国家医保目录后,患者的治疗费用显著降低,但在实际报销时仍存在一些障碍,例如医保可报销范围仍不够明确,病理报告是否为报销必备材料,患者是否能真正享受到索拉非尼纳入医保带来的经济负担减轻。本文将对索拉非尼治疗肝癌医保报销相关问题进行深入分析。

Hepatocellular carcinoma （HCC） is one of the most common malignant tumors with the characteristics of occult onset, high degree of malignancy and rapid development. Most patients can not be resected once diagnosed. Therefore, nonoperative treatment is playing a more and more important role. With the development of molecular biology, genomics and proteomics, molecular targeted therapy has been widely used in the fleld of cancer. Sorafenib is a targeted drug for the treatment of HCC, and its clinical application is limited because of its high price and heavy burden before entering the reimbursement list. Medical insurance drug negotiation policy aims to help patients further reduce the financial burden of medical treatment, popularize standardized treatment, so that patients can get tangible beneflts. After sorafenib was listed in the national medical insurance catalogue, the treatment cost of patients was significantly reduced, but there are still some obstacles in the actual reimbursement, such as the scope of reimbursement is still not clear enough, whether the pathological report is the necessary material for reimbursement, whether patients can really enjoy the economic benefits of sorafenib included in the medical insurance？ This article will carry out in-depth analysis of Sola Fini liver cancer medical insurance reimbursement related issues.