2025年度“北京普惠健康保”特药清单升级至121种 待遇可追溯至2025年1月1日

Core Points - The "Beijing Inclusive Health Insurance" project has updated its special drug list for 2025, increasing the number of drugs from 106 to 121, with 56 domestic and 65 foreign special drugs included [2][7] - The new special drug list is effective immediately, allowing for retrospective compensation for eligible claims from January 1 to June 9, 2025 [2] Domestic Special Drugs - The number of domestic special drugs has increased from 41 to 56, focusing on high-incidence cancer medications and expanding the range of diseases covered [3] - 11 drugs from the previous list that are now included in the medical insurance directory have been retained, ensuring continued coverage for patients [3] - New additions to the domestic special drug list include 15 new drugs targeting diseases such as lung cancer, multiple myeloma, leukemia, lymphoma, and breast cancer, thereby enhancing treatment options for patients [3] Expanded Indications - The updated guidelines have expanded the indications for 10 existing drugs, allowing for broader reimbursement coverage [4] - For example, the drug "Youhed" has expanded its indications from breast and stomach cancer to include lung cancer, thus benefiting a larger patient population [4] Foreign Special Drugs - The overseas special drug list has been upgraded to include 7 new drugs, with 5 of these approved for reimbursement in the Beijing Tianzhu Pilot Zone [5][6] - The list retains 13 previously approved drugs, ensuring that patients can continue to use "Beijing Inclusive Health Insurance" for reimbursement [5] Reimbursement Process - The updated special drug list includes a total of 121 drugs, with options for direct payment and post-reimbursement claims, making the process more convenient for insured individuals [7] - Insured individuals are encouraged to use the "special drug direct payment" service to avoid upfront costs, streamlining the reimbursement process [7]