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商业健康保险创新药目录7月将启动申报,开放险企参与制定
Nan Fang Du Shi Bao·2025-07-01 11:56

Core Viewpoint - The National Healthcare Security Administration (NHSA) has released measures to support the high-quality development of innovative drugs, indicating a policy intent to support innovation in pharmaceuticals, with more specific initiatives to follow in subsequent documents [1]. Group 1: Commercial Health Insurance Innovative Drug Directory - The NHSA has introduced a Commercial Health Insurance Innovative Drug Directory, which will include innovative drugs that are clinically valuable and exceed the basic medical insurance coverage [3][4]. - The directory is intended to be a reference rather than a mandatory list, allowing for flexibility in its application within the multi-tiered medical security system [4]. - The commercial health insurance market has seen rapid growth, with premium income reaching 977.3 billion yuan in the previous year, marking an 8.2% increase [3]. Group 2: Pricing and Approval Process - The NHSA will organize the development of the Commercial Health Insurance Innovative Drug Directory, involving insurance companies and industry experts in the pricing negotiation process [5]. - The approval process for drugs to be included in the directory will consist of five stages: preparation, application, expert review, negotiation, and announcement of results [6]. - The directory aims to clarify the boundaries of basic medical insurance coverage and provide more development space for commercial health insurance [4][5]. Group 3: Implementation Timeline and Future Adjustments - The application phase for the directory is expected to begin in July, with expert reviews scheduled for August to September, and negotiations to follow in September to October [6]. - The NHSA emphasizes the need for dynamic adjustments to the directory based on advancements in medical technology and changes in clinical demand [6]. - A stricter price confidentiality mechanism will be explored for drugs included in the directory to support their overseas market entry [6].