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创新药可同时申报商保和医保目录,医保保障不了的药也能用上
Xin Jing Bao·2025-07-09 11:11

Core Viewpoint - The recent measures introduced by the National Healthcare Security Administration (NHSA) and the National Health Commission (NHC) aim to support the high-quality development of innovative drugs, including the establishment of a commercial health insurance innovative drug catalog, which is expected to significantly impact drug accessibility for the public [1][2]. Group 1: Innovative Drug Development - The number of Class 1 innovative drugs approved in China has shown a significant upward trend, with 48 drugs expected to be approved in 2024, more than five times the number in 2018, and nearly 40 drugs approved in the first half of this year [1]. - The introduction of innovative drugs into the medical insurance catalog has led to a substantial improvement in the clinical medication structure, enhancing the level of medication security for the public [1]. Group 2: Commercial Health Insurance Innovative Drug Catalog - The establishment of the commercial health insurance innovative drug catalog is designed to clarify the boundaries of basic medical insurance coverage and provide more development space for commercial health insurance [2]. - The NHSA will ensure the integration of the medical insurance drug catalog and the commercial health insurance innovative drug catalog, providing a stable outlet for drugs in the commercial catalog [2]. Group 3: Policy Support for Innovative Drugs - The policy specifies that medical institutions cannot restrict the use of innovative drugs based on the number of drugs in the medical institution's drug catalog or drug expenditure ratio [3]. - A "three exclusions" policy will be implemented for drugs in the commercial health insurance innovative drug catalog, which will not be included in the basic medical insurance self-pay rate indicators or the monitoring of selected alternative varieties in centralized procurement [3]. Group 4: Investment Trends in Biopharmaceuticals - The biopharmaceutical sector has seen increased investment activity, with over 90 overseas licensing transactions completed by Chinese pharmaceutical companies in 2024, totaling over $50 billion [4]. - The NHSA has emphasized the importance of encouraging commercial health insurance to expand investment in innovative drugs, fostering patient capital to support the industry [4].