商保创新药目录今年将首次制定

Core Points - The 2025 National Medical Insurance Drug List adjustment has officially begun, with a focus on the newly established commercial health insurance innovative drug list [1][3] - The commercial health insurance innovative drug list aims to include high-innovation, clinically valuable drugs that cannot be included in the basic list due to their cost, thereby enhancing the multi-tiered medication security system [3][4] - The adjustment process includes a dual-track application for both the basic medical insurance and the commercial health insurance innovative drug lists, providing clear access pathways for eligible drugs [10][11] Summary by Category Policy Changes - The National Medical Insurance Bureau has initiated the adjustment process for the 2025 drug lists, allowing eligible applicants to submit online applications from July 11 to July 20 [3][10] - The new commercial health insurance innovative drug list is a significant step in integrating commercial health insurance into the national drug list system, enhancing the accessibility of innovative drugs [4][11] Focus Areas - The 2025 adjustment will prioritize areas with insufficient basic coverage, such as pediatric and rare disease medications, to address clinical needs [6][10] - The commercial health insurance innovative drug list serves as a supplement to the basic insurance list, potentially covering innovative drugs that are currently not reimbursed [6][7] Market Impact - The introduction of the commercial health insurance innovative drug list is expected to improve the effectiveness of commercial health insurance and provide a transitional solution for high-priced innovative drugs [7][11] - The adjustment mechanism has evolved since 2018, with the proportion of new drugs listed in the insurance directory increasing significantly, from 32% in 2019 to 98% in 2024 [8]