创新药目录申报破百，药企为何“想进又不想进”？

Core Viewpoint - The article discusses the complexities and varying attitudes of pharmaceutical companies towards the newly introduced innovative drug directory in the context of commercial health insurance, highlighting the potential market impact and the challenges faced by companies in navigating pricing and inclusion in the directory [3][4][31]. Group 1: Innovative Drug Directory and Market Dynamics - Over 100 drugs have been reported for inclusion in the innovative drug directory, indicating a significant interest from pharmaceutical companies [1][4]. - The innovative drug directory is seen as a bright spot in the policy landscape, with the Hang Seng Innovative Drug Index rising by 60.27% and the Wind Innovative Drug Index increasing by 23.93% in the first half of 2025 [4]. - The expectation of market growth driven by the innovative drug directory may be overly optimistic, as the actual sales impact of the commercial health insurance and the "policy for price" approach remains uncertain [5][6]. Group 2: Pharmaceutical Companies' Attitudes - Pharmaceutical companies exhibit three main attitudes towards the innovative drug directory: "participation-focused," "minimum guarantee," and "wanting to enter but hesitant" [17][19]. - Many companies are cautious about entering the directory due to concerns over pricing negotiations and the uncertain volume of sales from the commercial health insurance [19][20]. - The perception that entering the directory may not significantly enhance sales, especially for companies that have already penetrated the market, contributes to their hesitance [22][23]. Group 3: Financial Implications and Market Size - The commercial health insurance, known as Huiminbao, has a scale of nearly 20 billion, but its contribution to innovative drug sales is viewed as minimal, akin to "a drop in the ocean" [6][7]. - Huiminbao's reimbursement for innovative drugs is estimated to be around 2 billion, translating to approximately 4 to 6 billion in sales for pharmaceutical companies [7][8]. - The distribution of the reimbursement "cake" among the drugs included in the innovative drug directory is expected to be competitive, with a limited number of drugs likely to capture the majority of the funds [8][10]. Group 4: Challenges in Market Access - The innovative drug directory aims to facilitate market access through policies like direct listing and "three exclusions," but the actual implementation and effectiveness of these policies remain in question [29][30]. - Companies express skepticism about whether the proposed policies will lead to significant changes in market access, especially given the complexities involved in hospital procurement processes [30][31]. - The article highlights the ongoing challenges faced by pharmaceutical companies in navigating the regulatory landscape and achieving meaningful market penetration despite the introduction of supportive policies [24][25].