新华鲜报丨新增商保创新药目录！2025年医保目录调整启动

Core Points - The 2025 National Basic Medical Insurance Drug Directory adjustment has officially started, with a notable addition of a commercial health insurance innovative drug directory [1] - The adjustment will focus on areas with insufficient basic coverage, such as pediatric and rare disease medications, to address clinical medication needs [1] - The introduction of the commercial insurance innovative drug directory aims to better meet the diverse medication needs of insured individuals [1][2] Group 1: Drug Directory Adjustments - The basic medical insurance directory has seen a dynamic adjustment over the past seven years, adding a total of 835 new drugs, primarily high clinical value drugs for cancer, chronic diseases, rare diseases, and pediatric use [1] - A total of 438 drugs that are ineffective, prone to abuse, or have been eliminated from clinical use have been removed from the directory [1][2] - By the end of 2024, negotiated drugs have benefited 8.85 billion patient visits, reducing patient costs by over 930 billion yuan [2] Group 2: Commercial Insurance Innovative Drug Directory - The newly added commercial insurance innovative drug directory will include innovative drugs that exceed basic insurance coverage and are temporarily not included in the basic directory [2] - Drugs approved for marketing within the last five years or exclusive drugs for rare diseases can be submitted for the commercial insurance innovative drug directory [3] - The process for a drug to enter the commercial insurance innovative drug directory involves expert review and price negotiations among the National Medical Insurance Bureau, commercial insurance companies, and pharmaceutical companies [4]