国家医保局：药品通过形式审查，不代表其已纳入基本医保目录

Core Viewpoint - The National Healthcare Security Administration (NHSA) has published the preliminary results of the initial review for the 2025 National Basic Medical Insurance, Maternity Insurance, and Work Injury Insurance drug catalog adjustments, as well as the commercial health insurance innovative drug catalog adjustments, indicating a structured approach to drug approval and transparency in the process [1][2]. Group 1: Initial Review Process - The initial review serves to verify whether the submitted drugs meet the application conditions for the basic medical insurance and commercial health insurance innovative drug catalogs, ensuring the completeness and compliance of the application materials [1][2]. - The review process consists of four steps: initial review, public announcement of results, re-examination, and announcement of re-examination results, with the current publication representing the initial review results [1][3]. Group 2: Comparison with Previous Year - From July 11 to July 20, 2025, the NHSA received 718 applications for the basic medical insurance catalog, involving 633 drug generic names, with 534 passing the initial review, a significant increase from 249 in 2024 [4]. - The newly established commercial health insurance innovative drug catalog received 141 applications, with 121 drug generic names passing the initial review, indicating a robust interest in both catalogs [4]. Group 3: High-Cost Drugs and Review Implications - The NHSA emphasizes that passing the initial review does not guarantee inclusion in the basic medical insurance catalog, as further evaluations and negotiations are required, especially for high-cost drugs that exceed basic coverage [4][5]. - The agency aims to balance basic medical needs with clinical advancements while maintaining the sustainability of the insurance fund, indicating a cautious approach to including expensive drugs in the catalog [4]. Group 4: Next Steps - Following the public announcement, the NHSA will review feedback received during the public comment period to finalize the list of drugs that passed the initial review and will communicate the results to the applicants [6]. - The NHSA will proceed with expert evaluations, negotiations for the basic medical insurance catalog, and price discussions for the commercial health insurance innovative drug catalog as part of the ongoing adjustment process [6].