独家｜首版商保创新药目录完成专家评审 5款“天价”CAR-T过评

Core Points - The National Healthcare Security Administration (NHSA) announced the completion of expert review for the adjustment of the national basic medical insurance catalog and commercial insurance innovative drug catalog for 2025 [2][3] - This marks the 8th adjustment of the medical insurance catalog since the establishment of the NHSA and the first time a commercial insurance innovative drug catalog has been added [3] Summary by Sections - Expert Review Process - A total of 644 drugs passed the formal review, with 534 approved for the basic medical insurance catalog and 121 for the commercial insurance innovative drug catalog [3] - The expert review process is crucial, with less than half of the drugs passing this stage, indicating a low approval rate for both catalogs [5] - Focus on Innovative Drugs - Certain categories of innovative drugs are prioritized for inclusion in the commercial insurance innovative drug catalog, such as drugs already included in local health insurance and high-innovation drugs with strong patient benefits [5] - Five CAR-T drugs successfully passed the expert review, despite their high costs, which can reach around 1 million yuan per injection [5][6] - Future Payment Models - There is a discussion about a potential future payment model where the commercial insurance innovative drug catalog serves as a transitional phase before drugs are included in the basic medical insurance catalog [7] - The NHSA plans to hold a communication meeting in Beijing with companies involved in negotiations and price discussions [7]