新版医保药品目录调整“上新” 满足群众多层次、多元化用药需求

Core Points - The new basic medical insurance drug catalog and the first version of the commercial insurance innovative drug catalog are set to be released in Guangzhou on the first weekend of December, with implementation starting on January 1, 2024 [1] - The recent negotiations involved 120 domestic and foreign enterprises, with 127 drugs outside the basic medical insurance catalog participating in the negotiations, and 24 drugs involved in price negotiations for the commercial insurance innovative drug catalog [3] - The commercial insurance innovative drug catalog was organized by the National Medical Insurance Administration, allowing companies to apply for inclusion in either the basic medical insurance catalog or the commercial insurance innovative drug catalog, or both [5] Industry Insights - The addition of the commercial insurance innovative drug catalog aims to better meet the diverse medication needs of the population, with 1.326 billion people covered by basic medical insurance in 2024, maintaining a coverage rate of 95% [6] - Total expenditure for the basic medical insurance fund is projected to reach 2.97 trillion yuan in 2024, providing solid support for healthcare access [6] - The commercial health insurance market is experiencing rapid growth, with premium income reaching 977.3 billion yuan in 2024, an increase of 8.2% year-on-year, although there remains significant room for improvement in coverage levels compared to basic medical insurance [6] - Challenges exist in synchronizing medical insurance and commercial insurance settlements across provinces, but initiatives like the "commercial insurance + medical insurance" one-stop settlement payment platforms have been launched in various regions [6]