Core Insights - The National Medical Insurance Negotiation concluded on November 4, with 120 companies participating, involving 127 off-list drugs and 24 drugs for commercial insurance innovation [1] Group 1: Introduction of Commercial Health Insurance Innovation Drug Directory - The "Commercial Health Insurance Innovation Drug Directory" was introduced for the first time this year, building on the existing medical insurance directory adjustment mechanism [2] - A total of 121 drug names passed the formal review for the commercial health insurance innovation drug directory, with 79 drugs applying for both the basic medical insurance and the commercial health insurance directories [2] Group 2: CAR-T Therapy and Pricing Negotiations - The high-priced CAR-T therapies are highlighted as a significant focus in the commercial health insurance innovation drug directory [4] - Five CAR-T therapies have passed the formal review for the commercial insurance directory, with three also applying for the basic medical insurance directory [5] - The only CAR-T therapy priced below one million yuan is the one from Huyuan Biotechnology, priced at 999,000 yuan per injection, and negotiations for this therapy have reportedly gone smoothly [5][6] Group 3: Market Dynamics and Future Implementation - The introduction of the commercial health insurance innovation drug directory is seen as a key step to break the payment deadlock, potentially lowering patient out-of-pocket expenses and expanding the patient population [6] - The new basic medical insurance drug directory and the first commercial health insurance innovation drug directory are expected to be released in early December, with implementation starting on January 1 of the following year [6]
中新健康丨2025年国谈收官 “天价抗癌疗法”或迎支付破局