首版商保创新药目录共纳入19种药品,涵盖阿尔茨海默病等治疗药
Sou Hu Cai Jing·2025-12-07 14:30

Core Insights - The National Healthcare Security Administration has added a commercial health insurance innovative drug directory, including 19 new drugs, supplementing the traditional medical insurance drug list [1][3]. Group 1: Commercial Health Insurance Innovative Drug Directory - The commercial health insurance innovative drug directory serves as an effective supplement to basic medical insurance, allowing patients access to innovative drugs not covered by basic insurance [3]. - The drugs included in the commercial health insurance innovative drug directory do not affect the self-pay rate of basic medical insurance and are not included in centralized procurement monitoring indicators or disease-based payment ranges [5]. - The directory focuses on highly innovative drugs with significant clinical value and benefits for patients that exceed the coverage of basic medical insurance [7]. Group 2: Specific Drugs and Conditions - The 19 drugs encompass CAR-T therapies and immunotherapy drugs for liver cancer, which is prevalent in China, providing more treatment options for cancer [9]. - The directory also includes drugs for rare diseases such as Gaucher's disease and short bowel syndrome, as well as treatments for Alzheimer's disease, marking their first inclusion in the commercial insurance directory [9]. Group 3: Market Impact and Growth - In 2024, the original insurance premium income for commercial health insurance in China is projected to reach 977.3 billion yuan, reflecting an 8.2% year-on-year growth, nearing the total funding level of resident medical insurance for that year [11]. - The backing of the state for commercial health insurance through the innovative drug directory is expected to attract more participants, effectively reducing customer acquisition costs for commercial health insurance [13]. - The innovative drug directory allows basic medical insurance to maintain a universal coverage baseline while commercial insurance takes on high-value innovative drugs, encouraging companies to focus more on clinical innovation [15].