中国医保商保“双目录”发布 新药可及性再提升

Core Insights - The National Healthcare Security Administration and the Ministry of Human Resources and Social Security have issued the updated National Basic Medical Insurance, Maternity Insurance, and Work Injury Insurance Drug Catalog, along with the Commercial Health Insurance Innovative Drug Catalog for 2025, which includes 114 new drugs, 50 of which are Class 1 innovative drugs [1][2] Group 1: Drug Catalog Updates - The 2025 National Medical Insurance Drug Catalog will include drugs that fill gaps in basic insurance coverage, such as treatments for triple-negative breast cancer, pancreatic cancer, and lung cancer, as well as rare diseases like Langerhans cell histiocytosis and thalassemia [1] - The total number of drugs in the updated catalog will increase to 3,253, comprising 1,857 Western medicines and 1,396 traditional Chinese medicines, significantly enhancing coverage for key areas such as oncology, chronic diseases, mental health, rare diseases, and pediatric medications [1] Group 2: Innovation and Policy Support - The 2025 adjustment marks the eighth update since the establishment of the National Healthcare Security Administration, establishing a regular, standardized, and scientific adjustment mechanism aimed at "filling gaps, encouraging innovation, and optimizing structure" [2] - The new Commercial Health Insurance Innovative Drug Catalog includes 19 drugs from 18 innovative pharmaceutical companies, focusing on high innovation, significant clinical value, and patient benefits that exceed basic insurance coverage [2][3] Group 3: Characteristics of the Innovative Drug Catalog - The Commercial Health Insurance Innovative Drug Catalog emphasizes support for innovation, featuring drugs that represent significant advancements in medical technology, including CAR-T, TCE therapies, and bispecific antibodies [3] - It addresses key areas of concern, including drugs for Alzheimer's disease, which aligns with the aging population trend, and treatments for rare diseases prevalent in children, such as Gaucher disease and neuroblastoma [3] - The catalog delineates the boundary between basic medical insurance and commercial insurance, with basic insurance focusing on safe, effective, and mature-target mechanism drugs, while commercial insurance emphasizes innovative and cutting-edge medications [3]