国家医保局发布医保商保“双目录” 19种药品纳入首版商保创新药目录

Core Insights - The 2025 National Basic Medical Insurance, Maternity Insurance, and Work Injury Insurance Drug Catalog, along with the first version of the Commercial Health Insurance Innovative Drug Catalog, will be officially implemented on January 1, 2026 [1][2] Group 1: National Medical Insurance Drug Catalog - The 2025 update adds 114 new drugs, including 50 innovative drugs, while removing 29 drugs that are either not clinically available or can be replaced by better alternatives [1] - The total number of drugs in the catalog increases to 3,253, comprising 1,857 Western medicines and 1,396 traditional Chinese medicines [1] - New drugs included address significant medical needs, such as treatments for triple-negative breast cancer, pancreatic cancer, lung cancer, rare diseases, and chronic conditions like diabetes and autoimmune diseases [1] Group 2: Commercial Health Insurance Innovative Drug Catalog - The catalog includes 19 drugs from 18 innovative pharmaceutical companies, featuring advanced therapies such as CAR-T, TCE therapies, and bispecific antibodies [2] - The catalog emphasizes three key characteristics: support for innovation, focus on critical areas like Alzheimer's and pediatric rare diseases, and the distinction between basic medical insurance and commercial insurance [2] Group 3: Future Directions - The National Medical Insurance Administration aims to clarify the boundaries of basic medical insurance and promote the complementary development of commercial health insurance, establishing a multi-tiered medical security system [3] - Future policies will be refined to enhance management and ensure the effective implementation of the drug catalogs, ultimately improving the clinical medication needs of insured individuals [3]