Jing Ji Ri Bao·2026-01-06 02:11Core Viewpoint - The new National Basic Medical Insurance, Maternity Insurance, and Work Injury Insurance Drug Catalog (2025) and the first Commercial Health Insurance Innovative Drug Catalog (2025) will be implemented nationwide starting January 1, 2026, adding 114 new drugs to the basic insurance catalog and 19 to the commercial insurance catalog, aimed at enhancing drug accessibility and supporting innovation in the pharmaceutical industry [1][2]. Group 1: Drug Catalog Adjustments - The updated basic medical insurance catalog includes 114 new drugs, with significant representation from oncology (36 drugs), chronic diseases like diabetes (12 drugs), anti-infective drugs (13 drugs), and rare diseases (10 drugs), while 29 drugs were removed due to better alternatives [2]. - The total number of drugs in the national medical insurance catalog has increased to 3,253, comprising 1,857 Western medicines and 1,396 traditional Chinese medicines [2]. - The adjustment reflects a comprehensive coverage of diseases, addressing clinical pain points and improving access to previously unavailable treatments for conditions like triple-negative breast cancer and pancreatic cancer [2]. Group 2: Policy Implementation and Access - To address the issue of new drugs being listed but not available in hospitals, the policy mandates that all designated medical institutions must include new drugs in their procurement catalogs by the end of February 2026, with provisions for temporary green channels if necessary [3]. - Negotiated drugs will not be subject to administrative restrictions such as "one drug, two regulations" or overall medical insurance caps, allowing for more flexible access [3]. Group 3: Support for Innovative Drugs - Among the new drugs added to the basic medical insurance catalog, 50 are classified as category 1 innovative drugs, with an overall success rate of 88%, up from 76% in 2024, indicating a shift towards strategic purchasing and value-based reimbursement [4]. - The catalog includes both domestic innovative products and foreign original research products, enhancing the diversity of available treatments [4]. Group 4: Commercial Health Insurance Innovations - The newly established commercial health insurance innovative drug catalog includes 19 drugs, focusing on high-innovation, clinically valuable treatments that fill gaps in existing coverage, such as CAR-T cell therapies and treatments for rare diseases prevalent in children [7]. - This catalog complements the basic medical insurance, allowing pharmaceutical companies to expand their market reach while reducing the financial burden on patients [7]. Group 5: Industry Impact and Future Directions - The policy signals strong government support for independent innovation and encourages pharmaceutical companies to invest more in original and differentiated research and development [8]. - The National Medical Insurance Bureau plans to refine policies and enhance management to ensure effective implementation of the drug catalogs, ultimately improving the clinical medication needs of insured individuals [8].