新华鲜报｜用药利好事关你我！国家医保药品“清单”一览

Core Insights - The latest medical insurance drug list will be implemented on January 1, 2026, featuring significant updates that focus on clinical needs and expand access to essential medications [1] Group 1: New Drug Additions - A total of 114 new drugs have been added to the list, with 50 classified as first-class new drugs, marking a record high in both quantity and proportion [1] - Notable new drugs include treatments for triple-negative breast cancer, pancreatic cancer, and long-acting growth hormone injections for children with growth deficiencies [3] Group 2: Expanded Payment Coverage - The payment coverage has been expanded for 65 drugs, with new indications included for existing medications, such as additional targets for non-small cell lung cancer treatments and broader age eligibility for rare disease treatments [4] - Adjustments have been made to payment criteria to better align with clinical practices, such as changing the payment range for certain drugs from "previous chemotherapy" to "past chemotherapy" [4] Group 3: Restrictions and Adjustments - New limitations have been introduced for certain drugs to prevent misuse, ensuring that insurance funds are utilized effectively [5] - Some drugs have had non-core restrictions removed, but the fundamental usage requirements remain unchanged, such as the diabetes medication semaglutide [5] Group 4: Drug List Structure and Transition Policies - The updated list has removed 29 drugs that are either clinically obsolete or have not been produced for an extended period, including several that did not successfully renew their negotiation agreements [6] - A transition policy has been established, allowing a 6-month period for patients to purchase removed drugs at previous reimbursement standards [6] - A new query function for the basic medical insurance directory has been launched on the National Medical Insurance Bureau's WeChat account for easier access to the updated list [6]