29种药被“调出”新版国家医保药品目录，患者需找医生选用“替代药”

Core Viewpoint - The new National Medical Insurance Drug List will be officially implemented on January 1, 2026, expanding the inclusion of innovative drugs while removing 29 drugs from the list, raising concerns among patients about potential increased costs and reduced insurance coverage [1][3]. Summary by Relevant Sections Drug List Adjustments - The National Medical Insurance Bureau has adjusted the drug list for eight consecutive years, with a total of 467 drugs removed to date [1]. - The updated list includes 3,253 drugs, with 114 new additions primarily targeting cancer, mental health, and pediatric medications [1]. Reasons for Drug Removals - Among the 29 drugs removed, there are 21 Western medicines and 8 traditional Chinese medicines, many of which have alternative options available in the insurance list [3]. - The reasons for removal can be categorized into three main types: 1. Strong clinical substitutability, with many drugs having more effective and safer alternatives [3]. 2. Low reimbursement rates, with 15 of the removed drugs having less than 0.01% reimbursement from the insurance fund in 2024, indicating minimal patient benefit [3]. 3. Low cost-effectiveness, where some drugs, despite being effective, are priced higher than similar alternatives without offering additional benefits [3]. Impact of New Additions - The inclusion of 114 new drugs enhances the choices available to clinicians and patients, better meeting patient needs, especially with the increased speed and quantity of innovative drugs being added [4]. - Although the inclusion of innovative drugs may exert some pressure on the insurance fund, management tools such as total budget control and reasonable drug use management are in place to mitigate significant impacts on the fund [4]. Patient Guidance - Patients are advised to follow the guidance of healthcare professionals regarding medication adjustments and should not self-medicate, as all drugs in the insurance list are prescription medications [5].