做好医保药品目录的“加减法”

Core Insights - The latest medical insurance drug list has been officially implemented on January 1, 2026, marking the eighth consecutive year of optimization by the medical insurance department, aimed at enhancing both the efficiency of fund usage and the level of medication security for the public [1][2] Group 1: Drug List Adjustments - A total of 114 new drugs have been added to the list, covering critical areas such as oncology, chronic diseases, and rare diseases, including 10 specific drugs for rare diseases, providing more treatment options for patients [1] - The average price reduction for newly added drugs exceeds 60% due to national medical insurance negotiations, significantly lowering the financial burden on patients [1] Group 2: Fund Efficiency and Clinical Relevance - The adjustments are designed to ensure that the medical insurance fund is directed towards high-efficiency and urgently needed medications, removing those that are no longer supplied or have better alternatives [2] - Specific drugs have had their payment scope adjusted to better align with clinical realities, such as the change in coverage for a drug used to increase white blood cell counts [1] Group 3: Support for Innovation and Long-term Strategy - The introduction of a commercial insurance innovative drug directory alongside the basic medical insurance aims to create a multi-layered support system for diverse patient medication needs, alleviating long-term pressure on the medical insurance fund [2] - The new drug list supports high-value innovative drugs, encouraging pharmaceutical companies to shift from marketing-driven approaches to those focused on clinical value, fostering innovation in the pharmaceutical industry [2] Group 4: Patient-Centric Reforms - The adjustments represent a patient-centered reform driven by clinical needs, emphasizing the importance of timely integration of new drugs into hospital procurement lists and addressing practical challenges faced by patients [2] - A long-term mechanism involving collaboration among medical insurance departments, medical institutions, and companies is necessary to maximize the benefits of these reforms for the public [2]