国家医保药品“清单”一览

Core Insights - The latest version of the medical insurance drug list will be implemented on January 1, 2026, with significant updates aimed at improving access to essential medications for insured individuals [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 [2]. - New drugs include treatments for critical conditions such as triple-negative breast cancer and pancreatic cancer, as well as medications for chronic diseases and rare diseases [2]. Group 2: Expanded Payment Coverage - The payment scope has been broadened for 65 drugs, with new indications included for reimbursement, such as additional targets for non-small cell lung cancer treatments and expanded age eligibility for certain rare disease medications [3]. - Adjustments have been made to align payment criteria more closely with clinical practices, such as changing the payment range for certain drugs from "previous chemotherapy" to "past chemotherapy" [3]. - Some drugs have had restrictions removed or modified, while ensuring that reimbursement is still aligned with clinical guidelines [3]. Group 3: Drug Removal and Transition Policies - A total of 29 drugs have been removed from the list, primarily those that have been clinically obsolete or not produced for an extended period [4]. - A transition policy has been established for drugs that were removed but had not successfully renewed their contracts, allowing a 6-month period for insured individuals to purchase these drugs at the original reimbursement standards [4].