历史首次！医保局放出“双目录”大招

Core Viewpoint - The article discusses the recent adjustments to the national medical insurance drug catalog, highlighting the introduction of a commercial health insurance (commercial insurance) innovative drug catalog, marking the eighth adjustment since the establishment of the National Medical Insurance Administration. This new catalog aims to provide alternative payment pathways for high-priced innovative drugs, including CAR-T therapies, which have previously faced challenges in entering the basic medical insurance catalog [3][6][7]. Summary by Sections Medical Insurance Catalog Adjustments - A total of 534 drugs passed the preliminary review for the basic medical insurance catalog, while 121 drug generic names were approved for the commercial insurance innovative drug catalog [3][6]. - The introduction of the commercial insurance innovative drug catalog is seen as a significant development, providing a separate application channel for high-priced innovative drugs that exceed the basic insurance coverage [6][8]. Market Dynamics and Participation - Participation in the commercial insurance innovative drug catalog is voluntary for pharmaceutical companies and insurance firms, with the potential for significant market opportunities if successful [4][6]. - The commercial insurance catalog is expected to attract foreign companies, as early participation may yield policy benefits [8][9]. Financial Support for Innovation - The National Medical Insurance Administration has emphasized financial support for innovative drugs, with over 4.1 trillion yuan spent on negotiated drugs since 2018 [11]. - The new measures aim to enhance the efficiency of commercial insurance companies and support the development of innovative drugs through data services and one-stop compensation [11][12]. Challenges and Competition - The article notes the increasing competition and homogenization within the innovative drug market, with multiple similar drugs entering the market, leading to price competition [13][14]. - The National Medical Insurance Administration aims to support true innovation and differentiated innovation, focusing on drugs that provide additional clinical benefits and meet unmet medical needs [14].