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310个目录外药品拟角逐进入医保
第一财经·2025-08-23 09:09

Core Viewpoint - The annual adjustment of the national basic medical insurance (BMI) drug list has begun, with a significant increase in the number of drugs passing the preliminary review, indicating intensified competition for inclusion in the insurance coverage [3][5]. Summary by Sections Drug Approval and Competition - A total of 310 drug names passed the preliminary review this year, up from 249 in 2024, reflecting a growing number of innovative drugs approved [3][5]. - The number of first-class innovative drugs approved in China has shown a clear upward trend, with 48 approved in 2024, more than five times the number in 2018 [5]. Impact on Patients and Accessibility - The inclusion of innovative drugs in the BMI list significantly improves patient access, with over 70 anti-tumor drugs added from 2018 to 2024, addressing the issue of patients lacking available treatments [5][6]. - The pricing of new drugs is crucial for patient affordability, as high costs can limit access despite the availability of innovative treatments [7][8]. Pricing Negotiations and Challenges - The negotiation process for drug pricing involves expert evaluations and discussions with companies to establish mutually acceptable reimbursement standards [7][10]. - Balancing the need for affordable pricing with the necessity for companies to recoup R&D costs presents a significant challenge in the negotiation process [8][11]. Policy Directions and Innovation Support - The 2025 adjustment plan emphasizes maintaining fund security while encouraging innovation and optimizing the drug list structure [10][11]. - The focus is on supporting genuine innovation and ensuring that new drugs provide real clinical benefits, with a comprehensive evaluation of their value [10][12]. Real-World Data and Evaluation - The importance of real-world data in assessing drug effectiveness and safety is highlighted, as it provides insights beyond controlled clinical trials [14][15]. - The need for a robust drug value assessment system is increasingly urgent, as it informs decisions on funding and resource allocation [13][16].