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21世纪经济报道·2025-12-07 13:50

Core Viewpoint - The upcoming adjustment to China's medical insurance catalog, effective January 1, 2026, will be the largest expansion of innovative drugs in history, adding 114 new drugs, including 50 class 1 innovative drugs, reflecting a significant commitment to support innovation in the pharmaceutical sector [2][11]. Summary by Sections Medical Insurance Directory Adjustment - The total number of drugs in the medical insurance directory will increase to 3,253, with a notable enhancement in coverage for key areas such as oncology, chronic diseases, mental health, rare diseases, and pediatric medications [2]. - The proportion of innovative drugs in the directory is rising, with 50 out of 114 new additions being class 1 innovative drugs, accounting for nearly 44% [2][11]. Innovative Drug Market Dynamics - The inclusion of innovative drugs in the medical insurance directory is a critical factor for market expansion, as these drugs typically experience rapid sales growth within a year of being added [5]. - Companies like Heng Rui Medicine and Innovent Biologics have successfully included multiple innovative products in the new directory, indicating a trend towards greater access to innovative treatments [6][7]. Clinical Demand and Treatment Options - The new directory focuses on drugs with significant clinical value and urgent patient needs, particularly in oncology, where new treatments for blood cancers and breast cancer have been added [12][14]. - The inclusion of targeted therapies for severe asthma and diabetes reflects a commitment to addressing pressing health issues in the population [10][8]. Pricing and Insurance Collaboration - A new commercial insurance directory for innovative drugs has been established, which includes 19 innovative drugs from 18 companies, aiming to create a balanced payment mechanism between basic medical insurance and commercial insurance [19][23]. - The commercial insurance directory is expected to alleviate the financial burden on patients, particularly for high-cost treatments like CAR-T therapy [21][22]. Policy Coordination and Future Outlook - The development of innovative drugs requires coordinated policies across drug approval, medical insurance, and clinical application, which have seen significant reforms in recent years [25][26]. - The future of innovative drug development in China hinges on the collaboration between industry policies and capital markets, with expectations for more original innovations and a focus on global competitiveness [27][28]. Conclusion - The adjustment of the medical insurance directory marks a transformative step for innovative drugs in China, shifting from being luxury items to accessible treatment options for a broader population, ultimately enhancing patient outcomes and supporting the goal of universal health coverage [29].