全国医保会议16次提“创新”，明年医药产业迎来哪些利好

Core Viewpoint - The National Medical Insurance Administration (NMIA) will continue to support the innovation and development of China's pharmaceutical industry through financial resources, pricing projects, and medical insurance data in 2026, emphasizing the dual role of medical insurance as both a social welfare and economic tool [3]. Summary by Sections National Medical Insurance Work Tasks - The NMIA outlined eight key tasks for national medical insurance in 2026, including consolidating universal coverage, supporting the development of commercial health insurance, and enhancing the management of medical insurance funds [4]. - Specific tasks include promoting the development of maternity and long-term care insurance, optimizing payment mechanisms, and improving service quality in medical insurance [5]. Support for Pharmaceutical Innovation - The NMIA aims to leverage its strategic purchasing power to support the innovative development of the pharmaceutical industry, encouraging healthy competition and differentiated innovation [5]. - The 2026 National Basic Drug Directory includes 114 new drugs, with the number of Class 1 new drugs increasing from 38 to 50, marking a historical high [6]. Financial Commitment and Growth - During the 14th Five-Year Plan period, the NMIA is expected to spend approximately 13 trillion yuan on medical insurance, maintaining an annual growth rate of around 10%, providing a stable funding source for innovation [6]. - The introduction of a commercial health insurance innovative drug directory includes 19 high-value, innovative drugs, aiming to enhance patient benefits [6]. Integration of Commercial Health Insurance - The NMIA encourages the integration of commercial health insurance with basic medical insurance, promoting the inclusion of reasonable medical expenses outside the basic insurance directory [7]. - Commercial health insurance companies are encouraged to expand their investment in innovative drugs, enhancing the efficiency of claims processing through a "medical insurance + commercial insurance" one-stop settlement service [8]. Technological Innovation and AI Development - The NMIA supports the development of artificial intelligence in the medical insurance sector, encouraging participation from medical institutions, pharmaceutical companies, and research organizations [9]. - A comprehensive approach is being developed to facilitate the transition from concept to market for new medical technologies, ensuring a progressive upgrade of the industry [9].