2025.08. 23 本文字数：3329，阅读时长大约5分钟 作者 | 第 一财经 林 志吟 一年一度的国家基本医保目录调整已拉开序幕。 近日，国家医保局公布了通过初步形式审查的药品名单，通过初步形式审查的药品，并不代表着已进 入医保目录，还需要经过专家评审、谈判/竞价/价格协商、公布结果这些环节，最终才能被纳入医 保报销目录。 这次目录外通过初审的通用名有310个，较2024年249个通过形式审查明显增加，意味着今年的医 保准入竞争将更加激烈。 如何在定价跟患者用药可及性之间找到平衡点，如何在药品定价上体现"真创新"，是创新药进入医 保目录面临的考验。 比如今年4月份，乳腺癌药物卡匹色替片在国内获批上市，这是首个且唯一在华获批、用于任意特定 生物标志物（PIK3CA、AKT1或PTEN）改变的乳腺癌患者的AKT抑制剂。 这次国家医保局公布的通过初步形式审查的药品名单中，卡匹色替片亦现身其中。 角逐医保目录 一直以来，医保基金是我国药品费用最大的支付方。 今年是国家医保局自2018年成立以来第八年开展医保药品目录调整。 对于申请进入基本目录的药品，独家品种采用谈判方式、非独家品种采用竞价方式确认医保支付标准 ...

一年一度的国家基本医保目录调整已拉开序幕。 近日，国家医保局公布了通过初步形式审查的药品名单，通过初步形式审查的药品，并不代表着已进入 医保目录，还需要经过专家评审、谈判/竞价/价格协商、公布结果这些环节，最终才能被纳入医保报销 目录。 这次目录外通过初审的通用名有310个，较2024年249个通过形式审查明显增加，意味着今年的医保准入 竞争将更加激烈。 如何在定价跟患者用药可及性之间找到平衡点，如何在药品定价上体现"真创新"，是创新药进入医保目 录面临的考验。 角逐医保目录 一直以来，医保基金是我国药品费用最大的支付方。 今年是国家医保局自2018年成立以来第八年开展医保药品目录调整。 对于申请进入基本目录的药品，独家品种采用谈判方式、非独家品种采用竞价方式确认医保支付标准后 纳入目录。 这些年，通过医保谈判，已累计有530个药品新增进入医保目录通过谈判，成功纳入医保目录，显著提 高了创新药可及性。 以抗肿瘤药物为例，2018年至2024年期间，有超过70种抗肿瘤药物顺利进入医保目录，涉及超20个瘤 种，有效缓解部分患者无药可用的困境。 今年通过初步形式审查的310个目录外药品，较2024年249个通过形式 ...

今年的医保准入竞争将更加激烈。 一年一度的国家基本医保目录调整已拉开序幕。 近日，国家医保局公布了通过初步形式审查的药品名单，通过初步形式审查的药品，并不代表着已进入 医保目录，还需要经过专家评审、谈判/竞价/价格协商、公布结果这些环节，最终才能被纳入医保报销 目录。 这次目录外通过初审的通用名有310个，较2024年249个通过形式审查明显增加，意味着今年的医保准入 竞争将更加激烈。 如何在定价跟患者用药可及性之间找到平衡点，如何在药品定价上体现"真创新"，是创新药进入医保目 录面临的考验。 角逐医保目录 一直以来，医保基金是我国药品费用最大的支付方。 今年是国家医保局自2018年成立以来第八年开展医保药品目录调整。 对于申请进入基本目录的药品，独家品种采用谈判方式、非独家品种采用竞价方式确认医保支付标准后 纳入目录。 这些年，通过医保谈判，已累计有530个药品新增进入医保目录通过谈判，成功纳入医保目录，显著提 高了创新药可及性。 以抗肿瘤药物为例，2018年至2024年期间，有超过70种抗肿瘤药物顺利进入医保目录，涉及超20个瘤 种，有效缓解部分患者无药可用的困境。 今年通过初步形式审查的310个目录外药 ...

Group 1 - The core viewpoint is that the expectation of interest rate cuts by the Federal Reserve has boosted market sentiment, leading to a rise in the Medical Innovation ETF (516820.SH) by 2.08% [1] - Key stocks in the sector, such as Haikang (002653), Kanglong Chemical (300759), Kanghong Pharmaceutical (002773), and WuXi AppTec (603259), have seen significant increases in their share prices, with gains of 7.81%, 6.63%, 6.33%, respectively [1] - The National Healthcare Security Administration has announced a plan for the adjustment of the drug catalog for basic medical insurance and commercial health insurance, establishing a dual-track system of "basic medical insurance + commercial insurance for innovative drugs" to alleviate pressure on basic medical insurance funds [1] Group 2 - The upcoming catalysts include the release of mid-year reports in August, with positive trends expected in the innovative drug sector and its supply chain, as some companies are already seeing a recovery in orders [2] - The approaching Innovative Drug Industry Conference in late August, along with updates from major cancer conferences like WCLC and ESMO, are anticipated to be significant events for the sector [2] - Domestic policy changes, including adjustments to the medical insurance catalog and the promotion of commercial insurance policies in the second half of the year, are also seen as important catalysts for the industry [2]

国家医保局介绍，形式审查是对申报药品是否符合当年基本医保目录和商保创新药目录调整申报条件以 及药品信息完整性进行的审核。根据《2025年国家基本医疗保险、生育保险和工伤保险药品目录及商业 健康保险创新药品目录调整工作方案》，形式审查分为初审、初审结果公示、复审、复审结果公告四个 步骤。本次公示的内容即为今年的初审结果。 国家医保局表示，通过对药品申报资料进行形式审查，一方面，可以确保申报的药品符合申报条件；另 一方面，对申报资料的完整性、规范性进行审核，有利于后续评审、测算阶段相关信息的全面、真实、 准确。同时，为确保目录调整公开透明，国家医保局对通过初审的药品名单和主要信息进行公示，本身 也是主动接受监督的一种方式。 形式审查仅为第一步 国家医保局称，按照《基本医疗保险用药管理暂行办法》和《2025年国家基本医疗保险、生育保险和工 伤保险药品目录及商业健康保险创新药品目录调整工作方案》，目录调整分为企业申报、形式审查、专 家评审、谈判竞价/价格协商等环节，形式审查只是企业申报后目录调整所有程序中的第一步。一个药 品通过初步形式审查，只代表初审符合相应申报条件，还需要通过公示接受社会监督，即使药品最终确 定通 ...

新华财经北京8月12日电（记者刘旭阳李唐宁）国家医保局12日发布《关于公示通过2025年国家基本医 疗保险、生育保险和工伤保险药品目录及商保创新药目录调整初步形式审查的药品及相关信息》。国家 医保局共收到商保创新药目录申报信息141份，涉及药品通用名141个，经初步审核，121个药品通用名 通过形式审查。 国家医保局表示，目录调整分为企业申报、形式审查、专家评审、谈判竞价和价格协商等环节，形式审 查只是企业申报后目录调整所有程序中的第一步。一个药品通过初步形式审查，只代表初审符合相应申 报条件，还需要通过公示接受社会监督，即使药品最终确定通过形式审查，也仅代表该药品具备了参与 目录调整后续工作流程的资格，不代表其已经纳入了基本医保目录或商保创新药目录。 对于"如何看待一些目前市场价格较为昂贵等明显超出基本保障范围的药品通过了基本医保目录的形式 审查"的问题，国家医保局回应，有一些价格较为昂贵明显超出基本医保保障范围的药品通过了基本医 保目录初步形式审查，仅表示该药品符合申报条件，获得了进入下一个环节的资格。这类药品最终能否 进入基本医保目录，还需要经严格评审程序，通过专家评审的独家药品谈判成功、非独家药品竞价 ...

人民财讯8月12日电，8月12日，国家医保局发布《关于公示通过2025年国家基本医疗保险、生育保险和 工伤保险药品目录及商保创新药目录调整初步形式审查的药品及相关信息》提到，按照《基本医疗保险 用药管理暂行办法》和《2025年国家基本医疗保险、生育保险和工伤保险药品目录及商业健康保险创新 药品目录调整工作方案》，目录调整分为企业申报、形式审查、专家评审、谈判竞价/价格协商等环 节，形式审查只是企业申报后目录调整所有程序中的第一步。一个药品通过初步形式审查，只代表初审 符合相应申报条件，还需要通过公示接受社会监督，即使药品最终确定通过形式审查，也仅代表该药品 具备了参与目录调整后续工作流程的资格，不代表其已经纳入了基本医保目录或商保创新药目录。 ...

Core Viewpoint - The pharmaceutical sector has experienced significant growth, with major companies like Hengrui Medicine achieving record highs and forming strategic partnerships to enhance their innovation capabilities [1][3]. Group 1: Market Performance - On July 29, the pharmaceutical sector saw a substantial increase, with companies such as Asia-Pacific Pharmaceutical, Chenxin Pharmaceutical, and Zhongsheng Pharmaceutical reaching their daily price limits, while Hengrui Medicine rose by 5%, marking a new high for the year [1]. - According to data from Yao Medicine Magic Cube, the number of global pharmaceutical transactions reached 456 in the first half of 2025, a 32% year-on-year increase, with total upfront payments amounting to $11.8 billion, a 136% increase compared to the previous year [4]. Group 2: Strategic Partnerships - On July 28, Hengrui Medicine announced a collaboration with GlaxoSmithKline (GSK) to co-develop up to 12 innovative drugs, with GSK paying an upfront fee of $500 million and potential milestone payments totaling approximately $12 billion based on successful development and sales [3]. - Several Chinese pharmaceutical companies, including Hengrui Medicine, Heber Pharmaceuticals, and Shiyao Group, have recently engaged in overseas licensing collaborations, covering popular drug categories such as monoclonal antibodies, bispecific antibodies, GLP-1, and ADCs [3]. Group 3: Industry Trends - In the first half of the year, the total amount of license-out deals for Chinese innovative drugs approached $66 billion, surpassing the total BD transaction amount for the entire year of 2024, indicating sustained interest from multinational pharmaceutical companies in Chinese innovative drug assets [5]. - The current trend in the innovative drug industry is shifting from "follower" to "leader," with 2025 expected to be a breakout year for Chinese innovative drugs in overseas markets, as many products are projected to exceed $3-5 billion in sales [5].

Core Insights - The National Healthcare Security Administration (NHSA) released the "2024 National Medical Security Development Statistical Bulletin," highlighting key figures related to health insurance enrollment and fund operations [1][2]. Group 1: Health Insurance Enrollment and Fund Operations - As of the end of 2024, the total number of basic medical insurance participants reached 1.32662 billion, maintaining a coverage rate of 95% [2]. - The total revenue for the basic medical insurance fund (including maternity insurance) in 2024 was CNY 34,913.37 billion, while total expenditures reached CNY 29,764.03 billion, resulting in a cumulative fund balance of CNY 38,628.52 billion [2]. - The employee medical insurance fund (including maternity insurance) reported a revenue of CNY 23,732.47 billion in 2024, a 3.5% increase from the previous year, with expenditures of CNY 19,102.54 billion, marking a 7.6% increase [2]. Group 2: Medical Treatment and Benefits - In 2024, the number of treatment beneficiaries under employee medical insurance was 5.308 billion, reflecting a 9.9% increase year-on-year [3]. - The total medical expenses for employee medical insurance participants reached CNY 20,587.46 billion, which is a 3.6% increase compared to the previous year [3]. Group 3: Long-term Care and Cross-Region Medical Services - By 2024, 49 pilot cities had a total of 18,786.34 million participants in long-term care insurance, with the number of beneficiaries rising from 835,000 in 2020 to 1,462,500 in 2024 [5]. - The number of cross-region medical service visits reached 397 million in 2024, with associated costs amounting to CNY 7,867.74 billion [5]. Group 4: Drug Procurement and Insurance Directory Adjustments - The NHSA has conducted ten rounds of national drug procurement, covering 435 types of drugs, with the eleventh round focusing on established drugs with strict quality requirements [6][7]. - Since its establishment in 2018, the NHSA has dynamically adjusted the medical insurance drug directory for seven consecutive years, adding a total of 835 drugs, with 91 new drugs included in 2024 [8][9].

Group 1 - The number of visa-free countries for Chinese travelers has expanded to 55, indicating smoother travel for "Chinese tourism" [1] - The Ministry of Education has launched a hotline for university funding assistance starting July 15 [1] - The construction of 15,899 earthquake early warning observation stations has been completed, enabling second-level earthquake warning capabilities in five key areas nationwide [1] Group 2 - The adjustment of the medical insurance catalog has officially started, with the addition of innovative drugs from commercial insurance [1] - A criminal group involved in extensive telecom fraud in northern Myanmar has seen 21 key members, including Bai Suocheng, prosecuted [1] - The preliminary investigation into the Indian aviation accident is focusing on pilot operations, with a suspected accidental fuel switch activation [1]