南方财经全媒体记者 林汉垚 站在2026年开端回望2025年，保险业在深度调整与主动变革中走过关键一年。 从预定利率动态调整机制落地到"报行合一"向非车险领域深化，从险资入市配套政策不断完善到友邦保险资管等外资独资保险资管公司开业， 一系列重磅政策勾勒出行业在利率下行周期中强化资产负债管理、回归保障本源并服务实体经济的清晰主线。 在南方财经全媒体集团指导下，21世纪经济报道通过对保险行业2025年全年动态的梳理、研究，发布保险行业年度十大新闻，复盘2025年，并 特邀保险行业专家杨本心、北京大学经济学院风险管理与保险学系主任郑伟教授、天职国际金融业咨询合伙人周瑾进行点评，探索保险行业追 求高质量发展的轨迹。 一、预定利率与市场利率挂钩及动态调整机制建立 2025年1月10日，国家金融监管总局向中国保险行业协会及各人身保险公司下发《关于建立预定利率与市场利率挂钩及动态调整机制有关事项 的通知》，提出要建立预定利率与市场利率挂钩及动态调整机制，引导公司强化资产负债联动，科学审慎定价。 《关于建立预定利率与市场利率挂钩及动态调整机制有关事项的通知》表示，中国保险行业协会定期组织人身保险业责任准备金评估利率专家 咨询 ...

除了"吐故纳新"，65种药品的支付范围也迎来新变化。 1月1日，《国家基本医疗保险、生育保险和工伤保险药品目录（2025年）》正式落地实施。这是医 保部门连续第8年对基本医保药品目录进行优化，通过"有进有出"的动态调整机制，让更多临床急需、 疗效确切的新药好药纳入报销范围，同时将已被临床淘汰或长期未生产供应的药品调出目录，以实现医 保基金使用效率与群众用药保障水平的双提升。 这份事关参保人用药权益的"药品清单"发生了哪些变化？如何更好地满足百姓的用药需求？ 本次目录新增114种药品，其中50种为一类创新药，同时调出29种临床价值较低的药品。调整后， 目录内药品总数增至3253种，其中西药1857种、中成药1396种，涵盖肿瘤、罕见病、慢性病、儿童用药 等重点领域。 "新纳入医保目录的药品有3个显著特点：或是填补临床治疗空白，或是同类更优，或是拥有更高的 性价比。"国家医保局医药服务管理司司长黄心宇介绍说。截至目前，医保药品目录已累计调入949种新 药。 具体而言，以肿瘤治疗为例，治疗三阴性乳腺癌的芦康沙妥珠、胰腺癌用药伊立替康脂质体等新 药"入保"，让患者买得起、用得上。在慢性病领域，一年两针的降血脂药英克司 ...

（来源：衢州日报） 转自：衢州日报 国家医保局、人力资源社会保障部认真贯彻落实党中央、国务院决策部署，于2025年12月正式发布了新 版国家基本医疗保险、生育保险和工伤保险药品目录（以下简称基本医保目录）和首版商业健康保险创 新药品目录（以下简称商保创新药目录）。为了提供更加便捷的服务，国家医保局微信公众号已于2026 年1月1日上线新版基本医保目录和首版商保创新药目录查询功能。 什么是国家基本医保药品目录？报销类别中的甲类和乙类是什么意思？什么是商保创新药品目录？如何 查询目录内药品信息？一起来了解一下。 1.什么是国家基本医保药品目录？ 医保药品目录内的西药和中成药分为甲、乙两类。 "甲类药品"是指临床治疗必需、使用广泛、疗效确切、同类药品中价格或治疗费用较低的药品。参保人 使用这类药品时，可以全额纳入报销范围，之后按规定比例报销。 "乙类药品"是指可供临床治疗选择使用，疗效确切、同类药品中比"甲类药品"价格或治疗费用略高的药 品。参保人使用这类药品时，需个人先行自付一定比例，剩余部分纳入报销范围，再按规定比例报销。 3.什么是商保创新药品目录？ 为支持创新药高质量发展，推动多层次医疗保障体系建设，国家医 ...

Core Insights - The National Healthcare Security Administration (NHSA) has released the 2025 National Basic Medical Insurance, Maternity Insurance, and Work Injury Insurance Drug Catalog, along with the 2025 Commercial Health Insurance Innovative Drug Catalog, highlighting significant updates in drug listings and coverage [1][4]. Summary by Categories National Medical Insurance Drug Catalog - A total of 114 new drugs have been added to the National Medical Insurance Drug Catalog, with 50 classified as Class 1 innovative drugs, achieving an overall success rate of 88%, an increase from 76% in 2024 [1]. - The total number of drugs in the updated catalog has risen to 3,253, comprising 1,857 Western medicines and 1,396 traditional Chinese medicines, with enhanced coverage for critical areas such as oncology, chronic diseases, mental health, rare diseases, and pediatric medications [1]. Commercial Health Insurance Innovative Drug Catalog - The first edition of the Commercial Health Insurance Innovative Drug Catalog includes 19 new drugs, focusing on those with significant clinical value, high innovation levels, and clear patient benefits, which exceed the basic medical insurance coverage [2]. - The inclusion process involved self-reporting, expert reviews, and price negotiations, resulting in 19 drugs from 18 innovative pharmaceutical companies being successfully listed [2].

Core Insights - The National Healthcare Security Administration (NHSA) has included 114 new drugs in the national basic medical insurance catalog, covering various fields such as oncology, anti-infection, and chronic diseases [1][3] - The newly added drugs include significant innovations like GLP-1 diabetes medication Tirzepatide and long-acting growth hormone product Ipexi [1][3] - A new commercial health insurance innovation drug catalog has been introduced, featuring 19 products, including CAR-T therapies and new Alzheimer's drugs, aimed at addressing the payment challenges of high-priced innovative drugs [3][4] Summary by Category New Drug Additions - The updated medical insurance catalog includes drugs for chronic diseases, such as Tirzepatide for diabetes and Inclisiran for cholesterol reduction [1][2] - Other notable inclusions are Dupilumab for atopic dermatitis and the flu drug Masitinib [1] Pricing and Discounts - Although the NHSA did not disclose average price reductions, it is speculated that the discount rates may align with previous years' reductions of 50%-60% [3] - The long-acting growth hormone Ipexi is reported to have a price of approximately 850 yuan per injection, reflecting a nearly 50% reduction [3] Commercial Health Insurance Catalog - The commercial health insurance catalog aims to resolve the payment difficulties associated with high-priced innovative drugs, with 19 products included, of which 5 are CAR-T therapies [3][4] - The discount range for these products is between 15%-50%, slightly higher than the previously expected 30% [3][4] Market Dynamics and Implications - The inclusion of CAR-T therapies in the commercial insurance catalog marks a significant development, providing a national reimbursement pathway for these high-cost treatments [4][5] - The commercial insurance catalog's products benefit from a "three exclusions" policy, which allows for more favorable pricing and reimbursement conditions [4][6] Future Outlook - The introduction of the commercial insurance catalog is seen as a first step, with the focus now shifting to its implementation and integration with existing health insurance products [8][10] - The "Hui Min Bao" insurance products are expected to play a crucial role in accommodating the new catalog, with many products already providing coverage for CAR-T therapies [9][10] - The NHSA emphasizes a collaborative approach between basic medical insurance and commercial insurance, aiming for a complementary rather than competitive relationship [11]

Core Points - The article discusses the inclusion of 19 new drugs in the commercial health insurance innovation drug directory, highlighting their significance in the pharmaceutical market [10] - It emphasizes the advancements in CAR-T therapies and their impact on treating various cancers, particularly multiple myeloma and acute lymphoblastic leukemia [11][14][17] - The article also mentions the introduction of innovative drugs targeting Alzheimer's disease, showcasing their potential to change treatment paradigms [25][28] Group 1: New Drug Listings - A total of 19 new drugs have been added to the commercial health insurance innovation drug directory, including notable entries like Bristol-Myers Squibb's ipilimumab injection and Green Leaf Pharmaceutical's albituzumab injection [10] - The list includes various companies such as Pfizer, Novartis, and Jiangsu Hengrui Medicine, indicating a diverse range of pharmaceutical players involved [2][3][4] Group 2: CAR-T Therapies - The article highlights the global first approval of fully human CAR-T therapies, specifically targeting BCMA for treating relapsed or refractory multiple myeloma, with a five-year overall survival rate of 76.9% [12] - It mentions the efficacy of the CAR-T drug targeting GD2 for high-risk neuroblastoma, which has shown a real-world effectiveness rate exceeding 90% [14] - The introduction of dual-targeting CAR-T therapies, such as the one from Pfizer, is noted for significantly extending progression-free survival and overall survival in patients [15] Group 3: Alzheimer's Disease Treatments - The article discusses the launch of the first targeted drug for Alzheimer's disease in China, which aims to modify the disease's progression rather than just alleviate symptoms [25] - It highlights the significance of drugs like donanemab, which is the first to receive breakthrough therapy designation for Alzheimer's treatment, emphasizing its unique mechanism of action [28]

2025.12. 08 本文字数：1903，阅读时长大约3分钟 作者 | 第一财经 林志吟 过往，CAR-T这种百万级别的细胞治疗药物，始终无缘走到国家医保目录谈判桌上。如今，这些药 物在商保方面的支付迎来突破。 12月7日，在2025创新药高质量发展大会上，首版《商业健康保险创新药品目录》正式公布，共有5 款CAR-T细胞药物成功进入目录，分别是复星凯瑞的阿基仑赛注射液、药明巨诺的瑞基奥仑赛注射 液、合源生物的纳基奥仑赛注射液、驯鹿生物的伊基奥仑赛注射液、科济药业的泽沃基奥仑赛注射 液。 除了合源生物的纳基奥仑赛注射液是唯一低于百万元的CAR-T，定价为99.9万元/针，其他定价均过 百万，药明巨诺的瑞基奥仑赛注射液定价最高，达到129万元/针。 此次这些药物成功进入《商业健康保险创新药品目录》，利好在哪，后续如何进一步实现可及性？ 利好在哪 这些药物，主要用于血液瘤治疗，有治疗大B细胞淋巴瘤治疗的，也有治疗多发性骨髓瘤的，还有治 疗急性淋巴细胞白血病的。CAR-T细胞药物的出现，给一些血液瘤治愈的可能带来希望。过往数 年，CAR-T细胞治疗产品多次冲击医保谈判失败。业内普遍认为，这与国家医保谈判"50万不 ...

Core Insights - The first edition of the "Commercial Health Insurance Innovative Drug Directory" includes 19 drugs from 18 innovative pharmaceutical companies, highlighting advancements in medical technology [1][2] Group 1: Characteristics of the Innovative Drug Directory - The directory emphasizes support for innovation, featuring drugs that are significant achievements in recent medical advancements, including CAR-T, TCE therapies, and bispecific antibodies [2] - It focuses on key areas of concern, including drugs for Alzheimer's disease, which aligns with the aging population trend, as well as treatments for rare diseases prevalent in children, such as Gaucher disease and neuroblastoma [2] - The directory delineates the boundary between basic medical insurance and commercial insurance, with basic insurance prioritizing safety and efficacy of established drugs, while commercial insurance leans towards cutting-edge innovative medications [2]

Core Insights - The National Medical Insurance Negotiation concluded on November 4, with 120 companies participating, involving 127 off-list drugs and 24 drugs for commercial insurance innovation [1] Group 1: Introduction of Commercial Health Insurance Innovation Drug Directory - The "Commercial Health Insurance Innovation Drug Directory" was introduced for the first time this year, building on the existing medical insurance directory adjustment mechanism [2] - A total of 121 drug names passed the formal review for the commercial health insurance innovation drug directory, with 79 drugs applying for both the basic medical insurance and the commercial health insurance directories [2] Group 2: CAR-T Therapy and Pricing Negotiations - The high-priced CAR-T therapies are highlighted as a significant focus in the commercial health insurance innovation drug directory [4] - Five CAR-T therapies have passed the formal review for the commercial insurance directory, with three also applying for the basic medical insurance directory [5] - The only CAR-T therapy priced below one million yuan is the one from Huyuan Biotechnology, priced at 999,000 yuan per injection, and negotiations for this therapy have reportedly gone smoothly [5][6] Group 3: Market Dynamics and Future Implementation - The introduction of the commercial health insurance innovation drug directory is seen as a key step to break the payment deadlock, potentially lowering patient out-of-pocket expenses and expanding the patient population [6] - The new basic medical insurance drug directory and the first commercial health insurance innovation drug directory are expected to be released in early December, with implementation starting on January 1 of the following year [6]

Core Insights - The collaboration between Innovent Biologics and Zenas marks a significant global licensing agreement exceeding $2 billion, highlighting the trend of Chinese innovative drugs entering international markets [1] - The increasing number and value of overseas licensing agreements reflect the global recognition of China's R&D capabilities in the innovative drug sector [4][5] Group 1: Global Licensing Agreements - The recent licensing agreements by domestic companies are expected to accelerate the global development and commercialization of their products [2] - Innovent Biologics' agreement will expedite the global development of its drug, Oubatinib, and other pipeline products, enhancing its international competitiveness [2] - In September, several companies, including Heng Rui Medicine, secured overseas licensing deals, indicating a growing trend in the industry [2][3] Group 2: Market Recognition and Trends - By the first half of 2025, the total value of China's innovative drug licensing agreements reached nearly $66 billion, indicating increasing global acceptance [4] - The core drivers for overseas licensing include establishing trust through clinical validation and the need for efficient capital recovery in the long R&D cycles of innovative drugs [4][6] - The impending patent cliff for major pharmaceutical companies is driving them to seek innovative drug assets globally, further boosting the demand for Chinese innovations [4] Group 3: Policy Support and Market Dynamics - The development of innovative drugs in China is supported by government policies aimed at enhancing health insurance and promoting collaboration between health services and pharmaceutical companies [7] - The introduction of a commercial health insurance directory for innovative drugs is expected to expand the market, with projected payouts reaching approximately 12.4 billion yuan in 2024 [7] - The dual-driven model of R&D and commercialization is emerging, with leading companies leveraging their differentiated pipelines to enter profitability [8]