2026.01. 08 本文字数：3880，阅读时长大约6分钟 作者 | 第一财经 吴斯旻 今年1月1日起，首版商保创新药目录正式落地。在北京，与该目录同一天落地的是"第二批DRG付费 新药新技术除外支付名单"，纳入前述目录的达妥昔单抗β注射液赫然在列。 除外支付，更通俗地来说，就是对住院病例使用创新药的费用单独按实结算，不占用医保打包支付中 对应病组额度。 在国家医保局承诺对纳入商保创新药目录内药品执行的"三除外"政策中，"相关商业健康保险保障范 围内的创新药应用病例可不纳入按病种付费范围"被业界普遍视为对商保创新药目录内药品"进院"最 为利好也是最难执行的一条。 正如前述达妥昔单抗β注射液的案例，目前，北京、上海、浙江等省份为支持新药新技术应用而发布 的地方版激励清单中，已可见少数与商保创新药重叠的"身影"。但针对绝大多数商保创新药和更多医 保统筹地区，商保创新药的住院使用，仍面临与其他高倍率病例争夺特例单议名额的不确定性。 同时，创新药"进院"不仅仅要"进住院部"，也要"进门诊"。多名受访业界人士坦言，商保创新药的门 诊用药激励还处于政策空白阶段。 截至1月8日，据第一财经不完全统计，全国已有至少28个 ...

Group 1: National Healthcare Administration Updates - The National Healthcare Security Administration has announced the preliminary review results for the 2025 medical insurance directory and the commercial insurance innovative drug directory, with 534 out of 633 drug names passing the initial review [1] - A total of 121 drug names were approved for the commercial insurance innovative drug directory, which includes high-innovation drugs not yet included in the basic medical insurance directory [1] - The review results are a preliminary step, and the approved drugs will undergo further evaluation and negotiation before being officially included in the directories [1] Group 2: Drug Traceability in Qingdao - Qingdao has implemented a drug traceability code system, with 10.1 billion data entries collected, accounting for 26.5% of the total in the province [2] - The city has connected 4,268 retail pharmacies and 5,946 medical institutions to the traceability system, achieving over 99% and 90% scanning rates, respectively [2] - The traceability system aims to enhance drug safety and improve the supervision of medical insurance funds [2] Group 3: Drug Approvals and Clinical Trials - Heng Rui Medicine's application for the marketing license of Haqubopam Ethanolamine Tablets has been accepted by the National Medical Products Administration [3] - Fosun Pharma's application for the registration of Nadaplatin Injection has also been accepted, targeting various types of cancer [4] - Xingqi Eye Medicine has completed the first patient enrollment for the Phase II clinical trial of Voriconazole Eye Drops, aimed at treating fungal keratitis [5] - Haishi Ke has received approval for clinical trials of HSK47977 Tablets, a potential first-in-class drug for non-Hodgkin lymphoma [6] Group 4: Mergers and Acquisitions - Nanhua Biological is planning to acquire a 51% stake in Hunan Huize Biological Pharmaceutical Technology Co., which will become a subsidiary [7] - The acquisition aims to enhance Nanhua's capabilities in drug research and clinical evaluation [7] Group 5: Strategic Partnerships and Collaborations - East China Pharmaceutical's subsidiary has signed an exclusive commercialization agreement with Jiangsu Weikail, acquiring rights for the VC005 oral formulation in mainland China [8] - The agreement includes an upfront payment of 50 million RMB and potential milestone payments up to 180 million RMB [8] - KQ Bio plans to sign a collaborative research agreement with Huazhong Agricultural University, involving four projects with a total payment of 4.9 million RMB [9]

Investment Rating - The report maintains a "Recommended" investment rating for the healthcare sector [7]. Core Insights - The healthcare sector has shown a mixed performance, with the Shenyin Wanguo Pharmaceutical Bio Index rising by 1.60% from June 23 to June 27, 2025, underperforming the CSI 300 Index by 0.35 percentage points [2][12]. - Year-to-date, the pharmaceutical sector has increased by 6.24%, outperforming the CSI 300 Index by 6.57 percentage points, ranking 11th among 31 sectors [2][14]. - As of June 27, 2025, the valuation of the pharmaceutical sector stands at 27.54 times (TTM overall method, excluding negative values), with a premium of 140.94% compared to the CSI 300 [2][17]. Summary by Sections 1. Market Performance - The pharmaceutical sector's performance from June 23 to June 27, 2025, was a 1.60% increase, ranking 23rd among 31 sectors [12]. - The year-to-date performance shows a 6.24% increase, ranking 11th among 31 sectors [14]. 2. Important Events - The National Healthcare Security Administration released the "2025 Basic Medical Insurance Directory and Commercial Insurance Innovative Drug Directory Adjustment Application Guidelines," marking a significant step for commercial health insurance in the multi-level medical security system [4][21]. 3. Industry Perspective - The inclusion of the commercial insurance innovative drug directory indicates an enhanced role for commercial insurance in the multi-level medical security system, providing greater opportunities for the industry [5][22]. - The report expresses optimism for innovative drugs, overseas expansion, and the clearing of procurement in specific segments, suggesting a focus on companies involved in these areas [22].