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商保补缺口让创新药更可及
Jing Ji Ri Bao· 2025-12-16 23:21
Core Insights - The first edition of the "Commercial Health Insurance Innovative Drug Directory" has been released, including 19 innovative drugs, marking the first time the National Healthcare Security Administration has established a drug list specifically for commercial health insurance outside the basic medical insurance directory [1][2] Group 1: Drug Selection and Purpose - The selection process for the 19 drugs was rigorous, with a pass rate of less than 16% from an initial review of 121 drugs, highlighting the directory's role in filling gaps in medication not covered by basic medical insurance [1] - The 19 drugs include treatments for cancer, rare diseases, and Alzheimer's disease, emphasizing high clinical value and significant patient benefits, which cannot be replaced by drugs in the basic medical insurance directory [1][2] Group 2: Impact on Pharmaceutical Companies - The commercial health insurance directory provides direct incentives for pharmaceutical innovation, with about half of the selected drugs being Class 1 new drugs, including high-cost medications [2] - The integration of basic medical insurance and commercial health insurance funding is expected to enhance the economic support for the development of innovative drugs, addressing the previous dilemma faced by high-value innovative drugs [2] Group 3: Future Developments and Adjustments - The commercial health insurance innovative drug directory will be implemented on January 1, 2026, and will undergo dynamic adjustments based on advancements in medical technology, clinical needs, and the development of commercial health insurance [3] - There is an expectation for insurance companies to actively update their health insurance products based on the commercial health insurance directory, improving coverage levels to meet diverse medication needs of the public [3]