多层次用药保障体系
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目录“上新”让新药好药更可及 共同“托举”患者生命健康
Yang Shi Wang· 2025-12-08 07:18
Core Viewpoint - The newly released National Medical Insurance Drug List and the first Commercial Health Insurance Innovative Drug List aim to enhance drug accessibility and meet diverse medication needs, with 114 drugs included in the national insurance and 19 in the commercial insurance list, effective from January 1, 2026 [1][3][5] Group 1: National Medical Insurance Drug List - A total of 114 new drugs have been added to the National Medical Insurance Drug List, while 29 drugs that are either not clinically necessary or have better alternatives have been removed, bringing the total to 3,253 drugs [3] - The updated list includes 50 innovative drugs, significantly improving coverage for critical areas such as cancer, chronic diseases, mental health, rare diseases, and pediatric medications [3] - New entries include treatments for triple-negative breast cancer, pancreatic cancer, and long-acting growth hormones for children, enhancing patient accessibility and reducing costs [3] Group 2: Commercial Health Insurance Innovative Drug List - The new Commercial Health Insurance Innovative Drug List includes 19 drugs, featuring CAR-T therapies for cancer, treatments for neuroblastoma and Gaucher disease, and drugs for Alzheimer's disease, serving as a supplement to basic medical insurance [5] - The establishment of the commercial insurance list is expected to attract more participants to commercial health insurance due to the endorsement of innovative drugs, thereby lowering customer acquisition costs [5][7] - The integration of the commercial health insurance list with the basic medical insurance framework aims to create a multi-tiered medication security system that better meets the diverse needs of the population [7] Group 3: Future Implications - The introduction of the Commercial Health Insurance Innovative Drug List is a groundbreaking initiative that aligns the development of basic medical insurance and commercial health insurance, enhancing the overall medication security system [7] - The National Medical Insurance Bureau emphasizes the importance of defining the boundaries of basic medical insurance while allowing ample space for the growth of commercial health insurance [9] - Efforts will be made to explore the use of medical insurance data to empower commercial health insurance, facilitating synchronized billing for patients and reducing their administrative burden [9]