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进口药医保不报销?国家医保局回应公众关切
Zhong Guo Jing Ji Wang· 2025-09-29 06:35
Core Viewpoint - The National Healthcare Security Administration (NHSA) emphasizes the continuous improvement of medical insurance coverage since its establishment in 2018, with a total of 3,159 drugs included in the medical insurance catalog, significantly enhancing the coverage for major diseases like cancer [1] Group 1: Misconceptions about Medical Insurance - Misconception 1: Only 2% of drugs are reimbursed by insurance. The NHSA clarifies that this claim misrepresents data by comparing different statistical methods without proper conversion, leading to an incorrect conclusion about the proportion of drugs in the catalog [1] - Misconception 2: Imported drugs are not reimbursed. The NHSA states that reimbursement does not differentiate between manufacturers, as long as the drug is included in the insurance catalog [3] - Misconception 3: Only cheap, old drugs are reimbursed. The NHSA refutes this by highlighting that many new and effective drugs, including cancer treatments, are regularly added to the reimbursement list, often within a year of approval [4] Group 2: Drug Statistics and Approval - The NHSA explains that the total number of drugs in the insurance catalog is based on active ingredients, which counts drugs with the same active ingredient as one, leading to 3,159 drugs in the catalog [1] - An alternative method counts the number of drug approval numbers, resulting in over 150,000 approved drugs in China, with more than 110,000 having sales records. The NHSA indicates that if the approval numbers for the 3,159 drugs in the catalog are calculated, it would exceed 70,000, representing about 63% of the market [2]