北京商报讯(记者丁宁)1月22日晚间，商务部官网显示，商务部等9部门发布关于促进药品零售行业高质 量发展的意见。 意见提到，优化定点零售药店门诊统筹服务。参保人员凭定点医药机构处方在定点零售药店购买医保目 录内药品发生的费用可由医保基金按规定支付。定点零售药店门诊统筹起付标准、支付比例、最高支付 限额等，可执行本统筹地区基层医疗机构相同的医保待遇政策。支持职工医保个人账户用于支付参保人 及其已参保的近亲属在定点零售药店购药发生的个人自行负担的医药费用。优化医保基金与零售药店的 结算方式，有效压缩结算时长，提升结算效率。优化医保定点零售药店资源配置规划，结合一刻钟便民 生活圈建设，推动医保定点药店合理布局。 ...

Core Insights - The new drug directory includes 114 newly added drugs, focusing on key areas such as cancer and rare diseases, complementing the basic medical insurance directory [1][2] - The implementation of the updated drug directory will take effect on January 1, 2026, and will be valid until December 31, 2026 [1] Group 1: National Drug Directory Adjustments - A total of 114 drugs have been added to the national directory, with 29 drugs removed; the updated directory now includes 3,253 drugs [2] - Among the newly added drugs, 111 are new products launched within the last five years, with 36 being cancer medications and 10 for rare diseases, enhancing coverage for critical areas [2] - A six-month transition period will be provided for drugs that were removed from the negotiation list to ensure continuity of medication [2] Group 2: Commercial Health Insurance Innovation - The first version of the commercial health insurance innovation drug directory includes 19 drugs, focusing on high-value innovative treatments not fully covered by basic medical insurance [3] - The directory features 9 new drugs and includes 5 CAR-T products, highlighting significant advancements in treatment options [3] - The commercial insurance directory serves as a reference for insurance companies and does not guarantee reimbursement, as it depends on the specific insurance policy [3] Group 3: Payment Standards and Drug Access - The Hunan Provincial Medical Insurance Bureau has established self-payment ratios for the new drug directory, with Class A drugs having a self-payment ratio of 0% [4] - The province aims to facilitate the inclusion of new drugs in hospitals and has mandated local medical insurance departments to guide medical institutions in the proper use of listed drugs [4] - The payment for work-related injury and maternity insurance will not differentiate between Class A and Class B drugs, covering the full cost [4]

Core Insights - The National Medical Insurance Administration held a meeting on December 13, focusing on optimizing the medical insurance payment mechanism during the 14th Five-Year Plan period to promote the development of healthcare and the pharmaceutical industry [1] Group 1: Medical Insurance Policy Changes - A total of 949 new drugs have been added to the medical insurance catalog, bringing the total number of drugs in the catalog to 3,253 [1] - The issuance of measures to support the high-quality development of innovative drugs includes the establishment of a commercial health insurance catalog for innovative drugs, which includes 19 drugs with significant clinical value and high innovation levels [1] Group 2: Payment Mechanism Enhancements - The implementation of disease-based payment has started from pilot programs and is now set for comprehensive coverage, with the introduction of version 2.0 of the disease-based payment scheme [1] - Five supporting mechanisms, including special case negotiations, have been established to alleviate concerns for medical institutions regarding the treatment of critically ill patients and the use of new drugs and technologies [1] Group 3: Financial Relief for Medical Institutions - All coordinated regions across the country will implement immediate settlement, effectively relieving the financial pressure on medical institutions regarding upfront costs [1]