医保药品
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医药管理“组合拳”提升群众幸福感
Xin Lang Cai Jing· 2026-01-06 19:29
青海坚持医保药品目录动态调整,将更多新药、好药纳入医保支付范围。387种国家医保谈判药品、竞 价药等纳入"双通道"保障,提高患者用药可及性。在国家892种中药饮片的基础上,增加150种藏医用中 药饮片纳入医保支付范围,在全国率先出台并不断优化藏蒙医院制剂医保目录,目前共531种3200个。 加大对民族医特色优势医疗服务项目的政策倾斜力度,将499项民族医诊疗项目纳入医保支付范围,纳 入占比达到88%。将127项手术纳入医保日间手术结算范围,不设起付线,按住院政策报付。将项痹、 面瘫等6个中藏医优势病种纳入中藏医日间病房医保结算范围,住院不收取床位费,护理费用按照三级 护理标准的50%收取,持续降低参保群众就医负担。 本报讯 (记者 郭靓) 1月4日,记者从青海省医疗保障局了解到,"十四五"期间,省医保局立足省情实 际,通过打好医药管理"组合拳",持续提升参保群众获得感、幸福感。 强化与卫健部门协调联动,通过"一体化"管理,将村卫生室纳入医保定点,截至目前,全省村卫生室 4469家,纳入医保定点管理4343家,基本覆盖所有行政村。同时,强化定点医药机构管理,明确属地管 理责任,取消省内定点机构互认,一处纳入全省 ...
2026年1月,这些新规将影响你我生活
Xin Lang Cai Jing· 2025-12-26 12:21
来源:上海证券报·中国证券网 上证报中国证券网讯(记者 白丽斐)2026年1月,一批新规将施行,哪些新规将影响你我生活? 对特定历史时期的个人小额逾期记录实施有条件、一次性的信用修复 中国人民银行发布一次性信用修复政策,自2026年1月1日起,对特定历史时期的个人小额逾期记录实施 有条件、一次性的信用修复。该政策主要有以下四个适用条件。适用对象为个人在央行征信系统中展示 的信贷逾期信息;适用时间区间为2020年1月1日至2025年12月31日产生的逾期记录;适用金额为单笔逾 期金额不超过1万元;适用前提是逾期债务须在2026年3月31日前足额还清。 进一步规范上市公司董事、高级管理人员和控股股东、实际控制人行为 中国证监会修订发布《上市公司治理准则》,进一步规范上市公司董事、高级管理人员和控股股东、实 际控制人行为,提升上市公司治理水平。此次《治理准则》的修订主要包括完善董事、高级管理人员监 管制度;健全董事、高级管理人员激励约束机制;规范控股股东、实际控制人行为;做好与其他规则的 衔接四方面内容。自2026年1月1日起施行。 经纪机构应当实时、完整、准确对外披露最优经纪报价行情 中国人民银行发布的《银行间市 ...
薅医保羊毛侵占公众利益或涉刑
Xin Lang Cai Jing· 2025-12-21 02:13
Core Viewpoint - The article highlights the illegal practices surrounding the misuse of medical insurance funds, emphasizing the need for stricter regulations and awareness among both healthcare providers and patients to protect public interests and the integrity of the healthcare system [4][7][12]. Group 1: Illegal Practices - Some pharmacies and individuals have been found converting medical insurance cards into shopping cards, leading to illegal profits [5][8]. - A case was reported where an individual exploited their special disease insurance benefits to fraudulently acquire and resell medications, resulting in illegal profits exceeding 20,000 yuan [8]. - Organized crime groups have been identified that systematically defraud medical insurance funds, with one group reportedly stealing over 100 million yuan through various fraudulent practices over eight years [11][12]. Group 2: Regulatory Recommendations - The article suggests that regulatory bodies should enhance supervision of medical institutions, improve prescription audits, and establish mechanisms for tracing prescriptions and medical records to prevent fraudulent activities [12]. - It emphasizes the importance of maintaining the integrity of the medical insurance system, as misuse not only harms individual patients but also undermines the entire healthcare system [7][12]. Group 3: Public Awareness - Patients are urged to be cautious with their medical insurance cards, avoiding sharing them and only purchasing medications through legitimate channels [5][16]. - The article warns against the temptation to use medical insurance for non-medical purchases, which can erode the foundation of public health funding [15][16].
——医药生物行业周报:2025年医保药品目录和首个商保药品目录公布-20251214
Guohai Securities· 2025-12-14 10:28
Investment Rating - The report maintains a "Neutral" rating for the pharmaceutical and biotechnology industry [1]. Core Insights - The 2025 National Basic Medical Insurance Drug List has been published, adding 114 new drugs, with a negotiation/competitive bidding success rate of 88%, higher than the 76% in 2024. The total number of drugs in the insurance list has increased to 3,253, including 1,857 Western medicines and 1,396 traditional Chinese medicines [12]. - The pharmaceutical sector has underperformed compared to the CSI 300 index, with a year-to-date return of 14.65% against the CSI 300's 16.43%, resulting in a 1.77 percentage point lag [21]. - The current valuation of the pharmaceutical sector is 33.0 times PE based on 2026 earnings forecasts, representing a 41% premium over the overall A-share market (excluding financials) [21]. Summary by Sections Recent Performance - The pharmaceutical and biotechnology sector has seen a decline of 1.04% in the past week, ranking 17th among 31 primary sub-industries. The sub-sectors of chemical pharmaceuticals, biological products, medical devices, pharmaceutical commerce, traditional Chinese medicine, and medical services have experienced weekly changes of -0.75%, -1.85%, -1.79%, -4.26%, -2.03%, and +1.67%, respectively [11][22]. Market Dynamics - The pharmaceutical sector's performance from the beginning of 2025 to December 12 shows a return of 14.65%, while the CSI 300 index returned 16.43%, indicating a relative underperformance of 1.77 percentage points [21]. Valuation Analysis - The current valuation of the pharmaceutical sector is 29.0 times PE based on trailing twelve months (TTM) earnings, which is below the historical average of 35.0 times PE from January 4, 2010, to December 12, 2025. The sector's premium over the overall A-share market (excluding financials) is 16.3% [21]. Industry Developments - The first commercial health insurance drug list has been established, including 19 drugs that enjoy various policy benefits. This list is effective from January 1, 2026, to December 31, 2027, and includes five CAR-T products [12].
如何支持真创新?国家医保局详解“双目录”
2 1 Shi Ji Jing Ji Bao Dao· 2025-12-10 05:33
Core Insights - The National Healthcare Security Administration (NHSA) has introduced 114 new drugs to the basic medical insurance catalog for 2025, with a significant focus on innovative treatments and a record number of new drugs added [1][5][6] Summary by Sections New Drug Additions - A total of 114 drugs were added to the basic medical insurance catalog, including 105 through negotiation, 7 through competitive bidding, and 2 directly from national procurement [1] - Among the new additions, 111 are new products launched within the last five years, representing nearly 98% of the total, with 50 classified as Category 1 new drugs, marking a historical high in both proportion and quantity [1][5] Therapeutic Areas - The newly added drugs cover critical therapeutic areas such as oncology, anti-infection, chronic diseases, rare diseases, and mental health, addressing diverse clinical needs [1][5][6] Directory Adjustment Process - The adjustment process involved four main stages: application, review, negotiation/bidding, and results. A total of 718 applications were received, with 535 passing the initial review, resulting in an 85% approval rate [3] - In the expert review phase, 311 drugs were evaluated, with 129 passing, leading to a 41.48% approval rate [3][4] Negotiation Success Rates - The negotiation and bidding phase saw 127 drugs participate, with 112 successfully negotiated, achieving a success rate of 88.19%, the highest since 2018 [4][5] Commercial Insurance Innovation - The first commercial insurance innovative drug catalog was released alongside the basic insurance adjustments, featuring 19 innovative drugs from 18 companies, with 9 being Category 1 new drugs [2][7] - The commercial insurance catalog aims to complement the basic insurance, providing additional support for high-cost innovative drugs while ensuring basic medication needs are met [2][8] Future Considerations - The NHSA emphasizes the importance of a multi-layered medical insurance system, encouraging the integration of commercial health insurance and innovative drug catalogs to enhance patient access to diverse treatment options [8][10] - Key challenges include aligning the different execution cycles of basic insurance and commercial products, as well as improving communication between insurance companies and pharmaceutical firms [9][10]
中新健康丨“换汤不换药”不是真创新 “4不改”药品难进医保目录
Zhong Guo Xin Wen Wang· 2025-12-09 17:23
黄心宇还强调,在定价方面,一些比较贵、超出保基本功能定位的药品,或者定价离谱、价格与价值不 匹配的药品也不能通过评审,"所谓的'头戴三尺帽,不怕砍三刀'的药品,如果没有特别的临床价值, 专家一般不会考虑。" 此外,一些必要性不强、特别容易滥用的药品也不能通过专家评审。 中新网北京12月9日电(记者张尼)9日,国家医保局在线播出2025年医保药品目录解读。国家医保局医药 服务管理司司长黄心宇透露,2025版目录新增111种5年内新上市药品,50种为1类新药,无论是比例还 是数量都创历年新高。"4不改"药品、定价离谱的一些药品则难以通过专家评审。 近日,医保商保"双目录"对外公布引发关注。9日播出的解读活动透露,2025版目录新增的114种药品 中,105种谈判新增,7种竞价新增,2种国家集采中选药品直接调入,29种临床已被替代或长期未生产 供应的药品被调出(其中9种尚有相同治疗主成分的其他剂型在目录内,不减少目录编号)。 近年来,医保目录调整支持"真创新"力度增加,针对一些未通过专家评审的药品,黄心宇解释,原因有 多种。 例如,"4不改"药品(不改主成分、不改适应症、不改给药途径、不改临床价值);创新程度不高、 ...
每年万亿医保基金如何支持创新药?国家医保局详解
第一财经· 2025-12-09 08:16
2025.12. 09 本文字数:2099,阅读时长大约4分钟 作者 | 第一财经 郭晋晖 按照30%的药占比计算,我国每年约3万亿元的医疗保险基金支出中,有超过1万亿元用于药品支出, 这是我国医保基金支持医药创新的"基本盘"。 在12月7日的2025创新药高质量发展大会上,国家医保局局长章轲表示,医保购买创新医药产品,就 是为群众买健康,为健康买未来。医保基金作为中国医药领域最大的购买方,"十四五"期间累计支出 约13万亿元,并保持了年均10%以上的较高增速,为创新提供了稳定的资金来源,注入了持久的发展 动力。 2025年基本目录调整中新增114种药品,其中50种是一类创新药,再创新高。本次调整后,目录内药 品总数增至3253种,其中西药1857种、中成药1396种,肿瘤、慢性病、精神疾病、罕见病、儿童用 药等重点领域的保障水平得到明显提升。 医保仍然是中国创新药主要的支付方。 医保基金已为创新药支付超4600亿元 党的二十届四中全会明确提出,要加快建设健康中国,支持创新药和医疗器械发展。 章轲表示,国家医保局通过价值引领战略购买,实现需方牵引,旗帜鲜明地支持医药创新,有渴望创 新的基因,有服务创新的抓手, ...
新华时评:民生药箱“保基本”还要更多元
Xin Hua She· 2025-12-09 03:22
Core Insights - The release of the 2025 National Medical Insurance Drug List and the first version of the Commercial Insurance Innovative Drug List marks a significant step in the construction of a multi-tiered medical security system, enhancing the accessibility of essential medications while diversifying options for patients [1] Group 1: National Medical Insurance Drug List - The updated National Medical Insurance Drug List includes 114 new drugs, significantly improving coverage for key areas such as cancer, chronic diseases, mental health, rare diseases, and pediatric medications [1] - The approach of combining basic medical insurance with commercial insurance reflects the government's commitment to improving drug accessibility for the public and addressing diverse medication needs [1] Group 2: Commercial Insurance Innovative Drug List - The first version of the Commercial Insurance Innovative Drug List includes 19 drugs, primarily those with high innovation and clinical value [1] - The dual-list system aims to balance the principles of basic insurance coverage while providing a pathway for high-value innovative drugs, thus encouraging pharmaceutical companies to invest in research and development [1] Group 3: Benefits of the Dual-List System - The implementation of the dual-list system is expected to create a win-win situation for multiple stakeholders, allowing patients to reduce their economic burden through commercial insurance reimbursement for certain medical expenses [1] - Drugs included in the Commercial Insurance Innovative Drug List can benefit from support policies for hospitalization, while commercial insurance can increase enrollment rates by including these innovative drugs [1] Group 4: Future Considerations - Future efforts are needed to break down data barriers between basic medical insurance and commercial insurance, establishing a one-stop settlement system to better leverage the roles of basic insurance and commercial insurance [2]
资讯早班车-2025-12-08-20251208
Bao Cheng Qi Huo· 2025-12-08 02:10
| 发布日期 | 指标日期 | 指标名称 | 单位 | 当期值 | 上期值 | 去年同期值 | | --- | --- | --- | --- | --- | --- | --- | | 20251020 | 2025/09 | GDP:不变价:当季同比 | % | 4.80 | 5.20 | 4.60 | | 20251130 | 2025/11 | 制造业 PMI | % | 49.20 | 49.00 | 50.30 | | 20251130 | 2025/11 | 非制造业 PMI:商务活 动 | % | 49.50 | 50.10 | 50.00 | | 20251114 | 2025/10 | 社会融资规模增量:当 | 亿元 | 8161.00 | 35299.00 | 14120.00 | | | | 月值 | | | | | | 20251113 | 2025/10 | M0(流通中的现金):同 比 | % | 10.60 | 11.50 | 12.80 | | 20251113 | 2025/10 | M1(货币):同比 | % | 6.20 | 7.20 | -2.30 | | 20251 ...
今日财经要闻TOP10|2025年12月7日
Xin Lang Cai Jing· 2025-12-07 11:45
1、中国央行连续第13个月增持黄金 中国央行:中国11月末黄金储备报7412万盎司(约2305.39吨),环比增加3万盎司(约0.93吨), 为连续第13个月增持黄金。 2、海军新闻发言人就辽宁舰航母编队远海训练发布消息 中国人民解放军海军新闻发言人王学猛海军大校表示,日前,中国海军辽宁舰航母编队在宫古海峡 以东海域正常组织舰载战斗机飞行训练,事先公布了训练海空域。期间,日本自卫队飞机多次抵近中国 海军训练海空域滋扰,严重影响中方正常训练,严重危及飞行安全。日方有关炒作与事实完全不符,我 们严正要求日方立即停止污蔑抹黑,严格约束一线行动。中国海军将依法采取必要措施,坚决维护自身 安全和合法权益。(人民海军) 3、2025医保药品目录公布 新增药品114种 50种为1类创新药 2025创新药高质量发展大会今天(7日)上午在广州召开,会议将发布2025年《国家基本医疗保 险、生育保险和工伤保险药品目录》和首版《商业健康保险创新药品目录》。据了解,2025年国家基本 医疗保险、生育保险和工伤保险药品目录是国家医保局成立以来的第8次调整。本次目录调整新增114种 药品,其中50种为1类创新药。首版商保创新药目录共纳入 ...