2026.01.07 本文字数：2031，阅读时长大约4分钟 作者 |第一财经 林志吟 从本月起，首版《商业健康保险创新药品目录》（下称"商保创新药目录"）开始在各地启用。 作为普惠型商业健康保险产品代表之一，惠民保近年来得到普及。而惠民保参保者，尤其是一些重疾患 者，到底能从商保创新药目录获益多少？ 首版商保创新药目录在医保目录之外，收录了19种临床价值突出但超出医保支付能力的创新药。从治疗 领域看，这些药品覆盖肿瘤、罕见病、神经退行性疾病及代谢类疾病多个关键领域，具体包括CAR-T治 疗药物、阿尔茨海默症治疗药品、神经母细胞瘤和戈谢病等罕见病治疗药品，填补了基本医保目录空 白。 从目前看，商保创新药目录的落地，能让惠民保参保者获益多少，要取决于惠民保产品承接、相关创新 药进院情况等。 进入商保创新药目录的创新药，最后的推广使用要落实在医院端，当前看，这些高价高值创新药在打通 入院"最后一公里"上，仍有障碍。 有CAR-T药企对第一财经记者表示，他们进入商保创新药目录的CAR-T药物，目前还未看到可以直接入 院的。 有创新药进入商保创新药目录的罕见病药企对第一财经记者表示，产品能否入院，要看每家医院的要求 ...

2026.01. 07 本文字数：2031，阅读时长大约4分钟 作者 | 第一财经 林志吟 从本月起，首版《商业健康保险创新药品目录》（下称"商保创新药目录"）开始在各地启用。 作为普惠型商业健康保险产品代表之一，惠民保近年来得到普及。而惠民保参保者，尤其是一些重疾 患者，到底能从商保创新药目录获益多少？ 首版商保创新药目录在医保目录之外，收录了19种临床价值突出但超出医保支付能力的创新药。从 治疗领域看，这些药品覆盖肿瘤、罕见病、神经退行性疾病及代谢类疾病多个关键领域，具体包括 CAR-T治疗药物、阿尔茨海默症治疗药品、神经母细胞瘤和戈谢病等罕见病治疗药品，填补了基本 医保目录空白。 以CAR-T药物为例，有血液肿瘤医生对第一财经记者表示，对于一些真正难治的血液瘤患者而言， CAR-T是较好的治疗手段，在没有这类疗法之前，一些患者的中位生存期只有半年，但有了这种治 疗手段后，有部分患者的生存期可以提高到五年及五年以上，但CAR-T疗法费用高昂，无法在患者 中得到普及。商保支付的话，可以减轻患者费用负担。 从目前看，商保创新药目录的落地，能让惠民保参保者获益多少，要取决于惠民保产品承接、相关创 新药进院情况等 ...

从本月起，首版《商业健康保险创新药品目录》（下称"商保创新药目录"）开始在各地启用。 商保创新药目录公布以来，有个别惠民保产品率先主动衔接商保创新药目录，比如有产品规定，在住院 全自费药品费用，参保人使用《商业健康保险创新药品目录》中的药品产生的费用，报销比例单独提升 10个百分点。 作为普惠型商业健康保险产品代表之一，惠民保近年来得到普及。而惠民保参保者，尤其是一些重疾患 者，到底能从商保创新药目录获益多少？ 首版商保创新药目录在医保目录之外，收录了19种临床价值突出但超出医保支付能力的创新药。从治疗 领域看，这些药品覆盖肿瘤、罕见病、神经退行性疾病及代谢类疾病多个关键领域，具体包括CAR-T治 疗药物、阿尔茨海默症治疗药品、神经母细胞瘤和戈谢病等罕见病治疗药品，填补了基本医保目录空 白。 以CAR-T药物为例，有血液肿瘤医生表示，对于一些真正难治的血液瘤患者而言，CAR-T是较好的治疗 手段，在没有这类疗法之前，一些患者的中位生存期只有半年，但有了这种治疗手段后，有部分患者的 生存期可以提高到五年及五年以上，但CAR-T疗法费用高昂，无法在患者中得到普及。商保支付的话， 可以减轻患者费用负担。 从目前看， ...

从本月起，首版《商业健康保险创新药品目录》（下称"商保创新药目录"）开始在各地启用。 作为普惠型商业健康保险产品代表之一，惠民保近年来得到普及。而惠民保参保者，尤其是一些重疾患 者，到底能从商保创新药目录获益多少？ 首版商保创新药目录在医保目录之外，收录了19种临床价值突出但超出医保支付能力的创新药。从治疗 领域看，这些药品覆盖肿瘤、罕见病、神经退行性疾病及代谢类疾病多个关键领域，具体包括CAR-T治 疗药物、阿尔茨海默症治疗药品、神经母细胞瘤和戈谢病等罕见病治疗药品，填补了基本医保目录空 白。 以CAR-T药物为例，有血液肿瘤医生对第一财经记者表示，对于一些真正难治的血液瘤患者而言， CAR-T是较好的治疗手段，在没有这类疗法之前，一些患者的中位生存期只有半年，但有了这种治疗手 段后，有部分患者的生存期可以提高到五年及五年以上，但CAR-T疗法费用高昂，无法在患者中得到普 及。商保支付的话，可以减轻患者费用负担。 值得注意的是，该产品也标注称"必须为住院期间使用，且合并在住院医疗费用中一并结算并上传到国 家医保平台的全自费药品费用才可纳入"。 换言之，如果进入商保创新药目录的创新药无法顺利入院的话，参保的患 ...

国家医保局、人力资源和社会保障部于2025年12月正式发布了新版国家基本医疗保险、生育保险和工伤 保险药品目录以及首版商业健康保险创新药品目录。据介绍，用户可进入"国家医保局"微信公众号，点 击菜单栏"微服务"，选择"国家医保药品目录查询"或"商保创新药目录查询"，进入相应查询页面。输入 药品通用名，点击搜索，即可查看该药品是否在目录内、所属分类、报销类别（医保目录）或商保创新 药目录相关信息。用户也可以根据自己的需求，按"药品分类"或"医保报销类别"进行筛选查找。 本报讯（记者孟刚）记者从国家医保局获悉，为了提供更加便捷的服务，国家医保局微信公众号于1月1 日上线新版基本医保目录和首版商保创新药目录查询功能。 （来源：中国消费者报） 国家医保局介绍说，医保药品目录内的西药和中成药分为甲、乙两类。甲类药品是指临床治疗必需、使 用广泛、疗效确切、同类药品中价格或治疗费用较低的药品。参保人使用这类药品时，可以全额纳入报 销范围，之后按规定比例报销。乙类药品是指可供临床治疗选择使用，疗效确切、同类药品中比甲类药 品价格或治疗费用略高的药品。参保人使用这类药品时，须个人先行自付一定比例，剩余部分纳入报销 范围，再按规 ...

2025年，中国A股市场上的保险板块无疑是最亮眼的"明星"之一。从年初的缓慢升温到年末的屡创新 高，保险股在2025年多次强势领涨A股市场，其全年累计涨幅显著，大幅跑赢了银行与非银金融板块的 整体表现。若将观察周期拉长，自2024年低点以来，保险板块更是走出了趋势性的上涨行情，累计涨幅 可观，被市场投资者称为"走出了牛市的节奏"。 板块与个股齐飞，但估值仍处历史低位 2025年保险股的"强势"，既体现在板块指数的突破上，也反映在个股的分化与领涨中，更凸显在"市值 增长+估值洼地"的双重优势里。截至2025年12月31日，A股保险板块（申万二级分类）指数报收1554.89 点。从短期表现看，保险板块的"爆发力"尤为突出，其10日、20日及60日涨幅均位列A股各板块前列， 显示出强劲的短期动量。 从资金关注度来看，保险板块的成交额在年底持续放大，市场交投活跃度显著提升。以保险行业指数 （932136）为例，其单日成交额在12月中旬一度创下阶段新高，即便在月末市场震荡调整期间，其成交 额水平也远高于12月初，显示出市场资金对保险股的配置需求持续上升。 2025年A股5家上市险企（中国平安、中国太保、新华保险、中国人 ...

商保创新药目录跟普通人有啥关系？我买的百万元医疗险能不能报销？——网友"MIL" 商保创新药目录，全称是"商业健康保险创新药品目录"，主要聚焦于创新程度高、临床价值大、患 者获益显著且超出基本医保保障范围的创新药。根据《商业健康保险创新药品目录（2025年）》，商保 创新药目录推荐商业健康保险、医疗互助等多层次医疗保障体系参考使用。简单来说，这个目录是国家 医保局为商业保险公司列出的那些效果好但价格高的药品清单，将自2026年1月1日起实施。 首版商保创新药目录纳入的19款药品主要集中在三类关键领域。据中国人保介绍，一是天价抗 癌"神药"，共包含5款Car-T细胞治疗药物。这类药物专门针对难治性大B细胞淋巴瘤、B细胞急淋白血 病等恶性肿瘤，是部分癌症患者的最后希望。二是罕见病"救命药"，针对短肠综合征、HPA等罕见病的 专属药物被纳入目录，让"小众患者"不再面临有药无保的困境。三是重症靶向新药，涉及肝癌、肺癌、 多发性骨髓瘤、胆道癌等高发癌症的新型靶向药、双抗药物以及小细胞肺癌新型化疗药等，为重症患者 提供了更优的治疗选择。 与基本医保目录不同，纳入商保创新药目录的药品不能使用医保报销。不过，根据国家医保局给 ...

Investment Rating - The report maintains a "stronger than the market" investment rating for the non-bank financial sector [2] Core Insights - The Central Economic Work Conference has set a positive tone for macroeconomic policies and capital market reforms, emphasizing the importance of internal demand and the release of supportive policy signals for 2026 [6][13] - The report highlights the acceleration of mergers and acquisitions in the securities industry, which is expected to reshape the industry landscape towards a model of "leading firms excelling" and "small firms developing unique characteristics" [6][14] - The introduction of the first commercial health insurance innovation drug directory is anticipated to enhance the attractiveness of health insurance products and promote a shift from homogeneous compensation to precise protection [34][35] Summary by Sections Securities Business Overview - The report notes that the major indices have shown mixed performance, with the Shanghai Composite Index at 3,889.35 points, down 0.34% from the previous week, while the ChiNext Index rose by 2.74% [15] - The average daily trading volume in A-shares increased by 13.97% week-on-week, reaching 1.90 trillion yuan [15][21] - The report indicates that the total IPO underwriting scale for the year reached 113.97 billion yuan, with refinancing underwriting at 1,038.5 billion yuan [16] Insurance Business Overview - The report discusses the urgent need for capital replenishment among insurance companies due to the end of the transitional period for the second phase of the solvency regulatory framework, with the overall solvency adequacy ratio at 186.3%, down 11.1 percentage points year-on-year [35] - The newly implemented commercial health insurance innovation drug directory is expected to include 19 key innovative drugs, enhancing the health insurance ecosystem [34] - The report highlights that insurance companies have been actively seeking capital through various channels, with significant approvals for capital increases and bond issuances [35] Market Liquidity Tracking - The report notes that the central bank conducted a net injection of 4.7 billion yuan in the open market, with reverse repos totaling 668.5 billion yuan [38][40] - The issuance of local government bonds amounted to 106.9 billion yuan, with a net injection of 62.2 billion yuan [38][40] Industry News - The report mentions that the Shanghai Stock Exchange has revised its bond trading guidelines to enhance market efficiency and transparency [50] - The Central Economic Work Conference has reiterated the commitment to deepening capital market reforms and addressing "involution" competition [50]

Core Insights - The release of the first edition of the Commercial Health Insurance Innovative Drug Directory marks a new phase in China's innovative drug security system, transitioning to a complementary model of "basic medical insurance + commercial insurance" [1][3] - The directory includes 19 drugs, which are characterized by high innovation, significant clinical value, and high costs, addressing the financial burden on patients, especially those with cancer and rare diseases [2][3] Group 1: Directory Overview - The selection process for the Commercial Health Insurance Innovative Drug Directory was rigorous, with only 19 out of 141 submitted drugs making it into the final list, resulting in an overall acceptance rate of 13.5% [2] - Nearly half of the selected drugs represent original innovations in biomedicine, filling treatment gaps in critical areas such as oncology and rare diseases [2][3] Group 2: Implications for Patients and Companies - The directory aims to alleviate the financial burden of high-priced innovative drugs for patients, ensuring that eligible patients can access necessary medications through commercial insurance [4][6] - For pharmaceutical companies, particularly those focused on cutting-edge innovations, the directory opens up a dual payment structure of "medical insurance + commercial insurance," facilitating the commercialization of innovative drugs [4][5] Group 3: Market Structure and Future Projections - Historically, China's innovative drug market has relied on a binary payment structure of "medical insurance fund + patient out-of-pocket," with commercial health insurance's role being underutilized [6][7] - By 2035, the market for innovative drugs is projected to reach 1 trillion yuan, with commercial health insurance expected to cover a significantly larger share of costs, increasing from approximately 12.4 billion yuan to around 440 billion yuan [6][7] Group 4: Challenges and Considerations - The implementation of the directory is just the first step, with concerns about how effectively the listed drugs will be utilized by patients and the potential impact on insurance premiums [8][9] - The directory's limited number of drugs and the complexity of some innovative treatments may pose challenges for insurance companies in terms of risk management and pricing [9][11]

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]