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]

Core Insights - The 2025 National Medical Insurance Drug List has successfully added 114 new drugs, with 50 being innovative drugs, achieving an overall success rate of 88%, an increase from 76% in 2024 [2] - The new drug lists will be implemented starting January 1, 2026, enhancing coverage for critical diseases and rare conditions [2] Group 1 - The 2025 National Medical Insurance Drug List includes drugs for major diseases such as triple-negative breast cancer, pancreatic cancer, and lung cancer, as well as treatments for rare diseases like Langerhans cell histiocytosis and thalassemia [2] - The total number of drugs in the National Medical Insurance Drug List has increased to 3,253, comprising 1,857 Western medicines and 1,396 traditional Chinese medicines, significantly improving coverage for key areas such as cancer, chronic diseases, and rare diseases [2] Group 2 - Since the establishment of the National Medical Insurance Bureau in 2018, the drug list management policies have been continuously improved, allowing for annual dynamic adjustments instead of the previous 4-8 year cycle [3] - The focus on clinical value and patient benefits has led to the inclusion of innovative therapies, such as immune therapies and antibody-drug conjugates, enhancing the quality of the drug list [5] Group 3 - A total of 949 drugs have been added to the list since 2017, representing a nearly 40% increase from the 2,535 drugs in the 2017 list, while 467 drugs have been removed, facilitating the update of clinical medications [5] - As of October 2025, negotiated drugs have benefited 1.08 billion insured patients, with fund expenditures reaching 465.55 billion yuan, driving drug sales of approximately 680 billion yuan [5]