新华财经上海8月27日电（记者胡洁菲）近日，包括全球首个靶向Trop-2的ADC药物注射用戈沙妥珠单 抗、曾登顶全球"药王"的司美格鲁肽、国内首个血友病基因疗法波哌达可基注射液等在内，多款高 值"明星药物"在国家医保局公布的通过初步形式审查的商保创新药目录中亮相，引发行业对于多元支付 的关注。业内认为，这些高价值、高投入、获益显著的先进疗法，有望通过商保创新药目录这一路径， 开辟支付的新通道并惠及更广泛的患者群体。 从去年底国家医保局在全国医疗保障工作会议上多次提及"商保"，到今年国家医保目录调整首次增 设"商业健康保险创新药品目录"，系列，构建多层次、均衡化的支付格局逐渐迈入"进行时"。中信证券 近期研报指出，国家医保局启动商保创新药目录调整工作，标志着商保创新药目录进入实质性落地阶 段。医疗健康产业有望迎来戴维斯双击，估值体系有望重塑。 对此，在近日举办的陆家嘴金融沙龙上，镁信健康首席创新官冯昊认为，目录是很重要的基础。创新药 落地的"最后一公里"对于商业保险也非常重要，如何确保药品上市之后处方可流传、患者用药可及、最 终支付可以实现直付，都需要进一步去拓展。 业内人人士表示，平台企业"织网成链"系统性能 ...

Core Viewpoint - The article discusses the recent adjustments to the national medical insurance drug catalog, highlighting the introduction of a commercial health insurance (commercial insurance) innovative drug catalog, marking the eighth adjustment since the establishment of the National Medical Insurance Administration. This new catalog aims to provide alternative payment pathways for high-priced innovative drugs, including CAR-T therapies, which have previously faced challenges in entering the basic medical insurance catalog [3][6][7]. Summary by Sections Medical Insurance Catalog Adjustments - A total of 534 drugs passed the preliminary review for the basic medical insurance catalog, while 121 drug generic names were approved for the commercial insurance innovative drug catalog [3][6]. - The introduction of the commercial insurance innovative drug catalog is seen as a significant development, providing a separate application channel for high-priced innovative drugs that exceed the basic insurance coverage [6][8]. Market Dynamics and Participation - Participation in the commercial insurance innovative drug catalog is voluntary for pharmaceutical companies and insurance firms, with the potential for significant market opportunities if successful [4][6]. - The commercial insurance catalog is expected to attract foreign companies, as early participation may yield policy benefits [8][9]. Financial Support for Innovation - The National Medical Insurance Administration has emphasized financial support for innovative drugs, with over 4.1 trillion yuan spent on negotiated drugs since 2018 [11]. - The new measures aim to enhance the efficiency of commercial insurance companies and support the development of innovative drugs through data services and one-stop compensation [11][12]. Challenges and Competition - The article notes the increasing competition and homogenization within the innovative drug market, with multiple similar drugs entering the market, leading to price competition [13][14]. - The National Medical Insurance Administration aims to support true innovation and differentiated innovation, focusing on drugs that provide additional clinical benefits and meet unmet medical needs [14].

Core Points - The adjustment of the medical insurance catalog this year marks the 8th since the establishment of the National Medical Insurance Administration and introduces a commercial health insurance (commercial insurance) innovative drug catalog for the first time [1][6] - A total of 534 drugs passed the formal review for the basic medical insurance catalog, while 121 drug generic names were approved for the commercial insurance innovative drug catalog, including high-priced innovative drugs like CAR-T [1][3] - The establishment of the commercial insurance innovative drug catalog indicates a significant shift in China's pharmaceutical industry, introducing a second major buyer beyond the basic medical insurance fund [3][6] Summary by Sections Medical Insurance Catalog Adjustment - The National Medical Insurance Administration announced the preliminary review results for the 2025 medical insurance drug catalog, with 534 drugs approved for the basic insurance catalog and 121 for the commercial insurance innovative drug catalog [1][3] - The commercial insurance innovative drug catalog provides a separate application channel for high-priced innovative drugs, which have historically faced challenges in entering the basic insurance catalog [3][4] Market Dynamics and Opportunities - Participation in the commercial insurance innovative drug catalog is voluntary for pharmaceutical companies and commercial insurance firms, presenting both risks and potential first-mover advantages [2][5] - The commercial insurance catalog aims to support high-priced innovative drugs that exceed the basic insurance scope, such as CAR-T therapies and rare disease medications [3][4] Policy Support and Industry Impact - The National Medical Insurance Administration has implemented measures to support the high-quality development of innovative drugs, with a focus on integrating commercial insurance and medical insurance to create a multi-tiered payment system for innovative drugs [6][7] - The introduction of the commercial insurance innovative drug catalog is expected to enhance the market potential for innovative drugs, providing a pathway for companies to transition from commercial insurance to basic insurance as market conditions evolve [5][7] Innovation and Competition - The pharmaceutical industry is experiencing increased competition and a trend of homogenization among innovative drugs, leading to price competition and the need for differentiation in innovation [8][9] - The National Medical Insurance Administration emphasizes the importance of supporting true innovation that offers additional clinical benefits and addressing unmet medical needs [9][10]