今年1月1日，《国家基本医疗保险、生育保险和工伤保险药品目录（2025年）》（以下简称"新版 国家医保药品目录"）和首版《商业健康保险创新药品目录（2025年）》（以下简称"商保创新药目 录"）同步执行。其中，商保创新药目录共纳入19种药品，5款价格百万元级的CAR-T肿瘤治疗药品悉数 在列。随着这一政策正式落地，商业健康险能否接好高值药支付的"接力棒"，直接关乎多层次医疗保障 的惠民实效。 《金融时报》记者注意到，新年伊始，北京、河北、浙江、湖北等地纷纷开启首版医保"双目录"制 度，积极打通商业健康保险的衔接通道。在业内人士看来，这标志着医保与商保在破解高值创新药支付 难题上迈出实质步伐，商保补充作用被进一步激发，更多百姓有望用上"天价药"。政策利好下，商保公 司也可参照商保创新药目录加速产品创新、更新赔付范围，与基本医保形成保障合力。 商业保险填补创新药保障空白 进入2026年1月，医保商保药品"双目录"迎来启动关键节点，地方政策衔接、险企产品适配、技术 服务支撑的联动效应持续释放，"医保+商保"的协同医疗保障正从制度设计走向实操落地。 据《金融时报》记者观察，全国多地医保部门通过一系列政策举措为商保创新 ...

Core Insights - The National Healthcare Security Administration and the Ministry of Human Resources and Social Security announced the new National Basic Medical Insurance, Maternity Insurance, and Work Injury Insurance Drug Catalog (2025) and the Commercial Health Insurance Innovative Drug Catalog (2025), which will be implemented nationwide starting January 1, 2026 [1][2] Group 1: National Basic Medical Insurance Drug Catalog - The updated National Medical Insurance Drug Catalog includes 114 new drugs, of which 50 are first-class innovative drugs [1] - A total of 29 drugs that are either not clinically available or can be better replaced by other medications have been removed from the catalog [1] - The total number of drugs in the catalog has increased to 3,253, comprising 1,857 Western medicines and 1,396 traditional Chinese medicines, with significant improvements in coverage for key areas such as oncology, chronic diseases, mental illnesses, rare diseases, and pediatric medications [1] Group 2: Commercial Health Insurance Innovative Drug Catalog - The inaugural Commercial Health Insurance Innovative Drug Catalog includes 19 drugs, which complement the basic medical insurance effectively [2] - This initiative lays the groundwork for the complementary development of commercial insurance and basic medical insurance, contributing to the establishment of a multi-tiered medical security system [2]

（文章来源：人民日报） 首版商保创新药目录共纳入19种药品，与基本医保形成较好的互补衔接，也为推动商保与基本医保错位 发展、建立多层次医疗保障体系奠定基础。 本报北京12月8日电 （记者孙秀艳）7日，国家医保局、人力资源社会保障部公布《国家基本医疗保 险、生育保险和工伤保险药品目录（2025年）》和《商业健康保险创新药品目录（2025年）》，将于 2026年1月1日起在全国范围内正式实施。 新版国家医保药品目录新增114种药品，其中50种1类创新药，调出了29种临床没有供应或可被其他药物 更好替代的药品。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。 ...

Core Insights - The National Healthcare Security Administration and the Ministry of Human Resources and Social Security have issued the updated National Basic Medical Insurance, Maternity Insurance, and Work Injury Insurance Drug Catalog, along with the Commercial Health Insurance Innovative Drug Catalog for 2025, which will take effect on January 1, 2026 [1] Group 1: National Medical Insurance Drug Catalog - The 2025 National Medical Insurance Drug Catalog successfully adds 114 new drugs, including 50 innovative drugs classified as Category I, achieving an overall success rate of 88%, which is a significant increase from 76% in 2024 [1] - The total number of drugs in the adjusted National Medical Insurance Drug Catalog has increased to 3,253, comprising 1,857 Western medicines and 1,396 traditional Chinese medicines [1] - The updated catalog notably enhances coverage for key areas such as oncology, chronic diseases, mental health, rare diseases, and pediatric medications [1] Group 2: Commercial Health Insurance Innovative Drug Catalog - The first version of the Commercial Health Insurance Innovative Drug Catalog includes 19 new drugs [1]