编者按： 长期以来，我国创新药商业化面临着"进院难、支付难"的结构性困境，尤其是高值创新药，常常受限于 基本医保"保基本"的定位而难以纳入报销范围。此次政策组合拳的核心逻辑，在于通过明确的分工，厘 清了政府与市场的支付边界。 对外经济贸易大学创新与风险管理研究中心副主任龙格在接受采访时指出，《商保创新药目录》聚焦超 出基本医保保障范围，但临床价值显著的创新药，作为基本医保目录的补充。两者形成了"医保保基 本、商保接高端"的分工：基本医保覆盖基础药品，商保目录则满足多元化、高层次需求，并为创新药 提供"先商保后医保"的梯度准入路径。 具体而言，新版基本医保目录继续发挥"压舱石"作用。2025年医保目录新增114种药品，谈判/竞价成功 率高达88.19%，创下近七年新高。新增药品中，50种为1类创新药，重点覆盖肿瘤、慢性病、罕见病等 领域。调整后的目录内药品总数增至3253种，其中西药1857种、中成药1396种，极大地提升了重点领域 的用药保障水平。 与此同时，首版《商保创新药目录》则精准承接了基本医保"溢出"的高端需求。首批商保目录共纳入19 种药品，涵盖了CAR-T疗法、神经母细胞瘤和戈谢病等罕见病特效药以 ...

南方财经全媒体记者 孙诗卉 实习生 徐若萱 2025年12月7日，国家医保局与人力资源社会保障部联合发布了《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 2025年医保目录）及首版《商业健康保险创新药品目录》（以下简称《商保创新药目录》），两份目录均将于2026年1月1日起正式实施。 作为构建多层次医疗保障体系的里程碑事件，业内人士表示，此次"双目录"的同步发布，意味着我国医药支付体系正式进入"基本医保+商业健 康险"双轮驱动的新阶段。 长期以来，商业健康险在特药责任设计上存在"专业性不足"的痛点。资深从业者迈伦向21世纪经济报道记者指出，保险公司缺乏药物经济学专 家，自行制定目录难度极大。此次《商保创新药目录》的制定相当于为保险行业提供了一份官方背书的、高质量的"药品池"，极大地降低了产 品开发的准入门槛和信息不对称风险。 对于消费者而言，这一政策不仅夯实了基础用药的保障底线，更使得此前因价格高昂而难以企及的百万级CAR-T疗法、前沿阿尔茨海默病药物 等高值创新药，有了实质性的支付解决方案。 承接医保"溢出"创新药支付需求 长期以来，我国创新药商业化面临着"进院难、支付难"的结构性 ...

Group 1 - The 2025 National Medical Insurance Drug List includes 114 new drugs, with 50 being innovative drugs, showing an overall success rate of 88%, an increase from 76% in 2024 [1] - Nine innovative drugs from the Sci-Tech Innovation Board have been included in the medical insurance list, highlighting the strength and vitality of these companies [1] - The first version of the Commercial Health Insurance Innovative Drug List has been released, complementing the basic medical insurance and providing new possibilities for patients to access cutting-edge treatments [4] Group 2 - Nearly 90% of new drugs approved by Sci-Tech Innovation Board companies have received medical insurance support, indicating a shift towards value realization for these companies [2] - The drug "Junshi Biological's Junshida" is the only domestic PCSK9-targeted drug for patients intolerant to statins, now included in the medical insurance list [2] - The successful renewal negotiations for several innovative drugs confirm their clinical value and market position, benefiting a wider patient population [6][7] Group 3 - Innovative drugs from companies like Baiji Shenzhou and Junshi Biological have been recognized for their clinical value and patient benefits, leading to their inclusion in the medical insurance list [7] - The R&D investment of Sci-Tech Innovation Board companies reached a new high in the first three quarters of 2025, with a year-on-year increase of over 10%, indicating a strong commitment to innovation [7] - The cycle of "R&D investment - innovation results - insurance support - market return - reinvestment in R&D" is being established and strengthened within the industry [7]

Core Viewpoint - BeiGene (06160) experienced a significant stock increase of 3.53%, reaching HKD 223.2, following the announcement of positive results from the Phase III HERIZON-GEA-01 study [1] Group 1: Study Results - The HERIZON-GEA-01 study evaluated the efficacy and safety of the HER2-targeted bispecific antibody, Zhenidamab, either as a monotherapy or in combination with the PD-1 inhibitor, Tislelizumab, for first-line treatment of HER2-positive locally advanced or metastatic gastroesophageal adenocarcinoma (GEA) [1] Group 2: Market Performance and Analyst Ratings - CITIC Securities previously noted that BeiGene's Bruton’s tyrosine kinase (BTK) product is experiencing significant growth, leading to an upward revision of the annual performance guidance [1] - The company is expected to see continued commercialization success from its key pipelines, including BTK, PD-1 in the EU and Japan, and other significant products like BCL-2, CDAC, and CDK4, maintaining a "Buy" rating [1]

Core Insights - Dingtang Health has launched a new innovative drug, injection Vuxin Qibai monoclonal antibody (brand name: Jinbeixin), which was approved by the National Medical Products Administration in July 2023 for treating acute gouty arthritis in adults who are intolerant to or have contraindications for non-steroidal anti-inflammatory drugs and/or colchicine [1] - The prevalence of hyperuricemia among Chinese adults was reported at 14% from 2018 to 2019, with gout prevalence ranging from 0.86% to 2.20%, indicating a rising trend and younger onset age [1] - The gout medication market in China is projected to exceed 10 billion yuan by 2030 [1] Company Developments - Dingtang Health is actively expanding its innovative drug portfolio, having introduced several innovative drugs under its "New Special Drug Life Ark" plan and "Original Drug Supply Alliance" initiative, enhancing patient access and treatment adherence [1] - The company is enhancing its AI technology development and application, establishing smart warehouses and cold chain delivery services across major regions, and integrating online medical insurance payment systems [2] - For the first half of 2025, Dingtang Health reported revenues of 2.327 billion yuan, a year-on-year increase of 2.6%, with a gross profit of 816 million yuan and a gross margin of 35% [2] - The company narrowed its losses to 52.02 million yuan, a 42.1% improvement compared to the same period in 2024, with adjusted net profit losses reduced by 78.2% [2] - Future strategies include focusing on user lifecycle health management, expanding smart center warehouse construction, and enhancing service capabilities in major cities like Beijing, Shanghai, and Shenzhen [2]

Group 1 - The company has adjusted its 2025 annual operating performance forecast to provide investors with a clearer understanding of its business performance and future prospects [1][2] - The adjustment in expected operating income is primarily attributed to the leading position of Baiyueze in the US market and its continued expansion in Europe and other key global markets [3] Group 2 - For the first half of 2025, the company's product revenue reached 17.36 billion RMB, a year-on-year increase of 45.8%, while total operating revenue was 17.52 billion RMB, up 46.0% from the previous year [9] - The net profit attributable to the parent company for the first half of 2025 was 450 million RMB, with total assets at 44.87 billion RMB, an increase of 4.8% from the beginning of the period [9][19] - Baiyueze's global sales totaled 12.53 billion RMB in the first half of 2025, representing a year-on-year growth of 56.2%, with US sales at 8.96 billion RMB, up 51.7% [10][11] Group 3 - Baiyueze is the only BTK inhibitor with flexible dosing options, and it has been approved in 75 markets globally, with ongoing clinical trials in over 30 countries [12] - The company is also advancing its next-generation pipeline products and emphasizes a rapid concept verification strategy in its global clinical development [14] - The company has a significant presence in the oncology research field, with a large team dedicated to small molecule and antibody drug discovery [14] Group 4 - The company has initiated several key clinical trials for its products, including the global phase III trial for Sonrotoclax in combination with Baiyueze for CLL patients [15][16] - The company plans to launch multiple clinical trials for various cancer treatments in the coming years, including trials for breast cancer and lung cancer [17]