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百万抗癌药有望进入商保目录,5款CAR-T疗法通过专家评审
Guan Cha Zhe Wang· 2025-09-25 10:35
Core Insights - The introduction of a dual-track payment system for innovative drugs in China marks a significant shift in the healthcare landscape, allowing high-priced CAR-T therapies to enter both the basic medical insurance and commercial insurance innovation drug directories [1][4][5] Group 1: Policy Changes - The National Healthcare Security Administration (NHSA) announced that five CAR-T drugs have passed expert review and are expected to be included in the basic medical insurance and commercial insurance innovation drug directories [1][5] - The establishment of the commercial insurance innovation drug directory provides a separate pathway for high-value, innovative drugs that exceed the basic insurance coverage [1][5] Group 2: Market Dynamics - The dual-track system aims to address the challenges of high-priced drug payments, as traditional basic medical insurance has struggled to accommodate the rising costs of innovative therapies [4][5] - The commercial insurance directory is designed to complement the basic medical insurance directory, allowing companies to choose to apply for either or both directories [5][8] Group 3: CAR-T Drug Insights - The five CAR-T products that passed the review include therapies from companies such as Fosun Kite, WuXi AppTec, and others, with each treatment priced around 1 million yuan per dose [7][8] - The inclusion of CAR-T therapies in the commercial insurance directory is expected to alleviate the financial burden on patients, as seen with Fosun Kite's product, which has been covered by various commercial health insurance plans [7][8] Group 4: Future Implications - The commercial insurance innovation drug directory is anticipated to serve as a transitional phase for innovative drugs before they potentially enter the basic medical insurance directory, based on real-world data and market validation [8] - The establishment of this directory is reshaping the Chinese innovative drug market, making previously inaccessible high-priced therapies more available to a broader patient population [8]