12月7日，新版国家医保药品目录及首版商保创新药目录正式发布，此次调整纳入上百种创新药，降糖 药新"网红"、全新靶点"三兄弟"、百万元一针的抗癌药等悉数入选，目录将于明年1月1日起正式实施。 "四不改"是指不改主成分、不改适应证、不改给药途径、不改临床价值的药品。"四不改"药品所在同治 疗领域内目录药品已保障比较充分且具备价格优势，创新性低的药品不再考虑纳入。 "能够填补目录空白，有较大临床价值获益的药品，是我们认为的'真创新'药。"天津大学医学部药学院 教授吴晶表示，例如某靶点第三代药物在医保目录中已有多个，同靶点药物如果还想进入目录，就要证 明其能够给患者带来额外获益，否则就是同质化。 "药篮子"全面上新备受关注。面对近年来逐步成熟的靶向药物、免疫药物等，参保人不必再"望药兴 叹"。哪些药品填补空白？首版商保创新药如何落地临床？12月9日，相关专家在国家医保局举办的2025 年医保药品目录解读活动上就上述问题答疑。 第一问：哪些新药入选医保目录？ "98%的医保入选药品是5年内获批新药，其中50种是一类新药，数量创历史新高。"国家医保局医药服 务管理司司长黄心宇介绍，今年新增药品中，肿瘤药、慢性病药、罕见 ...

2025.12. 12 本文字数：3973，阅读时长大约6.5分钟 作者 | 第一财经 郭晋晖 从一年只需2针的超长效降脂针，到填补医保目录空白的治疗三阴性乳腺癌和KRAS非小细胞肺癌的 最新靶向药物，再到千元一针"鼻炎网红药"，国家基本医保药品目录又一次上新了114种新药好药。 与过去七年不同的是，今年国家医保局还同步发布了我国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"），纳入了"百万抗癌药"CAR-T，以及治疗阿尔茨海默病、戈谢病等的19款药 品。 明年1月1日医保商保双目录落地，对大家的"药箱子"和"钱袋子"有何影响？商保创新药目录又和普通 人有什么关系？在近日举行的全国创新药高质量发展大会和国家医保局举办的解读会上，政策制定 者、专家学者、业内人士就民众关心的十个问题给出答案。 脂）、司普奇拜单抗（特异性皮炎）。 在乳腺癌领域，三阴性乳腺癌（TNBC）因缺乏明确的治疗靶点，长期面临治疗选择匮乏、预后较差 的困境。中国自主研发的TROP2 ADC——芦康沙妥珠单抗进入新版医保目录之后填补了这项空白， 更多三阴性乳腺癌患者将受益。 国家医保局医保药品目录解读会现场/郭晋晖摄 50种1类新药 ...

Core Insights - The National Healthcare Security Administration (NHSA) has included 114 new drugs in the national basic medical insurance catalog, covering various fields such as oncology, anti-infection, and chronic diseases [1][3] - The newly added drugs include significant innovations like GLP-1 diabetes medication Tirzepatide and long-acting growth hormone product Ipexi [1][3] - A new commercial health insurance innovation drug catalog has been introduced, featuring 19 products, including CAR-T therapies and new Alzheimer's drugs, aimed at addressing the payment challenges of high-priced innovative drugs [3][4] Summary by Category New Drug Additions - The updated medical insurance catalog includes drugs for chronic diseases, such as Tirzepatide for diabetes and Inclisiran for cholesterol reduction [1][2] - Other notable inclusions are Dupilumab for atopic dermatitis and the flu drug Masitinib [1] Pricing and Discounts - Although the NHSA did not disclose average price reductions, it is speculated that the discount rates may align with previous years' reductions of 50%-60% [3] - The long-acting growth hormone Ipexi is reported to have a price of approximately 850 yuan per injection, reflecting a nearly 50% reduction [3] Commercial Health Insurance Catalog - The commercial health insurance catalog aims to resolve the payment difficulties associated with high-priced innovative drugs, with 19 products included, of which 5 are CAR-T therapies [3][4] - The discount range for these products is between 15%-50%, slightly higher than the previously expected 30% [3][4] Market Dynamics and Implications - The inclusion of CAR-T therapies in the commercial insurance catalog marks a significant development, providing a national reimbursement pathway for these high-cost treatments [4][5] - The commercial insurance catalog's products benefit from a "three exclusions" policy, which allows for more favorable pricing and reimbursement conditions [4][6] Future Outlook - The introduction of the commercial insurance catalog is seen as a first step, with the focus now shifting to its implementation and integration with existing health insurance products [8][10] - The "Hui Min Bao" insurance products are expected to play a crucial role in accommodating the new catalog, with many products already providing coverage for CAR-T therapies [9][10] - The NHSA emphasizes a collaborative approach between basic medical insurance and commercial insurance, aiming for a complementary rather than competitive relationship [11]

Core Insights - The new national basic medical insurance directory has included 114 new drugs, covering various fields such as oncology, anti-infection, and chronic diseases [3][4] - The introduction of the commercial health insurance innovative drug directory aims to address the payment challenges of high-priced innovative drugs, marking a significant development in the healthcare sector [6][10] Group 1: New Drug Inclusion - The new drugs added to the medical insurance directory include significant innovations such as GLP-1 diabetes medication Tirzepatide and long-acting growth hormone product Ipeglutide [3][4] - Notable drugs include the anti-allergy drug Dupilumab and the new flu medication Maribavir, which have also been accepted into the insurance coverage [3] Group 2: Pricing and Discounts - Although the average price reduction was not disclosed, it is estimated to be similar to previous years' reductions of 50%-60%, with some drugs like Ipeglutide seeing a price drop of nearly 50% [5] - The commercial health insurance directory includes 19 products with price reductions ranging from 15% to 50%, slightly higher than the industry expectation of a 30% cap [6][7] Group 3: Commercial Health Insurance Directory - The commercial health insurance directory has strict entry requirements, focusing on high innovation, significant clinical value, and the inability to be replaced by the basic medical insurance directory [7] - CAR-T therapies, which have been historically expensive, now have a national reimbursement pathway, allowing for more streamlined negotiations for pharmaceutical companies [8][11] Group 4: Implications for Pharmaceutical Companies - The inclusion of drugs in the commercial health insurance directory allows pharmaceutical companies to negotiate discounts directly with insurers, potentially reducing their costs significantly [10][11] - The directory's establishment is seen as a critical step for CAR-T companies to improve their market access and sales volume [11][12] Group 5: Future Outlook - The commercial health insurance directory is expected to enhance the service capabilities of existing health insurance products, such as "Hui Min Bao," and improve patient experiences [15][16] - Recent initiatives in various provinces indicate a trend towards integrating the commercial health insurance directory with local health insurance systems, enhancing coverage for innovative drugs [16]

今年的医保目录， 纳入了多款"重磅新药"。 文 ｜ 胡香赟 编辑 ｜ 海若镜 封面来源 ｜ pixabay 今年的医保目录，纳入了多款"重磅新药"。 12月9日上午，国家医保局在北京召开沟通会，对两天前在广州"2025创新药高质量发展大会"公布的新版国家基本医保目录，及首个《商业健康保险创新药 品目录》（"商保目录"）名单，进行了详细解读。 国家医保局方面在沟通会上提到，今年医保目录新增药物114个，覆盖肿瘤、抗感染、慢病等诸多领域。 其中，包括慢病领域集中"更新换代"的新品：GLP-1降糖/减重药替尔泊肽；半年打一针的降脂药英克司兰钠；治疗痛风"富贵病"的多替诺雷片均被纳入。另 外，"过敏救星"司普奇拜单抗、国产流感新药玛舒拉沙韦片、长效生长激素产品怡培生长激素等也纷纷被医保接收。 本次，商保目录共纳入19款产品，包括5款售价百万元、被网友称为"抗癌针"的CAR-T疗法，2款新型阿尔茨海默病药物和多款治疗肿瘤及罕见病的药物。其 中罕见病药物在目录中占比接近1/3。 36氪获悉，19款产品的"降幅"在15%-50%不等（5%为一档，视产品特性而定），略高于行业此前预期的30%以内的降幅区间，但整体低于往年医保 ...

两份药品清单，让新药、好药更加触手可及。 聚焦临床急需、医保可负担——进医保的114种药品中，有36个肿瘤用药、12个糖尿病等慢性病用药、 13个抗感染类药品、10个罕见病用药等，29种临床用不上、或有更好替代的药品被调出目录。 一些能够弥补基本医保保障空白的药品进入医保目录，用于治疗三阴性乳腺癌的芦康沙妥珠、胰腺癌用 药伊立替康脂质体、套细胞淋巴瘤用药匹妥布替尼片等"救命药"入围；一年仅需两针就可以有效降低血 脂水平的英克司兰钠、糖尿病用药替尔泊肽等慢性病新药也进了医保。 此次调整中，一款用于治疗KRAS靶点肺癌的新药格外引人关注，这款药有多新？它在2025年5月刚刚 获批。 查询新版医保药品目录，不乏刚获批不久的新药，如流感用药昂拉地韦片、玛舒拉沙韦片等。此次调整 有50种药品为一类创新药，创新药正以更快速度惠及患者。 人力资源社会保障部工伤保险司司长郑玄波介绍，此次调整后，新版国家医保目录内药品总数增至3253 种，其中西药1857种、中成药1396种。 近年来，医保目录持续扩容，但部分救急、救命的创新药在刚上市时价格高昂，基本医保目录难以覆 盖，不少患者依然难以负担。 新华财经广州12月8日电（记者彭 ...

一年一度的国家医保药品目录调整，始终牵动着万千百姓的心。 12月7日，在2025创新药高质量发展大会上，新版国家医保药品目录及首版商保创新药目录正式发布，114种药品成功纳入医保、19种新药进 商保创新药目录，对参保人"药篮子"全面升级。 人力资源社会保障部工伤保险司司长郑玄波介绍，此次调整后，新版国家医保目录内药品总数增至3253种，其中西药1857种、中成药1396 种。 近年来，医保目录持续扩容，但部分救急、救命的创新药在刚上市时价格高昂，基本医保目录难以覆盖，不少患者依然难以负担。 今年，对这些患者来说，也许希望能够被重新定义。 聚焦创新程度高、临床价值大、患者获益显著且超出基本医保保障范围的创新药，商保创新药目录纳入了CAR-T、TCE疗法、双特异性抗体 等靶点肿瘤药物，也有短肠综合征、戈谢病等罕见病药物，阿尔茨海默症治疗药物等，共计19种新药。 两份药品清单，让新药、好药更加触手可及。 聚焦临床急需、医保可负担——进医保的114种药品中，有36个肿瘤用药、12个糖尿病等慢性病用药、13个抗感染类药品、10个罕见病用药 等，29种临床用不上、或有更好替代的药品被调出目录。 一些能够弥补基本医保保障空 ...

Core Insights - Sanofi has confirmed the cessation of the promotion of its PCSK9 inhibitor, Alirocumab, in the Chinese market due to global supply issues and a strategic upgrade in its cardiovascular product line [2][3] - The exit of Alirocumab from the market has opened opportunities for domestic pharmaceutical companies to enter the PCSK9 inhibitor space [1][3] Industry Overview - PCSK9 inhibitors are considered a milestone in lipid-lowering therapies, with significant implications for managing high LDL cholesterol levels, which are primarily influenced by genetic factors [1][3] - The understanding of lipoprotein(a) [Lp(a)] in cardiovascular diseases has led to increased interest in developing new lipid-lowering drugs targeting this specific marker [1][7] Market Dynamics - The market for lipid-lowering medications is competitive, with established statin drugs and newer PCSK9 inhibitors being used in combination for optimal patient outcomes [4][5] - There are currently seven approved PCSK9 inhibitors in China, including both imported and domestic products, with ongoing developments from various companies [5][6] Emerging Opportunities - Companies are actively pursuing the development of alternative medications in light of Alirocumab's market exit, indicating a robust interest in the PCSK9 inhibitor segment [3][6] - The market is also seeing advancements in therapies targeting Lp(a), with several multinational corporations engaged in clinical trials for new drugs aimed at lowering Lp(a) levels [7]

Core Viewpoint - Novartis (NVS.US) has registered a Phase III clinical trial for inclisiran aimed at evaluating its efficacy and safety in patients with acute coronary syndrome (ACS) during early hospitalization [1] Group 1: Clinical Trial Details - The trial is a multicenter, randomized, double-blind, placebo-controlled study involving patients who have recently experienced ACS, including ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) [1] Group 2: Drug Background - Inclisiran is the first approved PCSK9siRNA drug globally, receiving approval from the EU and FDA in 2020 and 2021 for the treatment of adult hypercholesterolemia and mixed dyslipidemia, demonstrating the therapeutic potential of small nucleic acid drugs in chronic disease management [1] - To date, inclisiran has been approved for four indications in the EU, three indications in the US, and four indications in China [1]