公布新增纳入目录的114种药品，是非小细胞肺癌、宫颈癌、罕见病的患者在等待的创新药、救命药。 比如说有一款药，打一针可维持半年有效的降血脂的效果，上市不久就能纳入医保，患者可以以非常合 理的价格控制血脂，这对患者来说，就是民生。 专题：新浪健康保险研究院 来源：中国医疗保险 2025年12月7日，国家医保局公布了2025年版《国家基本医疗保险、生育保险和工伤保险药品目录》和 首版《商业健康保险创新药品目录》。新公布的医保药品目录有什么新变化？又如何更好地满足大家的 用药需求呢？ 本次目录调整新增114种药品，其中50种为一类创新药，同时调出了29种临床没有供应或可被其他药物 更好替代的药品。本次调整后，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。新版目录于2026年1月1日 在全国范围内正式实施。 2025年的药品目录调整与此前有哪些不同？ 而人们对于健康的不懈追求，一方面推动着药品日新月异的发展，同时也要求政策的调整，要跟得上行 业的变化。所以医保局成立以来，每年一次药品目录的调整，都是对民生需求的回应。 不 ...

Core Viewpoint - The article discusses the recent update of China's National Medical Insurance Drug List, which includes 114 new drugs, highlighting the introduction of a commercial health insurance innovative drug directory alongside the basic insurance list, aiming to enhance patient access to innovative treatments and address gaps in drug coverage [6][13]. Group 1: New Drugs in the National Medical Insurance Directory - A total of 114 new drugs have been added to the directory, covering various treatment areas including 36 for tumors, 12 for chronic diseases, and 10 for rare diseases, with the number of class 1 new drugs increasing from 38 to 50, setting a new historical high [6][7]. - Notable "star drugs" include LuKangsa Tazhu (for tumors), Fluorazirase tablets, and Spilumab (for specific dermatitis), which will benefit a wide range of patients, including those with triple-negative breast cancer and chronic sinusitis [7][8]. Group 2: Financial Impact on Patients - The average price reduction for negotiated drugs has historically been around 60%, with 112 out of 127 drugs successfully negotiated this year, resulting in significant cost savings for patients [9]. - The introduction of Spilumab, priced at around 1,000 yuan per injection, is expected to significantly lower the financial burden on patients, making innovative treatments more accessible [9]. Group 3: Implementation Challenges - There are concerns regarding the "last mile" issue in drug availability at hospitals, as many negotiated drugs are still provided through external pharmacies, and hospitals may hesitate to prescribe these due to cost concerns [10][11]. - The new regulations require that hospitals must not limit the availability of negotiated drugs based on overall budget constraints, ensuring that these drugs are accessible to patients [11]. Group 4: Changes in the Drug Directory - This year, 29 drugs were removed from the directory due to being replaced or not produced, with a total of 467 drugs removed over the past eight years for similar reasons [12]. - A six-month transition period has been established for patients using drugs that are not renewed in the directory, ensuring continuity of care [12]. Group 5: Commercial Health Insurance Innovative Drug Directory - The newly established commercial health insurance innovative drug directory includes 19 drugs, focusing on high-value innovative treatments that cannot be covered by the basic insurance directory [13][15]. - The drugs in this directory are characterized by high innovation, significant clinical value, and the need for diverse payment options, with 50% being class 1 new drugs [15]. Group 6: Benefits for Patients - The commercial health insurance directory aims to provide a curated list of high-quality drugs, reducing the selection burden for insurance companies and potentially lowering costs for patients through reduced premiums or increased reimbursement rates [16]. - The integration of the commercial insurance directory with existing medical insurance systems is being explored to enhance patient experience and access to innovative treatments [16]. Group 7: Future Prospects and Challenges - The implementation of the commercial health insurance innovative drug directory is dependent on market mechanisms, with insurance companies determining the usage and timing of these drugs [19]. - Emphasis on actuarial pricing and collaboration between insurance companies and pharmaceutical firms is crucial for the sustainable rollout of these innovative drugs [19].

12月7日，国家医保局公布了2025年版《国家基本医疗保险、生育保险和工伤保险药品目录》和首版 《商业健康保险创新药品目录》。新公布的医保药品目录有什么新变化？又如何更好地满足大家的用药 需求呢？ 本次目录调整新增114种药品，其中50种为一类创新药，同时调出了29种临床没有供应或可被其他药物 更好替代的药品。本次调整后，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。新版目录将于2026年1月1 日在全国范围内正式实施。 今年的药品目录调整与此前有哪些不同？ 公布新增纳入目录的114种药品，是非小细胞肺癌、宫颈癌、罕见病的患者在等待的创新药、救命药。 比如说今年有一款药，打一针可维持半年有效的降血脂的效果，上市不久就能纳入医保，患者可以以非 常合理的价格控制血脂，这对患者来说，就是民生。 而人们对于健康的不懈追求，一方面推动着药品日新月异的发展，同时也要求政策的调整，要跟得上行 业的变化。所以医保局成立以来，每年一次药品目录的调整，都是对民生需求的回应。 不断纳入新药 医保基金能承受吗？ 八年八次调整，每次都新增 ...

Group 1 - The core viewpoint of the articles is that regulatory reforms in Beijing are significantly enhancing the pharmaceutical and healthcare industry, aiming for a market value exceeding one trillion yuan through various supportive policies [1][2][3]. Group 2 - The approval time for clinical trials of innovative drugs has been reduced from 60 days to 30 days, with some projects being approved in as little as 18 working days [2][3]. - A total of 26 drug varieties have been approved, including 21 for rare diseases, benefiting approximately 4,900 patients [2]. - The Beijing model includes measures such as bonded stockpiling and multiple uses of a single customs clearance to expedite access to urgently needed drugs [2][3]. Group 3 - The overall time for initiating clinical trial projects is targeted to be reduced from 28 weeks to under 20 weeks by 2024, with some hospitals already achieving a reduction to around 7 weeks [3][4]. - A green channel has been established for innovative drugs, allowing for simultaneous reviews of project initiation, ethical review, and contract review, significantly shortening approval times [4]. Group 4 - The National Medical Insurance Bureau has implemented a dynamic adjustment mechanism for the medical insurance catalog, adding 835 new drugs over seven years, including 149 innovative drugs [5]. - Approximately 80% of innovative drugs are expected to be included in the medical insurance catalog within two years of their market launch [5][6]. - In the first seven months of 2025, 13.05 million patients purchased national negotiated drugs, totaling 3.95 billion yuan in expenses [5]. Group 5 - A dual-channel supply mechanism for national negotiated drugs has been established to ensure accessibility and address issues related to slow and difficult hospital entry [5][6]. - The Beijing Medical Insurance Fund will separately pay 4.5 billion yuan for national negotiated drugs in 2024, ensuring that these drugs are not subject to DRG payment limits [6][7]. Group 6 - The establishment of a drug and medical device review center in the Beijing-Tianjin-Hebei region aims to accelerate the approval process for innovative drugs and medical devices [8]. - The center will provide comprehensive technical services, including guidance and consultation for drug and device registration, focusing on clinical needs [8].

Core Viewpoint - The story highlights the journey of a child with spinal muscular atrophy (SMA) and the impact of national healthcare policies on access to life-saving treatments, showcasing the importance of medical advancements and insurance negotiations in improving patient outcomes [1][14]. Group 1: Medical Condition and Treatment - The child, known as Little Stone, was diagnosed with SMA at eight months old, with initial medical advice suggesting a grim prognosis and no available treatments in China [3][5]. - A special drug, Nusinersen, was introduced in China in early 2019, but its high cost of approximately 700,000 yuan per injection posed a significant financial burden for the family [5][10]. - In 2020, the drug's price was reduced to 550,000 yuan per injection, and the company offered a buy-one-get-five-free deal, improving the child's condition through ongoing rehabilitation and treatment [8][12]. Group 2: Healthcare Policy and Insurance Negotiations - The first round of national healthcare negotiations in 2021 saw the drug's price drop dramatically from 550,000 yuan to around 30,000 yuan, making it accessible for more patients [10][12]. - The negotiations aimed to balance the interests of patients, pharmaceutical companies, and the healthcare fund, reflecting a significant shift in the availability of rare disease treatments in China [10][14]. - Following the successful negotiations, the number of patients using Nusinersen in 2022 increased significantly, with a reported 2.6 times growth in sales compared to the previous year [12]. Group 3: Social Integration and Support - Little Stone successfully enrolled in elementary school, with the institution making special accommodations to support his learning needs, demonstrating a positive societal response to children with disabilities [16][18]. - The family continues to face challenges, including ongoing rehabilitation sessions and the aging of family members who provide support [20]. - The narrative emphasizes the importance of community support, family involvement, and healthcare policies in enabling children with rare diseases to integrate into society and pursue education [21].