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国家医保局谢章澍:医保赋能健康新质生产力
Xin Lang Cai Jing· 2026-02-03 19:47
Core Viewpoint - The National Medical Insurance Administration is transforming its role from traditional fund management to a strategic hub that connects public health needs with pharmaceutical industry development, emphasizing dual functions of "social security + innovation empowerment" [1][2]. Group 1: Fund Support and Expenditure - During the 14th Five-Year Plan period, the total expenditure of the medical insurance fund is projected to reach 13 trillion yuan, with an average annual growth of 10%, providing stable financial support for innovation [2]. - The adjustment cycle for the medical insurance catalog has been compressed from 8 years to 1 year, focusing on new drugs launched within the last 5 years, with 98% of new effective drugs expected to be included in the catalog by 2024 [2]. - Over the past 8 years, more than 900 new drugs have been added, with 80% of new drugs being included in the payment scope within 2 years of their market launch, driving drug sales exceeding 600 billion yuan [2]. Group 2: Price Governance and Innovation Support - The establishment of the first national drug price registration network aims to achieve low drug prices through centralized procurement and catalog negotiations, while also supporting the application of innovative technologies such as surgical robots and digital customized imaging [2]. - The medical insurance department has proactively focused on the development of cutting-edge medical technologies, with the support process for brain-computer interface technology serving as a typical example [2][3]. - In March 2025, the medical insurance department established pricing and charging standards for brain-computer interfaces, addressing payment challenges for technology applications [2]. Group 3: Future Outlook and Strategic Initiatives - The medical insurance department is also incorporating a range of new technologies and drugs, such as remote operations, proton heavy ion therapy, and CAR-T tumor treatment, into its support framework, ensuring that the public benefits from innovative outcomes [3]. - The department is actively building international platforms to promote Chinese pharmaceutical innovations globally, while real-world comprehensive value evaluation serves as crucial evidence for medical insurance decision-making [3]. - Looking ahead to the 15th Five-Year Plan, the medical insurance department will continue to deepen its dual-driven strategy of "policy guidance" and "value evaluation," optimizing payment policies for innovative technologies like brain-computer interfaces [3].