转自：北京日报客户端 新版医保目录已进入实质性落地阶段。1月8日，北京商报记者注意到，包括替妥尤单抗N01注射液、夫 那奇珠单抗注射液在内的多款新增创新药，已在多地医院纷纷开出医保首方。这标志着患者使用这些高 价创新药的实际门槛正在快速降低，新版目录的惠民效应开始显现。 本次医保目录调整不仅新增了114种药品，更首次同步推出《商业健康保险创新药品目录（2025 年）》，通过"基本医保+商保"的双重保障，为肿瘤、罕见病等领域19种高值药品开辟了可及的支付通 路，医保支付体系向多层次保障的实质性转型迈出关键一步，创新药企也迎来了加速商业化放量的重要 节点。 从上市到开出医保首方不足一年 创新药迅速落地医保，是新版医保目录对具有高临床价值"真创新"支持力度加大的直接体现。本次调整 中，新版医保目录与商保创新药目录共纳入独家品种124个。 其中，备受关注的替妥尤单抗N01注射液是国内首款用于治疗甲状腺眼病的靶向药物，从2025年3月上 市，到开出医保首方，用时不到一年，填补了我国该领域近70年的治疗空白。 夫那奇珠单抗注射液则是用于治疗银屑病的生物制剂1类创新药，由恒瑞医药自主研发。恒瑞医药在本 次医保目录调整中被视 ...

新版医保目录已进入实质性落地阶段。1月8日，北京商报记者注意到，包括替妥尤单抗N01注射液、夫 那奇珠单抗注射液在内的多款新增创新药，已在多地医院纷纷开出医保首方。这标志着患者使用这些高 价创新药的实际门槛正在快速降低，新版目录的惠民效应开始显现。 倒逼药企研发策略转向真创新 本次医保目录调整不仅新增了114种药品，更首次同步推出《商业健康保险创新药品目录（2025 年）》，通过"基本医保+商保"的双重保障，为肿瘤、罕见病等领域19种高值药品开辟了可及的支付通 路，医保支付体系向多层次保障的实质性转型迈出关键一步，创新药企也迎来了加速商业化放量的重要 节点。 不到一年开出医保首方 创新药迅速落地医保，是新版医保目录对具有高临床价值"真创新"支持力度加大的直接体现。本次调整 中，新版医保目录与商保创新药目录共纳入独家品种124个。 其中，备受关注的替妥尤单抗N01注射液是国内首款用于治疗甲状腺眼病的靶向药物，从2025年3月上 市，到开出医保首方，用时不到一年，填补了我国该领域近70年的治疗空白。 夫那奇珠单抗注射液则是用于治疗银屑病的生物制剂1类创新药，由恒瑞医药自主研发。恒瑞医药在本 次医保目录调整中被视为 ...

新版医保目录已进入实质性落地阶段。1月8日，北京商报记者注意到，包括替妥尤单抗N01注射液、夫那奇珠单抗注射液在内的多款新增创新药，已在多地 医院纷纷开出医保首方。这标志着患者使用这些高价创新药的实际门槛正在快速降低，新版目录的惠民效应开始显现。 本次医保目录调整不仅新增了114种药品，更首次同步推出《商业健康保险创新药品目录（2025年）》，通过"基本医保+商保"的双重保障，为肿瘤、罕见病 等领域19种高值药品开辟了可及的支付通路，医保支付体系向多层次保障的实质性转型迈出关键一步，创新药企也迎来了加速商业化放量的重要节点。 从上市到开出医保首方不足一年 创新药迅速落地医保，是新版医保目录对具有高临床价值"真创新"支持力度加大的直接体现。本次调整中，新版医保目录与商保创新药目录共纳入独家品种 124个。 其中，备受关注的替妥尤单抗N01注射液是国内首款用于治疗甲状腺眼病的靶向药物，从2025年3月上市，到开出医保首方，用时不到一年，填补了我国该 领域近70年的治疗空白。 | | | 基本医保目录"上新"药品定点医药机构销售情况(2026年1月1日至1月6日) | | | | --- | --- | --- | ...

今年1月1日，《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"新版 国家医保药品目录"）和首版《商业健康保险创新药品目录（2025年）》（以下简称"商保创新药目 录"）同步执行。其中，商保创新药目录共纳入19种药品，5款价格百万元级的CAR-T肿瘤治疗药品悉数 在列。随着这一政策正式落地，商业健康险能否接好高值药支付的"接力棒"，直接关乎多层次医疗保障 的惠民实效。 《金融时报》记者注意到，新年伊始，北京、河北、浙江、湖北等地纷纷开启首版医保"双目录"制 度，积极打通商业健康保险的衔接通道。在业内人士看来，这标志着医保与商保在破解高值创新药支付 难题上迈出实质步伐，商保补充作用被进一步激发，更多百姓有望用上"天价药"。政策利好下，商保公 司也可参照商保创新药目录加速产品创新、更新赔付范围，与基本医保形成保障合力。 商业保险填补创新药保障空白 进入2026年1月，医保商保药品"双目录"迎来启动关键节点，地方政策衔接、险企产品适配、技术 服务支撑的联动效应持续释放，"医保+商保"的协同医疗保障正从制度设计走向实操落地。 据《金融时报》记者观察，全国多地医保部门通过一系列政策举措为商保创新 ...

嘉陵江畔，重庆渝中半岛与江北嘴隔江对望，是数亿游客心中"魔幻山城"的最初印象。与此同时， 鳞次栉比的高楼中汇聚数百家银行、证券、保险等金融机构，金融服务正如神经网络般融入城市发展， 为西部金融中心建设注入活力。 重庆城市景象。新华社记者 王全超 摄 成渝共建西部金融中心，是《成渝地区双城经济圈建设规划纲要》的重要部署。近年来，重庆 以"智融惠畅"工程为总抓手，扎实做好科技金融、绿色金融、普惠金融、养老金融、数字金融"五篇大 文章"，加快西部金融中心建设，在服务国家重大战略、赋能实体经济、惠及民生福祉的实践中，交出 金融赋能西部内陆高质量发展的答卷。 锚定国家战略筑牢金融支撑体系 "中国工商银行(泰国)股份有限公司罗勇工业园分行等6家金融机构加入陆海新通道金融服务联合 体！" 重庆还创造了多项首批、首试：全国首笔陆海新通道多式联运"一单制"数字提单动产质押融资业 务，全国首单"一带一路"科技创新绿色公司债券，推动亚洲首个奥特莱斯REITs落地，全国首个全省域 覆盖的绿色金融改革创新试验区…… 重庆市开州区九龙山镇天白水库。新华社记者 黄伟 摄 位于开州区九龙山镇的天白水库，犹如群山环抱着一颗明珠，水库大坝下，已 ...

来源：财经五月花 作者：丁艳 杨芮 这种支付与需求的错配正在找到新的解决路径。12月13日，全国医疗保障工作会议在北京召开，明确提 出2026年要支持商业健康保险发展，健全多层次医疗保障体系，并特别强调要"积极落地商保创新药品 目录"，在个人充分授权和确保数据安全基础上，为有需要的商业健康保险产品提供"医保+商保"一站式 清分结算服务。 12月7日，2025年国家基本医保药品目录及首版商保创新药目录在广州正式发布，将于2026年1月1日起 正式实施。此次国家医保局首次在基本医保目录之外增设商保创新药目录，共纳入19种药品，涵盖 CAR-T等肿瘤治疗药品、神经母细胞瘤等罕见病治疗药品，以及社会关注度较高的阿尔茨海默病治疗药 品。 商保创新药目录的出台标志着医保与商保协同进入实质性阶段，开辟了一条市场化的支付通 道，提升了创新药可及性 "当化疗成为唯一选项时，我们需要的不仅是技术，更是支付的勇气。"一位鼻咽癌患者曾在其自述中如 是写道。这句话背后，是无数癌症患者面对天价创新药时的无奈——即便新药能带来生存希望，但高昂 的费用却让希望沦为奢望。这种困境在罕见病领域尤为突出，患者往往需自费承担数十万元甚至上百万 元的 ...

Core Viewpoint - Fosun Pharma announced plans to invest approximately 1.412 billion yuan to acquire Green Valley Pharmaceutical, aiming to integrate the latter's Alzheimer's treatment drug, Manluo Sodium Capsule, into its innovative drug pipeline. This move reflects Fosun Pharma's strategy to accelerate its transition from generic to innovative drugs and seek a revaluation in the capital market [1][15]. Acquisition Details - Fosun Pharma's subsidiary, Fosun Pharma Industry, will invest a total of 1.412 billion yuan to acquire control of Green Valley Pharmaceutical, which will become a subsidiary of Fosun Pharma. The transaction includes a capital transfer of 143 million yuan for 15.15 million yuan of registered capital and an additional 1.27 billion yuan for 2.009 billion yuan of new registered capital [2][16]. - After the acquisition, Fosun Pharma will hold 53% of Green Valley's shares, with plans to reduce this to 51% after further share transfers. Green Valley focuses on developing, producing, and selling drugs for neurodegenerative diseases, with its core product, Manluo Sodium Capsule, conditionally approved for Alzheimer's treatment in November 2019 [3][16]. Controversies Surrounding the Drug - Manluo Sodium Capsule has faced significant controversy since its launch, with questions regarding its mechanism of action and clinical efficacy. The drug's registration has expired, and it will not resume commercial production until it completes ongoing post-marketing confirmatory clinical trials and receives approval from regulatory authorities [4][17]. - Due to the halt in sales of its core product, Green Valley's financial performance has been adversely affected, reporting revenues of 572 million yuan in 2024 and a net profit of 70.77 million yuan, followed by a loss of 67.61 million yuan in the first nine months of 2025 [5][17]. Market Reaction - Following the acquisition announcement, Fosun Pharma's stock fell significantly, with a drop of over 9% at one point in Hong Kong, closing down 5.81% at 21.06 HKD per share, and a decline of 4.22% in A-shares, closing at 26.75 yuan per share [5][18]. Strategic Moves in Innovative Drugs - Fosun Pharma has been actively expanding its innovative drug portfolio through various strategies, including partnerships and licensing agreements. For instance, in July, it signed a licensing agreement with Newco for the development of AR1001, another drug targeting Alzheimer's disease [6][19]. - The company has also made significant investments in its cell therapy platform, acquiring full ownership of Fosun Kite and planning further capital injections to enhance its capabilities in oncology [6][20]. Financial Performance and Challenges - Fosun Pharma's financial performance has shown mixed results, with revenues of 439.52 billion yuan in 2022, declining to 410.67 billion yuan in 2024. The company reported a net profit of 25.23 billion yuan in the first three quarters of 2024, reflecting a year-on-year decline of 4.91% in revenue [10][22]. - The company has faced scrutiny regarding its financial health, with short-term borrowings reaching 16.447 billion yuan and cash reserves insufficient to cover these debts, indicating potential liquidity pressures [11][24]. Future Prospects - The success of the acquisition and the potential re-approval of Manluo Sodium Capsule remain uncertain, raising questions about its contribution to Fosun Pharma's future performance [13][24].

Core Viewpoint - The inclusion of 19 drugs in the first version of the commercial health insurance innovation drug directory marks a significant step towards improving access and affordability of innovative drugs, particularly high-cost CAR-T therapies, while presenting challenges for insurance companies in product development and risk management [1][4][10]. Group 1: Policy and Implementation - The National Medical Security Work Conference emphasized the support for the development of commercial health insurance and the establishment of a multi-tiered medical security system, with a focus on the implementation of the commercial health insurance innovation drug directory by January 1, 2026 [1][2]. - The first version of the commercial health insurance innovation drug directory includes 19 drugs, focusing on high-cost and innovative treatments, including five CAR-T products and drugs for rare diseases [2][4]. Group 2: Challenges for Insurance Companies - Insurance companies face significant challenges in translating the drug directory into viable insurance products, including issues related to pricing, risk control, and compliance [4][5]. - Accurate pricing for insurance products relies on detailed data regarding potential patient populations, disease incidence, treatment cycles, and real-world efficacy, which are primarily held by pharmaceutical companies and hospitals [4][5]. Group 3: Risk Management and Compliance - The inclusion of Alzheimer's disease treatments raises concerns about adverse selection risks, as these drugs have high costs and long treatment durations, necessitating strict eligibility criteria for insurance coverage [5][6]. - Establishing transparent and compliant financial flows between insurance companies and pharmaceutical firms is crucial for effective collaboration [5][6]. Group 4: Data Sharing and Integration - The "医保+商保" one-stop clearing and settlement model aims to break down data silos, enhancing the efficiency of claims processing and improving patient experiences [6][8]. - Successful implementation of data sharing initiatives in regions like Shanghai and Beijing indicates potential for nationwide adoption, which could facilitate better integration of commercial health insurance with innovative drug offerings [8][10]. Group 5: Investment in Innovative Drugs - The policy encourages insurance funds to invest in the upstream of the pharmaceutical industry, positioning them as "patient capital" for innovative drug development [10][11]. - Major insurance companies are already investing in health industry funds, supporting numerous innovative drug companies and enhancing the overall funding environment for drug development [10][11]. Group 6: Future Outlook - Despite the potential for increased investment in innovative drugs, insurance companies remain cautious due to the high risks and costs associated with drug development, which may lead to a preference for established pharmaceutical firms over smaller, innovative companies [12].

Core Insights - The national medical insurance work conference emphasized the support for the development of commercial health insurance by 2026, aiming to establish a multi-tiered medical security system and promote the "医保+商保" one-stop settlement service for innovative drug products [1][4] Group 1: Policy and Implementation - The first edition of the "Commercial Health Insurance Innovative Drug Directory" includes 19 high-value drugs, focusing on advanced therapies and rare diseases, set to be implemented on January 1, 2026 [1][2] - The release of the directory marks a significant step for commercial health insurance in addressing the accessibility and affordability of innovative drugs, although challenges remain in translating the directory into marketable insurance products [2][3] Group 2: Challenges for Insurance Companies - Insurance companies face three main challenges: pricing, risk control, and compliance, particularly in obtaining accurate data from pharmaceutical companies and hospitals for effective pricing models [3][5] - The inclusion of Alzheimer's disease treatments in the directory raises concerns about adverse selection risks, necessitating strict eligibility review mechanisms to mitigate potential high payout risks [3][6] Group 3: Data Sharing and Settlement - The "医保+商保" one-stop settlement aims to break down data silos, facilitating data sharing to enhance claims processing and improve patient experience [4][5] - Concerns exist regarding the transparency of the settlement process, as a "black box" approach could hinder compliance with regulatory data reporting requirements [5][6] Group 4: Investment in Innovative Drugs - The policy encourages insurance funds to invest in the upstream of the pharmaceutical industry, positioning them as "patient capital" for innovative drug development [6][7] - Major insurance companies are already investing in health industry funds, supporting numerous innovative drug companies, although they remain cautious due to the high risks associated with drug development [7][8] Group 5: Future Outlook - There is potential for insurance companies to become shareholders in large pharmaceutical groups to mitigate investment risks, while maintaining a cautious approach towards smaller innovative firms [8]

Core Viewpoint - WuXi AppTec's management restructuring aims to enhance operational stability and drive growth in the competitive CAR-T therapy market, particularly following the inclusion of its CAR-T product in the national commercial health insurance directory [1][2][5]. Management Changes - Tian Feng will officially become the CEO and Executive Director on December 29, 2025, while Dr. Liu Cheng will assume the role of Chairman of the Board from December 12, 2025 [1]. - The current CEO, Liu Min, will resign on December 12, 2025, due to personal career development plans, and his previously approved stock options will be canceled [1][2]. - The existing management team will temporarily take over the CEO responsibilities to ensure smooth operations during the transition period [1]. New Leadership Background - Tian Feng has over 20 years of experience in the biopharmaceutical industry, with a strong background in commercialization, marketing, and strategic management [2]. - Dr. Liu Cheng has more than 20 years of experience and holds over 300 patents in the biopharmaceutical field, ranking highly in global CAR-T patents [3]. Financial Performance - In the first half of the year, WuXi AppTec reported revenues of 106 million yuan, a year-on-year increase of 22.5%, but also recorded a loss of 267 million yuan, with the loss margin widening by 11.24% [3]. - The company's core product, the CAR-T therapy, has been approved for treating specific types of lymphoma [3]. Strategic Partnerships - WuXi AppTec has entered into several business collaborations, including a technology licensing agreement with Juno Therapeutics valued at up to 10 million USD and a strategic cooperation agreement with Regeneron worth up to 50 million USD [4]. Market Context - The inclusion of WuXi AppTec's CAR-T product in the national commercial health insurance directory is a significant breakthrough, with five CAR-T therapies listed, including WuXi's product priced at 1.29 million yuan per dose [5][6]. - The price reduction for these therapies is expected to range between 15% and 50%, which may facilitate better access to these innovative treatments [6]. Challenges and Opportunities - The new management faces the challenge of improving market penetration for core products and accelerating pipeline development amid intense competition in the new drug development landscape [5][7]. - The company must also navigate hospital access issues to ensure the successful implementation of its products in the healthcare system [6][7].