Two departments: actively promote the inclusion of innovative drugs in the commercial health insurance guarantee range, and enhance the management of medical insurance payment scope.

14:28 07/12/2025

Actively promote the inclusion of innovative drugs in the commercial insurance drug list into the scope of commercial health insurance coverage. Local medical insurance departments should work together with relevant departments to promote the construction of a multi-level medical security system, actively support the development of universal commercial health insurance, and recommend the use of commercial health insurance, medical mutual aid, and other multi-level medical security systems for the commercial insurance drug list.

On December 7th, the National Medical Insurance Administration and the Ministry of Human Resources and Social Security issued the "National Basic Medical Insurance, Maternity Insurance, and Work-related Injury Insurance Drug List" and the "Commercial Health Insurance Innovative Drug List" (2025). The new version of the drug list will officially take effect on January 1, 2026, and the "National Basic Medical Insurance, Work-related Injury Insurance, and Maternity Insurance Drug List (2024)" (Medical Insurance No.202433) will be simultaneously abolished. It is proposed that efforts should be made to actively promote the inclusion of innovative drugs in the commercial health insurance coverage. Local medical insurance departments should work with relevant departments to promote the construction of a multi-level medical security system, actively support the development of universal commercial health insurance, and recommend the use of innovative drugs in the commercial health insurance and medical mutual aid systems. Support commercial health insurance institutions to design new products, update reimbursement ranges, adjust reimbursement methods based on the innovative drug list, better meet the medication needs of patients, and effectively reduce the burden of medical expenses on patients. Encourage regions with conditions to explore the implementation of a "one-stop" settlement system for medical insurance, work-related injury insurance, and commercial health insurance. The article goes on to provide guidelines and procedures for the implementation of the new drug list, the management of drug payment standards under the medical insurance, and strategies to improve the supply guarantee level of medical insurance drugs. --- This is a detailed document discussing the issuance of new drug lists in the context of national medical insurance in China. It covers various aspects such as the implementation of new drug lists, management of drug payment standards, and measures to improve the supply of medical insurance drugs.

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