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The National Health Insurance Administration and the Ministry of Human Resources and Social Security issued the “Catalogue of Drugs for National Basic Medical Insurance, Maternity Insurance, and Work Injury Insurance” and the “Catalogue of Innovative Drugs for Commercial Health Insurance”. Among them, it is proposed to actively promote the equipment and use of drugs in the commercial insurance innovative drug catalogue. Each provincial health insurance bureau shall implement the requirements of the “Certain Measures”. In principle, the listing and distribution of drugs in the commercial insurance innovative drug catalogue is carried out with reference to the drugs negotiated by medical insurance to protect clinical diagnosis and treatment needs and patients' rights and interests in rational drug use. Medicines and health insurance funds in the commercial insurance innovative drug catalogue are not paid, and are not included in the basic medical insurance self-rate index of designated medical insurance institutions and the scope of monitoring of alternative varieties selected from the collection. Innovative drug application cases in the commercial insurance innovative drug catalogue within the scope of relevant commercial health insurance coverage may not be included in the scope of medical insurance payments by disease type and paid after review and review procedures. Health insurance departments in various provinces can explore and support designated medical insurance retail pharmacies to equip drugs from the commercial insurance innovative drug catalogue, and do a good job of monitoring the terminal prices of medical institutions and retail pharmacies. Support regions that are in a position to do so to connect the availability of drugs in the commercial insurance innovative drug catalogue into the “Medicare Drug Cloud Platform”. Encourage real-world health insurance comprehensive value evaluations for drugs that are in a position to do so.

Zhitongcaijing·12/07/2025 04:17:00
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The National Health Insurance Administration and the Ministry of Human Resources and Social Security issued the “Catalogue of Drugs for National Basic Medical Insurance, Maternity Insurance, and Work Injury Insurance” and the “Catalogue of Innovative Drugs for Commercial Health Insurance”. Among them, it is proposed to actively promote the equipment and use of drugs in the commercial insurance innovative drug catalogue. Each provincial health insurance bureau shall implement the requirements of the “Certain Measures”. In principle, the listing and distribution of drugs in the commercial insurance innovative drug catalogue is carried out with reference to the drugs negotiated by medical insurance to protect clinical diagnosis and treatment needs and patients' rights and interests in rational drug use. Medicines and health insurance funds in the commercial insurance innovative drug catalogue are not paid, and are not included in the basic medical insurance self-rate index of designated medical insurance institutions and the scope of monitoring of alternative varieties selected from the collection. Innovative drug application cases in the commercial insurance innovative drug catalogue within the scope of relevant commercial health insurance coverage may not be included in the scope of medical insurance payments by disease type and paid after review and review procedures. Health insurance departments in various provinces can explore and support designated medical insurance retail pharmacies to equip drugs from the commercial insurance innovative drug catalogue, and do a good job of monitoring the terminal prices of medical institutions and retail pharmacies. Support regions that are in a position to do so to connect the availability of drugs in the commercial insurance innovative drug catalogue into the “Medicare Drug Cloud Platform”. Encourage real-world health insurance comprehensive value evaluations for drugs that are in a position to do so.