The new version of the national medical insurance drug catalog has been announced, with 91 new innovative drugs included, accounting for a relatively high proportion
2024-11-29
On November 28th, the National Medical Insurance Administration held a press conference to introduce the adjustment of the 2024 National Medical Insurance Drug Catalog and officially released the "National Basic Medical Insurance, Work Injury Insurance, and Maternity Insurance Drug Catalog (2024)" (hereinafter referred to as the "new version of the medical insurance catalog"). The new version of the medical insurance catalog will officially come into effect on January 1, 2025. Out of the 117 drugs outside the catalog that participated in negotiations/bidding this year, 89 were successfully negotiated or bid, with a success rate of 76%. Additionally, 2 drugs selected through national centralized procurement were directly included. Therefore, a total of 91 new drugs were added to this adjustment; At the same time, this adjustment also included 43 drugs that have been replaced clinically or have not been produced or supplied for a long time. After this round of adjustment, the total number of drugs in the national medical insurance drug list reached 3159, including 1765 western medicines and 1394 traditional Chinese patent medicines and simple preparations. At the press conference, Huang Xinyu, Director of the Medical Management Department of the National Medical Insurance Bureau, stated that the bureau has carried out adjustments to the list of medical insurance drugs for seven consecutive years, forming a normalized, standardized, and scientific adjustment mechanism. Enterprises have more objective and rational expectations for drug prices; At the same time, with more new drugs entering the catalog, the level of benefit for patients will steadily increase, and it will also effectively boost the confidence of the pharmaceutical industry to increase research and development innovation, which is conducive to better promoting economic and social development. The main theme of the new version of the medical insurance catalog is still "ensuring basic needs", which is expected to reduce the burden on patients by more than 50 billion yuan next year. From the perspective of drug prices, "ensuring basic needs" is still the main theme. From the perspective of included varieties, of the 91 drugs newly added in this adjustment, 26 drugs were used for tumors (including 4 rare diseases), 15 drugs were used for chronic diseases such as diabetes (including 2 rare diseases), 13 drugs were used for rare diseases, 7 drugs were used for anti infection, 11 drugs were used for traditional Chinese patent medicines and simple preparations, 4 drugs were used for mental diseases, and 21 drugs were used for other fields. According to Huang Xinyu, on the basis that the medical insurance fund can afford, the new version of the medical insurance catalogue included more drugs with better cost performance, so as to achieve "quality improvement without price increase". Combined with the dual factors of negotiating price reductions and medical insurance reimbursements, it is expected to reduce the burden on patients by over 50 billion yuan next year. Regarding the background of the adjustment of the new version of the medical insurance directory, Wang Guodong, Deputy Director of the Medical Insurance Center of the National Medical Insurance Bureau, stated that the bureau has made multiple optimizations in terms of procedural rules, evaluation and calculation, ensuring the openness, transparency, fairness and impartiality of the adjustment work. During the evaluation stage, the National Healthcare Security Administration organized experts to conduct a strict review of the declared drugs, fully considering factors such as clinical value, safety, and economy of the drugs. During the negotiation phase, the National Healthcare Security Administration conducted multiple rounds of communication and negotiation with the enterprise, ultimately determining a reasonable payment standard. In addition, the National Healthcare Security Administration has strengthened the construction of information systems, relying on a unified national healthcare information platform to achieve information management of the entire process of application, review, negotiation, etc., greatly improving work efficiency. The release of the new catalog will also help further optimize the expenditure structure of the medical insurance fund and improve the efficiency of the use of medical insurance funds. Through negotiation and price adjustment mechanisms, the prices of drugs in the new version of the catalog are more reasonable and cost-effective. This will help reduce waste and unreasonable expenditures in the medical insurance fund, ensuring that every penny is spent wisely Wang Guodong said. In addition, the new catalog also pays special attention to the rigid constraints on fund expenditures. During the negotiation of the base price calculation stage, a reasonable fund budget was determined and used as a "hard constraint" for adjusting the directory. For drug varieties with high costs and large fund expenditures, the new version of the catalog has appropriately increased the price reduction range, fully reflecting the principle of "quantity for price". These measures will help ensure the smooth operation and sustainable development of the medical insurance fund. The success rate of negotiations for the inclusion of 38 "globally new" innovative drugs exceeds 90%. Among the 91 new drugs added to the new version of the medical insurance catalog, 38 are "globally new" innovative drugs (i.e. the world's first innovative drugs). The success rate of innovative drugs during the negotiation phase exceeded 90%, which is 16 percentage points higher than the overall success rate. Many "global new" innovative drugs are independently or collaboratively developed by Chinese companies. Regarding this, Huang Xinyu stated, "During the process of directory adjustment, the National Healthcare Security Administration has always insisted on supporting 'true innovation', and through mechanisms such as negotiation admission and price adjustment, has encouraged pharmaceutical companies to increase research and development investment, actively promote new drug research and innovation." Among the drugs newly included in the medical insurance directory, there are 65 drugs from domestic enterprises, accounting for more than 70%, involving many listed companies such as Hengrui Pharmaceutical, BeiGene, Yunding Xinyao, Xiansheng Pharmaceutical, Kangfang Biotechnology, Renfu Pharmaceutical, Xinda Biotechnology, and Yasheng Pharmaceutical. Among them, innovative drugs account for a relatively high proportion. From the drugs included in the new version of the directory, the innovative achievements of domestic pharmaceutical companies occupy a significant position, such as Kangfang Biotechnology's card. Du Nili and Yi Woxi, as well as BeiZeAn and BeiYueZe from BeiGene, All of them are innovative drugs independently developed by domestic pharmaceutical companies. In addition, innovative drugs from multiple multinational pharmaceutical companies have also been successfully included in the new version of the medical insurance catalog. Novartis' innovative drug Feiheda in the field of blood disease treatment has been successfully included in the catalog; Bayer's world's first precision targeted drug for unlimited tumor types, Vitaike, has also been successfully approved for medical insurance. These multinational pharmaceutical companies have expressed their willingness to actively respond to national policies and help reduce the burden on Chinese patients through price reductions, expanding supply, and other means. At the same time, they will continue to increase their research and development investment in China, introduce more innovative drugs, and meet the diverse needs of Chinese patients. Sanofi's two new drugs for blood transplantation and cardiovascular treatment were included in medical insurance for the first time in less than a year since their commercial launch, which enhances the company's confidence in the Chinese innovative drug market. Sanofi Greater China President Shi Wang said, "We will always be committed to introducing more breakthrough innovative products, actively responding to national policies, exploring diverse ways to improve drug accessibility, and making innovative achievements benefit a wider range of Chinese patients." From a commercial return perspective, entering the medical insurance catalog is an important opportunity for innovative drugs to open up the market. According to data from the National Healthcare Security Administration, in the past six years, 446 new drugs have been added through healthcare insurance negotiations. During the agreement period, the cumulative expenditure of the healthcare insurance fund exceeded 340 billion yuan, benefiting 800 million people and driving the total sales of related drugs to nearly 500 billion yuan. Further expanding the coverage of cancer and rare disease patients is expected to benefit from the new version of the medical insurance catalog, which not only expands the types of drugs in the medical insurance catalog, but also provides patients with more diversified treatment options. Especially for those suffering from rare or major diseases, the release of the new catalog undoubtedly brings them more hope and opportunities for treatment. For example, Yunding Xinyao's Nifukang, an innovative pharmaceutical company in the Hong Kong stock market, is the world's first IgA nephropathy treatment drug. Its inclusion in the new catalog will enable more Chinese IgA nephropathy patients to have the opportunity to access this innovative drug and obtain substantial therapeutic benefits from it. In addition, the inclusion of Hengrui Pharmaceutical's fumarate Taijilide injection, Otconazole capsules and other drugs has further improved the medication security level of relevant patients. Xia Yu, Chairman of Kangfang Biotechnology, told reporters: "Being included in the medical insurance catalog will greatly improve the accessibility of drugs, reduce the burden on patients, and encourage more patients to benefit from truly globally leading drugs. Kangfang Biotechnology's drugs have been included in the new version of the medical insurance catalog, further strengthening the company's confidence in pursuing innovative development at the source. In addition, the new catalog also pays special attention to the protection of children's medication and rare disease medication. By incorporating children's rare disease medications such as Chlorpheniramine tablets into Renfu Medicine, as well as adding multiple rare disease medications, the new catalog significantly improves the medication status of these special patients and effectively reduces their economic burden. At the same time as adding new drugs, the new version of the catalog has also removed some drugs with low clinical value and strong substitutability. A total of 43 drugs were withdrawn this time, including some varieties that have not been produced or supplied for a long time or have been clinically replaced. Through this "in and out" dynamic adjustment mechanism, the structure of the medical insurance drug catalog has been further optimized, and the level of protection has been significantly improved. Especially in the treatment fields of tumors, chronic diseases, rare diseases, etc., the inclusion of new drugs will effectively alleviate the problem of difficult and expensive medication for patients. Industry insiders told reporters that the release of the new catalog will further accelerate the transformation and upgrading of the pharmaceutical industry. As more and more innovative drugs are included in the medical insurance catalog, traditional generic drug companies will face greater market competition pressure, which will force them to increase research and development investment, promote product upgrades and transformations. In the long run, this will help enhance the innovation capability and international competitiveness of the entire pharmaceutical industry. (New Society)
Edit：Yao jue Responsible editor：Xie Tunan
Source：Securities Daily
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