Medical insurance drugs affect thousands of households. The latest version of the medical insurance drug catalog has been officially implemented on January 1, 2026. What are the new highlights of this adjustment? What benefits does it bring to insured individuals? The National Healthcare Security Administration provided an interpretation on the 7th. Focusing on urgent clinical needs, the number of Class 1 new drugs has reached a new high - the catalog has added 114 new drugs, of which 50 are Class 1 new drugs. Both in terms of proportion and quantity, they have reached a new historical high. ”Huang Xinyu, Director of the Medical Service Management Department of the National Medical Insurance Administration, said. The newly added drugs cover tumors, rare diseases, chronic diseases, etc. A number of new drugs that have attracted much attention have been successfully "insured": such as Lukang Shatuozhu, which is used to treat triple negative breast cancer, Irinotecan liposome, which is used to treat pancreatic cancer; Long acting growth hormone injections used to improve slow growth in children caused by endogenous growth hormone deficiency; Two hypolipidemic needles a year, Inksram sodium, diabetes drug Tilpolide and other new drugs; Flu medications such as anladevir tablets and marsupiravir tablets. The payment scope has been further expanded, and "life-saving drugs" are faster and more accessible - there have been new changes in the payment scope for 65 types of drugs. Through sorting, it can be found that many new indications for drugs have been included in the payment scope, such as the addition of two new targets for the treatment of non-small cell lung cancer with Amitinib tablets, the expansion of the treatment of rare disease narcolepsy with telmisartan hydrochloride tablets to patients aged 6 and above, and the addition of endometriosis to triptorelin. Eligible insured persons can enjoy relevant benefits. For the convenience of clinical medication, drugs such as Topafegliptin injection used to increase white blood cell count have had their payment scope adjusted from "previous chemotherapy" to "previous chemotherapy", which is more in line with clinical practice. Some centrally purchased drugs have also had their payment scope marked and can be paid according to the drug instructions. In response to the risk of abuse of a few drugs, the catalog has added restrictions, such as clarifying that niacinamide can only be reimbursed to patients with niacinamide deficiency, ensuring that medical insurance funds are used effectively. The payment scope for some drugs has been reduced to include non core restricted content, but it does not change the medication requirements. For example, "on the basis of exercise and diet control" has been deleted for the use of smeglutide in diabetes. After adjustment, clinicians still need to use drugs according to the drug instructions. Dynamically 'reviewing the old and introducing new', with a more reasonable directory structure -29 drugs have been retrieved, all of which are drugs that have been clinically eliminated or have not been produced or supplied for a long time. This includes 8 negotiation drugs that were not successfully renewed and brought out of the list, including benazepril injection, danorevir sodium tablets, ravidawir hydrochloride tablets, aleximumab injection, dovalizumab capsules, octafluoropropane lipid microsphere injection, Ganlute sodium capsules, and loprolizumab tablets. In order to ensure the continuity of medication for insured persons, the National Healthcare Security Administration has set a transition period policy. During this adjustment, there is a 6-month transition period for negotiated drugs within the agreement period that were not successfully renewed and were removed from the list. By the end of June 2026, insured persons who purchase these drugs can still be reimbursed according to the original reimbursement standards. At present, the WeChat official account of the National Health Insurance Bureau has launched the new basic medical insurance directory query function. The insured can access the WeChat official account of the "National Medical Insurance Bureau", click "Medical Insurance Service", and select "Basic Medical Insurance Directory Query". (New Society)
Edit:He Chuanning Responsible editor:Su Suiyue
Source:Xinhua
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