Source: Xinhua
Editor: huaxia
2025-12-10 21:45:30
BEIJING, Dec. 10 (Xinhua) -- Treatments for complex illnesses like Alzheimer's and leukemia may not be so financially intimidating for Chinese patients in the future. The country's first commercial insurance innovative drug catalog, released on Sunday, offers easier access to effective drugs that are often new in the market and priced higher.
Notably, the catalog has included Lecanemab and Donanemab, two specific remedies for Alzheimer's that were successively approved for market release in China last year, renewing hope for patients who are often deterred by the exorbitant costs of these medications.
Another standout on the list is axicabtagene ciloleucel, a CAR-T cell therapy primarily used to treat leukemia. As China's only approved CAR-T drug for clinical use, it previously commanded a staggering price tag of over 1 million yuan (approximately 141,337 U.S. dollars) per dose.
"The catalog incorporated 19 drugs, encompassing targeted tumor drugs, medications for rare diseases like Gaucher disease, and treatments for Alzheimer's," said Huang Xinyu, an official with the National Healthcare Security Administration (NHSA). "It serves as a supplement for the basic medical insurance system."
In recent years, China has significantly bolstered its support for the development of innovative drugs, accelerating the approval process for new medications and expanding the inclusion of cutting-edge pharmaceuticals in its basic medical insurance catalog.
Concurrently, the nation's commercial health insurance sector has witnessed rapid growth, fueled by rising household incomes and an increasing awareness of the importance of health insurance coverage, thereby enhancing accessibility to costly medical treatments.
A white paper released this year estimates that in 2024, China's innovative drug sales market reached approximately 162 billion yuan, with commercial health insurance covering roughly 7.65 percent of that total.
Industry insiders see the commercial insurance list of innovative drugs, which will take effect on Jan. 1, 2026, as a renewed sign of government endorsement of such medications and expect it to foster a mutually beneficial arrangement for patients, pharmaceutical firms, and insurers alike.
They say the list will enable patients to access high-cost medications more conveniently, receive reimbursement, and boost the appeal of commercial health insurance products.
"The policy will also significantly encourage pharmaceutical companies to allocate more resources toward pioneering innovation and differentiated R&D," said Lyu Lulu, chief executive officer of Juventas Cell Therapy Ltd., a biopharmaceutical company focusing on the R&D and commercialization of innovative drugs.
The NHSA has pledged to facilitate the rollout of the catalog, which will ease hospitals' concerns about prescribing innovative drugs.
"Physicians can now prescribe these medications within hospitals and process claims through commercial insurance," said Wei Li, director of the insurance research institute at Beijing-based Renmin University of China.
Experts have also raised concerns about the challenges faced by insurance companies, proposing the establishment of a mechanism to negotiate prices jointly and involve reinsurance companies to enhance price control.
"Innovative drugs typically have a short time on the market, and due to the lack of historical claims data, accurately predicting claims costs is quite challenging," said a manager of New China Life Insurance.
The manager suggested that insurance companies refine the liability and claims structures of their medical insurance products, develop products for individuals with pre-existing conditions and chronic diseases, and actively integrate into the broader health industry chain.
Wang Jian, vice dean of the Dong Fureng Institute of Economic and Social Development, Wuhan University, said it is essential to break down data barriers and make insurance claims a full-process service, ensuring that innovative drug coverage is "truly accessible, claimable, and well-managed." ■