China Insurance Association Completes Drug Selection for Commercial Insurance List; NHSA to Expand Innovative

The system for commercial insurance payment for innovative drugs is being accelerated. The "commercial insurance drug list" promoted by the China Insurance Association under the National Financial Regulatory Administration has completed preliminary drug selection and is awaiting release. This list differs from the commercial insurance innovative drug list previously launched by the National Healthcare Security Administration (NHSA) and is mainly designed to connect with various pure commercial health insurance products, such as million-yuan medical insurance. In 2026, the NHSA's commercial insurance innovative drug list will expand for the first time, and the NHSA has added a condition that newly included innovative drugs must have "strong insurance suitability."

The number of drugs submitted for the 2026 commercial insurance innovative drug list is less than half of the number submitted for 2025. After the first version of the commercial insurance innovative drug list was implemented, some innovative drugs faced challenges in their use in Huiminbao products. For example, from 2025 onwards, many innovative drugs were included in local Huiminbao special drug lists before the start of national medical insurance negotiations, but the discount range (15% to 50%) of the commercial insurance innovative drug list and the discount rebate channels were not fully connected, affecting the actuarial models of Huiminbao. In addition, for Alzheimer's disease treatments, lecanemab injection has been included in at least 12 local Huiminbao products, and donanemab injection has entered at least 5 products. In 2026, both drugs entered the national medical insurance list. The same year, four other Alzheimer's disease-related drugs appeared on the formal review list of the commercial insurance innovative drug list, but they were not explicitly included in local Huiminbao products.

In June 2026, the China Insurance Association convened several pharmaceutical companies for exchanges, with commercial insurers such as PICC, China Life, and Ping An participating in cooperation. Currently, the drug guarantee list being drafted by the association has taken shape, aiming to provide insurers with a reference for connecting drugs and the medication needs of target customers, thereby promoting the standardization of commercial insurance drug lists. In 2021, the former China Banking and Insurance Regulatory Commission issued guidance proposing to explore the establishment of commercial health insurance drug lists and diagnosis and treatment item lists. In 2022, the Insurance Association of China took the lead in launching related research. In 2025, the NHSA announced the release of the first version of the commercial insurance innovative drug list within the year, and the same year the Insurance Association restarted its push to formulate the commercial insurance drug list. As China's pharmaceutical innovation accelerates, innovative drug companies are increasingly eager to use commercial health insurance as a channel to realize value in the domestic market.