By Fineline Cube 
The National Healthcare Security Administration (NHSA) released the 2025 National Medical Insurance Drug List and Commercial Insurance Drug List, adding 114 drugs to the medical insurance directory and 19 to the commercial insurance directory. The new lists take effect January 1 2026, with specific implementation guidelines for medical institutions and insurance reimbursement rules.
Key Numbers: 2025 Drug List Updates
| List Type | Drugs Added | Implementation Date | Notable Changes |
|---|---|---|---|
| Medical Insurance Directory | 114 | 01 Jan 2026 | 98 Western drugs via negotiation, 7 TCMs via negotiation, 7 Western via bidding, 2 from centralized procurement |
| Commercial Insurance Directory | 19 | 01 Jan 2026 | Separate reimbursement track; not counted in basic insurance self-pay ratio |
| Time from Approval to Inclusion | 1 year 5 months (average) | — | Faster than historical 2‑year average |
Implementation Guidelines for Medical Institutions
Procurement Requirements:
- Pharmacy committee meetings must be convened by end‑of‑February 2026
- Institutions must adjust drug procurement or establish temporary green channels
- Negotiated drugs exempt from “one‑product, two‑specification” limits
- Access barriers prohibited: No hindrance due to医保budget limits, formulary size restrictions, or drug expenditure ratio caps
Regional Encouragement:
- All regions encouraged to promote connection with designated medical institutions and pharmacies
- Support for integrating Commercial Insurance Directory stocking into “Medical Insurance Drug Cloud Platform”
Commercial Insurance Directory: Key Provisions
| Provision | Details |
|---|---|
| Reimbursement Status | Medical insurance funds will not reimburse these drugs |
| Monitoring Exclusion | Not counted in basic medical insurance self‑pay ratio indicator |
| Procurement Scope | Not included in national centralized drug procurement monitoring |
| DRG/Payment Method | Application cases covered by commercial health insurance may be excluded from DRG/bundled payment after audit |
| Pharmacy Stocking | Provincial医保departments can explore supporting retail pharmacies to stock Commercial Insurance Directory drugs |
Drug Breakdown & List Changes
114 Medical Insurance Drugs Added:
- 98 Western drugs: Via negotiation
- 7 Traditional Chinese Medicines (TCMs): Via negotiation
- 7 Western drugs: Via competitive bidding
- 2 drugs: Directly transferred from National Centralized Drug Procurement
56 drugs: Converted from negotiated/competitive-bid to routine access status
25 drugs: Removed from routine list
4 drugs: Specifications reduced on routine list
Forward-Looking Implementation Measures
- Real-world evaluations: Conditional drugs encouraged to conduct comprehensive value evaluations for medical insurance
- One-stop settlement: Conditional regions encouraged to explore integrated settlement for medical insurance, work-related injury insurance, and commercial insurance
- Price monitoring: Provincial departments to monitor end-user prices at both medical institutions and retail pharmacies
Forward‑Looking Statements
This brief contains forward‑looking statements regarding implementation timelines, insurance reimbursement impacts, and pharmaceutical market dynamics. Actual outcomes may differ due to regional execution variations, policy adjustments, and market adoption rates.-Fineline Info & Tech