On December 7, the 2025 High-Quality Development Conference for Innovative Drugs was held in Guangzhou, marking the first time in eight years that the annual drug list was announced outside Beijing. After months of anticipation, the inaugural "Commercial Health Insurance Innovative Drug List" was unveiled: only 19 out of 121 high-value innovative drugs that initially passed formal review made the final cut.

Key highlights include: - Two Alzheimer’s drugs from Eisai and Eli Lilly. - All five CAR-T therapies (each priced at over a million yuan) were included. - Multiple rare disease drugs were added. - Domestic players like BeiGene, CANbridge Pharmaceuticals, and Luye Pharma secured spots.

To recognize the first batch of participants, Zhang Ke, Director of the National Healthcare Security Administration (NHSA), personally awarded certificates on stage—a symbolic gesture reinforcing policy direction.

**Basic Medical Insurance List: A Strong Showing** The basic medical insurance list also saw significant updates, with 114 new drugs added. Huang Xinyu, Director of the NHSA’s Pharmaceutical Management Department, announced each entry individually—a first in the history of the list.

**China’s Innovative Drug Era Arrives** By October 2025, China’s outbound licensing deals for innovative drugs exceeded $100 billion, with upfront payments hitting $8.1 billion—both surpassing 2024’s totals. The NHSA’s eight-year negotiation efforts have driven over 600 billion yuan in sales for listed innovative drugs.

However, the commercial health insurance (CHI) innovative drug list remains in its infancy. In 2024, city-based supplementary insurance (e.g., "Huiminbao") contributed only 1.1 billion yuan to innovative drug payments—a drop in the ocean for a near-trillion-yuan market.

**Winners and Losers** The 2025 NHSA negotiations signaled a structural shift, with 50 first-in-class drugs (44% of new additions) making the list—a record high. Yet competition was fierce: only 114 of 534 submitted drugs (21% success rate) were included.

Notable exclusions: - PCSK9 inhibitor alirocumab (discontinued in China). - Controversial Alzheimer’s drug GV-971 (production halted due to lapsed license). - GSK’s daprodustat and Innovent’s sintilimab (failed renewals).

**Multinationals vs. Domestic Players** Unlike their retreat in volume-based procurement, multinationals aggressively pursued the NHSA list: - AstraZeneca led with 3 new drugs and 8 expanded indications. - Roche added 3 new drugs and 7 indications. - Eli Lilly’s tirzepatide (a global blockbuster for diabetes) debuted on the list.

Domestic companies shone brighter: - Hengrui Pharma dominated with 20 drugs/indications (10 new entries). - Innovent Biologics secured 7 spots (6 new). - CAR-T therapies from five Chinese firms all made the CHI list.

**CHI List: A Cautious Start** The inaugural CHI list featured: 1. **CAR-T cluster**: All five domestic CAR-T therapies included, signaling NHSA’s focus on high-value innovation. 2. **Oncology dominance**: 14 of 19 drugs target cancer, led by Bristol Myers Squibb’s ipilimumab ($2.53 billion global sales in 2024). 3. **Breakthroughs in Alzheimer’s and rare diseases**: Eisai’s lecanemab and Lilly’s donanemab both listed.

**Industry Skepticism** Despite excitement, unresolved challenges loom: - CHI covers just 7% of China’s 162 billion yuan innovative drug market (2024 data). - "Huiminbao" contributed only 1.1 billion yuan to innovative drugs last year. - Policy gaps persist in payment models, data sharing, and multi-stakeholder coordination.

As one expert noted, "Rare and chronic disease drugs defy traditional insurance risk models—globally, insurers avoid them." While hopeful, the industry acknowledges the long road ahead to make CHI a true pillar of innovative drug funding.

The 2025 lists mark progress, but the journey to sustainable financing for innovation has just begun.