Summary of Key Points
Over the past 25 years, the total number of medications included in our country's medical insurance catalog has doubled, increasing from 1,535 in 2000 to 3,253 in 2025. The dynamic adjustment mechanism has become well-established, reducing the time required for innovative drugs to be approved and included in the insurance from five years to one year. Through a negotiation-based inclusion process, many innovative and exclusive drugs have seen their prices reduced, expanding coverage from common illnesses to serious conditions such as cancer and rare diseases. Special attention has also been given to pediatric medications, addressing the issue of having to rely on guessing dosages when administering medicine.
Detailed Analysis
1. Expansion of the Medical Insurance Catalog: A Doubling in Number, with Western Medications Leading the Growth
The number of medications in the catalog (including both western and traditional Chinese medicines) has more than doubled, rising from 1,535 to 3,253 over the 25-year period. It is important to note that the "number" refers to the generic names of these drugs; for example, all manufacturers producing acetaminophen tablets use the same generic name. As of July 2026, the 3,253 catalog entries correspond to 5,890 different generic names, each with multiple brand names and dosage options, providing ample choices for everyday medical needs. Western medications have seen the most significant growth, increasing from 913 in 2000 to 1,857 in 2025, contributing substantially to this expansion.
2. Negotiation-Based Inclusion: Reducing Prices of High-Price Innovative Drugs
Since 2017, our country has engaged in price negotiations with pharmaceutical companies for exclusive and high-priced innovative drugs, resulting in lower prices and their inclusion in the insurance coverage. The number of negotiated drugs has increased from 36 in 2017 to 472 in 2025, making many previously unaffordable medications (such as targeted cancer therapies) available for reimbursement. This has expanded insurance coverage beyond common illnesses like the cold and hypertension to include more severe and challenging conditions, such as cancer and rare diseases. The number of cancer-related drugs has increased from 54 to 219, and rare disease drugs have risen from 39 to 121.
3. Special Focus on Pediatric Medications
Pediatric medications have long faced difficulties due to a lack of specialized formulations. To address this, the Medical Insurance Bureau adds new pediatric-specific drugs annually: 580 in 2017, 76 in 2019, and an average of 25 per year since then. These medications are clearly labeled with indications and dosing instructions for children, ensuring safety when administering them.
4. Accelerated Inclusion of Innovative Drugs: Encouraging Pharmaceutical Research and Development
Previously, it took about five years for innovative drugs to be approved and included in the insurance. Now, this process has been shortened to around one year, allowing patients to access the latest and most effective treatments more quickly. During the 14th Five-Year Plan period, 516 new medications were added to the catalog, 167 of which were innovative drugs (primarily category 1 new drugs, meaning those that are either globally first or domestically leading). The Medical Insurance Bureau's approach aims to motivate pharmaceutical companies to innovate by ensuring that only truly novel and differentiated drugs can be quickly included in the insurance system, thereby encouraging more research and development.
5. Mature Dynamic Adjustment Mechanism: Continuous Addition of New and Better Drugs
The medical insurance catalog is not static but undergoes annual adjustments. Eligible new and better drugs are added through a formal process. In the future, efforts will also be made to integrate with commercial insurance to further reduce the financial burden on patients by making more innovative drugs eligible for reimbursement.
In Summary
The changes in the medical insurance catalog over the past 25 years have primarily aimed to make medications more accessible and affordable for a wider range of people, especially those suffering from serious illnesses, children, and rare diseases. This initiative also promotes innovation among pharmaceutical companies, creating a mutually beneficial cycle that benefits both patients and the industry.