Economic Observer reporter Liu Xiaonuo

From September 5th to September 8th, the negotiation bidding for the 2026 basic medical insurance catalog will be held at the National People's Congress Conference Center; On the 9th, the price negotiation for the commercial insurance innovative drug catalog came to an end.

In this national negotiation, a total of 124 drugs outside the catalog were shortlisted for the bidding stage, involving hundreds of domestic and foreign enterprises; A total of 12 drugs have entered the price negotiation for the commercial insurance innovative drug catalog.

In the eyes of business people, the annual national medical insurance negotiation rules have gradually become more perfect. However, the representatives outside the venue remained on high alert, with only 5 minutes left before the start of the negotiations. Some people still gathered under trees, pressing calculators and holding tables to discuss the price reduction ratio.

This medical insurance negotiation has added pre declaration rules, allowing some innovative drugs that were launched later to apply for this year's medical insurance catalog. Enterprises can also apply for the basic medical insurance catalog for drugs included in the commercial insurance innovation drug catalog. For the first time, CAR-T enterprises have entered the negotiation stage. Previously, they were stopped at the formal review of basic medical insurance negotiations due to the cost of millions of yuan.

The new version of the directory is expected to be released in November 2026 and officially implemented on January 1, 2027.

On the morning of September 9th, representatives took a group photo outside the venue to commemorate the occasion

12 drugs discussed for commercial insurance

At around 7:40 am on the 9th, the staff of the Medical Insurance Bureau read out the names of 11 companies. After verifying their identities on site, they entered the price negotiation site of the commercial insurance innovative drug catalog.

We feel that it is still not easy for rare disease drugs to enter basic medical insurance. The innovative drug catalog of commercial insurance can provide products with an additional opportunity for commercialization, "said a business person before entering." The government designed this policy, so we will use it

In 2026, the second price negotiation will be conducted for the Shangbao Innovative Drug Catalog. In 2025, the National Healthcare Security Administration launched the first price negotiation for the commercial insurance innovative drug catalog. A total of 121 drugs passed the formal review, 24 drugs participated in the specialized negotiation, and ultimately 19 drugs were successfully negotiated.

In 2026, a total of 62 drugs applied for the commercial insurance innovative drug catalog, of which 58 passed the formal review. According to CCTV News, a total of 12 drugs were shortlisted for on-site price negotiations, with fewer quantities than last year.

Among these varieties, there are several cell and gene therapy drugs that cost over one million yuan to treat serious diseases. Keji Pharmaceutical (02171. HK) brings the world's first solid tumor CAR-T; Hengrun Dasheng and Precision Biosciences have applied for their respective CAR-T for hematological malignancies; Faith Medicine has once again applied for the development of its first AAV gene therapy drug in China - Popadakoji Injection.

Some previously highly anticipated varieties, although passing the formal review, did not enter the negotiation stage, such as the three new DORA insomnia drugs approved in 2025-2026.

Since the implementation of the Shangbao Innovative Drug Catalog one year ago, various entities such as enterprises have encountered multiple bottlenecks and are still exploring how to implement it in compliance. For example, in the negotiation of the commercial insurance innovative drug catalog, enterprises need to negotiate prices with insurance companies and other entities on site, which is equivalent to determining discount prices for insurance companies. However, in practice, how to compliantly return the discounts to the insurance companies is a major challenge. What is the attractiveness of the commercial insurance innovative drug catalog for enterprises?

During the waiting period for the results, business person Li Yu stated that they value the favorable policies that drugs can enjoy after entering the commercial insurance innovative drug catalog, such as the "three exclusions": not included in the basic medical insurance self payment rate indicator, not included in the monitoring of alternative varieties for centralized procurement, and not included in the medical insurance coverage scope after review and evaluation, and can be paid according to the disease type. She also heard that other companies have found a pathway for compliant return ratios and are almost paving the way for implementation. There is still a chance to land in the future, so we also want to give it a try, "said Li Yu.

She believes that a rule change in 2026 may also give companies more motivation to apply: drugs that have been included in the "Catalogue of Innovative Drugs for Commercial Health Insurance (2025)" can be applied for inclusion in the basic medical insurance catalogue.

Thanks to this policy, CAR-T companies will appear for the first time in the 2026 basic medical insurance negotiations. On the morning of September 6th, Heyuan Biotechnology and WuXi AppTec (02126. HK) entered the negotiations for their respective CAR-T drugs, both led by their CEOs. The CAR-T products of these two companies are priced at 990000 yuan per unit and 1.29 million yuan per unit respectively. They have previously applied for the basic medical insurance catalog for their products several times and have been stuck in the formal review stage.

At around 9 o'clock that day, the delegation of Heyuan Biotechnology was the first to end the negotiations. They wore masks and looked cautious. About 50 minutes later, the team of Yao Ming Ju Nuo quickly left after the negotiation ended, responding to the media with a smile.

Li Yu believes that in the past, there was an implicit threshold of "not talking about 500000 yuan" in medical insurance, but entering the list of innovative drugs in commercial insurance can cross this threshold. In the future, drugs in the commercial insurance innovation drug catalog may also enjoy such policy benefits - but this does not mean that companies can negotiate successfully, as there is still a threshold of "300000 yuan not allowed".

With the same policy, two star drugs for Alzheimer's disease, namely Eisai's lencanazumab and Eli Lilly's donenumab, have also passed the basic medical insurance form review.

Pre application for inclusion in the world's first star drug

From September 5th to 8th, the basic medical insurance negotiations lasted for three and a half days.

Since the first day of negotiations, many leading companies such as Hengrui Pharmaceutical (600276. SH/01276. HK), Xinda Biotechnology (01801. HK), BeiGene (688235. SH/06160. HK/ONC. NASDAQ), Kelun Botai (06990. HK), Baili Tianheng (688506. SH), Zhengda Tianqing, and Shiyao Group (01093. HK) have appeared intensively, with some companies bringing multiple varieties. More than a dozen multinational pharmaceutical companies, including AstraZeneca, Pfizer, Roche, Novartis, have also appeared multiple times.

Xinda Biotechnology aims to strive for multiple innovative drugs in Class 1.1 to be included in medical insurance. In addition to the hypoglycemic indication of the GCG/GLP-1 drug, Masidu Peptide Injection, two new drugs from Xinda Biotechnology in the fields of skin and oncology have passed formal review. Hengrui Pharmaceutical also has three Class 1.1 innovative drugs approved in the first half of the year that have passed formal review, including two oncology drugs and one gout drug.

One of the most obvious policy adjustments in the 2026 medical insurance negotiations is to allow "pre declaration", which allows companies to apply for the basic medical insurance catalog for drugs that have basically completed the technical review of the drug regulatory bureau, as long as they supplement the drug registration approval within the prescribed time.

Both Baili Tianheng's Lenconazole monoclonal antibody and Keji Pharmaceutical's Shuruiqiolongsai have utilized the "pre declaration" policy. According to the work plan of the National Healthcare Security Administration, the deadline for application is June 10th. Both of these globally pioneering drugs were officially approved on June 22nd, but they have separately applied for the 2026 basic medical insurance catalog and the commercial insurance innovative drug catalog, so there is no need to wait for the following year's application.

The idea of supporting innovation by the Medical Insurance Bureau is very clear. "A corporate executive said that their products are included in the national encouraged generic drug catalog, but the price negotiated by the medical insurance is" not polite at all ", exceeding the expectations of the company. Moreover, the company only has two opportunities to quote, and they are eliminated for every penny higher." They almost do not give you the 'soul exchange' segment of coming and going and fighting wits.

He learned that for products with high innovation value, medical insurance negotiations are relatively gentle. In addition, when it comes to innovative drugs, the medical insurance bureau will also give priority to drugs that can truly prolong life or solve clinical pain points.

The 2026 medical insurance negotiations will be advanced to early September, compared to the previous two years which were at the end of October or early November. 2026 is almost two months earlier than previous years. The National Healthcare Security Administration stated in its interpretation activity in May that this is to provide necessary preparation time for the implementation of the directory after its release, as well as for the connection between commercial insurance and other related matters.

Many business people believe that due to the earlier time, the preparation for this negotiation is indeed more rushed than in previous years, but the subsequent work preparation will be slightly more relaxed. A company participating in the discussion of the commercial insurance innovative drug catalog stated that if it is successfully approved, the company's commercialization team can negotiate with the insurance company in advance.

Yin Jinqun, director and vice president of Kanghong Pharmaceutical (002773. SZ), has been involved in medical insurance negotiations since 2017. His biggest feeling this time is that the rules of medical insurance negotiations are becoming clearer and more professional. He remembers that in 2017, many rules for medical insurance negotiations were still being explored and improved, and how some indicators were calculated had not yet been made public. Both sides of the negotiation were experiencing it for the first time, and the on-site encounter was completely "back-to-back". The requirements for negotiation representatives' on-site adaptability, negotiation ability, professional nutrition, and willpower were higher.

Yin Jinqun said that in 2022, the National Healthcare Security Administration released standard calculation methods such as A value and B value, and in 2026, it added communication and pre negotiation mechanisms for reference drug applications before formal negotiations. "Transparency, technicality, and institutionalization are becoming stronger, and the expectations of both parties will be closer, which may increase the efficiency and success rate of formal negotiations.

Reference drugs are drugs used for comparison when evaluating the price of new drugs. In 2026, the National Healthcare Security Administration established a separate reference drug pre communication link for Class 1 new drugs, and conducted two batches of reference drug pre communication in advance from April to June, involving a total of 59 drugs (times).

However, at the negotiation site, it is inevitable that some people are happy while others are worried. Some business representatives burst out laughing as soon as they left the house, while others exclaimed, "Finally, I can take a vacation." There were also representatives in suits and leather shoes who put on helmets, stepped onto electric bikes, and leisurely entered the early autumn of Beijing.

After waiting outside for several hours, some people cheered and ran to the fence to record a video for their representatives. However, the representatives frowned and shook their heads, and the atmosphere quickly became low. The group left silently.

Another company representative looked at the road and murmured, "We can't accept this price..." His colleague interrupted him, "But didn't you accept it in the end

(Li Yu is a pseudonym)