China released the updated 2025 National Reimbursable Drug List (NRDL), effective from January 1, 2025, and the first list of innovative commercial insurance drugs. 91 new drugs were added to the NRDL, increasing the total number to 3,159 drugs[1]. Of these new drugs, 90 were introduced in the last five years, 38 represent global innovations and 65 originate from domestic development in China[1]. The process involved price negotiation for 117 off-list drugs, of which 89 gained listing with an average price reduction of 63%[1][4]. The novelty is category C for high-cost innovative medicines with significant clinical benefits and special valuation[1]. The revision of the NRDL was completed in early December 2025 and includes both Western and traditional Chinese medicines[1][3]. The first list of commercial insurance allows the inclusion of innovative medicines approved by the NMPA from 1 January 2020 to 30 June 2025, including medicines for rare diseases[2]. These changes support access to medicines for 95% of the population through basic health insurance[6][8].