增设商保创新药目录，健康险承接医保外用药空间

Core Insights - The establishment of the Commercial Health Insurance Innovative Drug Directory (referred to as "Commercial Drug Directory") is a significant change aimed at clarifying the boundaries of basic medical insurance and providing more development space for commercial health insurance [1][2]. Group 1: Policy Changes - The new measures introduced by the National Healthcare Security Administration and the National Health Commission emphasize the need for a multi-tiered medical security system, which includes the Commercial Drug Directory focusing on high-innovation, clinically valuable drugs that exceed basic insurance coverage [1][2]. - The Commercial Drug Directory will not be included in the self-pay rate indicators of basic medical insurance or monitored for alternative products in centralized procurement [1][3]. Group 2: Market Opportunities - The introduction of the Commercial Drug Directory is expected to expand the "coverage boundary" for commercial health insurance, allowing it to evolve from merely supplementing basic insurance to independently covering innovative drugs [2][4]. - The commercial health insurance sector is projected to see significant growth, with the total compensation for innovative drugs reaching 12.4 billion yuan, reflecting a compound annual growth rate of 103% over the past three years [4]. Group 3: Industry Dynamics - The shift from a directory nature to a "recommended list" for the Commercial Drug Directory indicates that commercial insurance companies may no longer directly participate in the directory formulation, which could lead to the cancellation of intended price negotiations [3][4]. - The new policy encourages commercial health insurance to expand its investment in innovative drugs, potentially creating a stable long-term investment environment for drug development [6][5]. Group 4: Future Directions - The measures aim to enhance the integration of basic medical insurance and commercial health insurance, creating a collaborative effort to support public health and provide economic backing for innovative drugs [5][6]. - The commercial health insurance industry is encouraged to explore new product directions, such as outpatient coverage and digital health management, to transition from a "cost reimbursement" model to a "health value" model [5][6].