支付端和需求端利好共振，创新药有望长期向好？

Core Insights - The pharmaceutical industry, particularly the innovative drug sector, is undergoing significant changes in both payment and demand sides after a four-year bear market, leading to a revolution in industrial upgrading [1][2]. Pricing Dynamics - The National Healthcare Security Administration (NHSA) is providing more pricing flexibility for innovative drugs, with price reductions during negotiations narrowing from 60%-80% to around 30% for PD-1 inhibitors, and allowing price retroactivity to cover R&D costs [1][2]. - A new market exclusivity system for innovative drugs grants three to five years of price protection for first-in-class drugs, stabilizing return expectations [1]. Clinical Trial and Approval Process - The approval process for clinical trials for innovative drugs has been expedited, reducing the review period from 60 working days to 30, and the average time for market application approval has been shortened to 235 days, facilitating faster commercialization [2]. Payment System Expansion - The introduction of DRG 2.0 and prepayment systems is expected to alleviate financial pressure on medical institutions, helping maintain stable cash flow between healthcare providers and upstream manufacturers [2]. - The financial support from the government is evident, with 63% of the 2024 resident health insurance contributions coming from fiscal subsidies, which have been consistently above 60% and are increasing annually [2]. Commercial Insurance Development - The development of commercial insurance is crucial for a multi-tiered medical security system, addressing the previous dominance of public health insurance and the tight balance in resident health insurance [3]. - Recent initiatives from the NHSA aim to enhance commercial insurance through data sharing and the establishment of a new innovative drug directory, which could alleviate payment pressures for innovative drugs in the long term [3]. Future Outlook - The synergy between supply-side technological upgrades and demand-side payment reforms is expected to create a positive feedback loop, positioning the Chinese innovative drug industry for sustainable growth and improved fundamentals [3].