新规下“惠民保”迎差异化定价变革，业内聚焦竞争格局调整与突破

Core Viewpoint - The development pattern of "Hui Min Bao" products, as an important carrier for multi-level payment of innovative drugs and medical devices in China, is set to undergo significant adjustments [1][2]. Group 1: Regulatory Changes - The National Financial Supervision Administration issued a notice on July 31 to further standardize the business model of urban customized commercial health insurance, emphasizing scientific premium setting and differentiated pricing principles [2]. - Insurance companies are required to base premium rates on reliable historical data regarding disease incidence, payout rates, and cost rates, ensuring fairness and adaptability in products and services [2]. Group 2: Market Trends - The scale of medical insurance premiums has been growing, with the scale surpassing critical illness insurance in 2024, indicating a significant boost from "Hui Min Bao" for insurance companies in the medical sector [3]. - In 2024, there were 173 "Hui Min Bao" products operating across 30 provinces, with an average operational time of 3.6 years, and the premium scale reached 20 billion yuan [3]. Group 3: Industry Collaboration and Product Development - There is a need for better collaboration between pharmaceutical companies and insurance providers to develop specialized insurance products for innovative drugs and medical devices [5]. - The establishment of a selection mechanism for innovative drugs based on clinical value is essential, along with exploring innovative payment methods linked to clinical outcomes [5]. Group 4: Future Directions - The focus will be on designing insurance products for individuals with pre-existing conditions and enhancing patient service experiences [3][4]. - The integration of innovative drugs into insurance product directories should not lead to price competition but rather promote a fair distribution of benefits among stakeholders [4].