多款救命药有望商保报销 保费怎么定是关键

Core Insights - The National Healthcare Security Administration (NHSA) has released a list of drugs that passed the preliminary review for the commercial insurance innovative drug directory, which is a new supplement to the basic medical insurance directory aimed at covering high-priced drugs [2][3] - A total of 121 drugs have passed the initial review, with over half being cancer or rare disease medications, including several high-cost therapies [2][5] - The final commercial insurance innovative drug directory is expected to be published between October and November 2023, following expert evaluations and price negotiations [2][3] Summary by Category Drug Characteristics - The drugs included in the commercial insurance innovative drug directory are characterized by high innovation, significant clinical value, and substantial patient benefits, exceeding the basic insurance's "basic protection" scope [2] - Among the 121 drugs, 57 are imported, accounting for 47%, with notable entries from companies like Pfizer, Johnson & Johnson, and Merck [5] Pricing and Negotiation - The drugs will undergo price negotiations, which may lead to price reductions, but the extent of these reductions remains uncertain [9][10] - The commercial insurance innovative drug directory allows for simultaneous applications to both the basic medical insurance and the commercial insurance directories, providing a "double insurance" for companies [7] Market Dynamics - The directory includes a variety of drugs, including CAR-T therapies priced around 1 million yuan per injection, which have faced challenges in entering the basic medical insurance directory [6][9] - The directory's implementation may alleviate payment difficulties for rare disease medications, with companies actively submitting applications [6][8] Insurance Industry Considerations - The insurance industry faces challenges in pricing and market growth potential due to the voluntary nature of commercial insurance participation [9][11] - There is a need for better data integration between commercial insurance and basic medical insurance to enhance pricing strategies and product development [11]