Core Insights - The national medical insurance work conference emphasized the support for the development of commercial health insurance by 2026, aiming to establish a multi-tiered medical security system and promote the "医保+商保" one-stop settlement service for innovative drug products [1][4] Group 1: Policy and Implementation - The first edition of the "Commercial Health Insurance Innovative Drug Directory" includes 19 high-value drugs, focusing on advanced therapies and rare diseases, set to be implemented on January 1, 2026 [1][2] - The release of the directory marks a significant step for commercial health insurance in addressing the accessibility and affordability of innovative drugs, although challenges remain in translating the directory into marketable insurance products [2][3] Group 2: Challenges for Insurance Companies - Insurance companies face three main challenges: pricing, risk control, and compliance, particularly in obtaining accurate data from pharmaceutical companies and hospitals for effective pricing models [3][5] - The inclusion of Alzheimer's disease treatments in the directory raises concerns about adverse selection risks, necessitating strict eligibility review mechanisms to mitigate potential high payout risks [3][6] Group 3: Data Sharing and Settlement - The "医保+商保" one-stop settlement aims to break down data silos, facilitating data sharing to enhance claims processing and improve patient experience [4][5] - Concerns exist regarding the transparency of the settlement process, as a "black box" approach could hinder compliance with regulatory data reporting requirements [5][6] Group 4: Investment in Innovative Drugs - The policy encourages insurance funds to invest in the upstream of the pharmaceutical industry, positioning them as "patient capital" for innovative drug development [6][7] - Major insurance companies are already investing in health industry funds, supporting numerous innovative drug companies, although they remain cautious due to the high risks associated with drug development [7][8] Group 5: Future Outlook - There is potential for insurance companies to become shareholders in large pharmaceutical groups to mitigate investment risks, while maintaining a cautious approach towards smaller innovative firms [8]