睿智投资|中国医药 - DRG/DIP 2.0版本分组方案公布,持续利好创新

Investment Rating - The report indicates a positive outlook for the healthcare industry, particularly in the context of the DRG/DIP payment reform, which is expected to enhance cash flow for commercial circulation enterprises and support the clinical use of innovative drugs [1][2][3]. Core Insights - The National Healthcare Security Administration has implemented the DRG/DIP 2.0 version, which includes adjustments to groupings that better reflect clinical realities, with a total of 409 core groups and 634 detailed groups [1]. - The report highlights that over 90% of regions in the country have adopted DRG/DIP payment methods, with 26 provinces achieving full coverage within their jurisdictions [1]. - The new policy allows for exceptions in cases of long hospital stays, high medical costs, and the use of innovative drugs and technologies, which will create a more favorable payment environment for innovative drug costs [2]. - The overall settlement cycle for medical insurance funds is expected to shorten, benefiting commercial circulation and pharmaceutical manufacturing companies by accelerating payment collection [1][3]. Summary by Sections - DRG/DIP Payment Reform: The 2.0 version introduces 33 new core groups and 6 new detailed groups, with a focus on high-resource consumption areas. The core disease groups have been reduced from 11,553 to 9,520 [1]. - Implementation Timeline: By the end of 2024, all regions that have not yet adopted DRG/DIP payment methods are required to implement the 2.0 version, while existing regions must prepare for the transition by December 31, 2024 [1]. - Impact on Innovative Drugs: The report emphasizes that the healthcare fund will maintain a supportive payment environment for innovative drugs, allowing for project-based payments or weighted additions during the initial application phase [2].