国君医药|分组优化贴近临床,创新支持力度不减

Investment Rating - The report indicates a positive outlook for the industry, particularly for innovative medical products and high-demand categories due to the DRG payment reform [2]. Core Insights - The DRG 2.0 version was released by the National Healthcare Security Administration, which aims to optimize payment grouping and enhance clinical relevance, with a focus on 13 medical disciplines [1]. - The new grouping scheme has improved the grouping efficiency (RIV) to 71%, an increase of 3 percentage points from the previous version, and the inclusion rate has reached 92.8%, up by 1 percentage point [1]. - The report emphasizes the ongoing support for special case negotiations and the exploration of exclusion mechanisms, which are expected to enhance transparency and operational feasibility for innovative medical device companies [1]. Summary by Sections DRG 2.0 Implementation - The DRG 2.0 version is set to be implemented by the end of 2024, building on previous versions while aligning more closely with clinical practices [1]. - The updated grouping scheme includes enhancements for critical care, oncology, and other specialized fields, making it more scientifically sound [1]. Special Case Negotiations - The report outlines that special case negotiations will not exceed 5% of total DRG discharges, aiming for a more standardized approach across regions [1]. - The notification serves to raise awareness and understanding of the special case negotiation mechanism among healthcare providers [1]. Impact on Innovation - The DRG payment reform is expected to benefit truly innovative medical products and those with high cost-effectiveness, supporting the dual themes of innovation and domestic substitution in the industry [2].