肿瘤复发险有需求没销路，上海探索“商保进医院”

Core Viewpoint - The article discusses the challenges and opportunities in the commercial health insurance market, particularly focusing on cancer recurrence insurance, as patients increasingly seek additional coverage due to high out-of-pocket costs despite improvements in the national healthcare system [3][4]. Group 1: Market Dynamics - The self-payment ratio for cancer treatment in China has reached or exceeded 50%, prompting patients to consider commercial health insurance [3]. - The growth rate of premium scale in the health insurance sector is below market expectations, leading to a search for new growth areas, particularly in niche products like cancer recurrence insurance [3][4]. - Commercial health insurance companies face difficulties in product design and pricing, with many newly launched products struggling to sell [4][5]. Group 2: Product Development Challenges - Specialized disease insurance, such as cancer recurrence insurance, is still in its infancy, with a market size of only a few billion compared to hundreds of billions for broader medical insurance [6]. - The development of recurrence insurance is complicated by the need to accurately predict disease recurrence rates and survival rates, which affects pricing and market acceptance [7][10]. - The insurance industry must balance the need for affordable premiums with comprehensive coverage, leading to conservative product designs [7][10]. Group 3: Sales and Distribution Issues - The primary challenge for insurance companies is not pricing but effectively reaching consumers, as traditional sales channels are limited [9][10]. - The small target population for recurrence insurance, such as the estimated 6,000 annual breast cancer recurrence cases in Shanghai, complicates sales efforts [9][10]. - High sales costs combined with low payout rates create a challenging environment for the recurrence insurance market [9][10]. Group 4: Data Utilization and Collaboration - Access to comprehensive patient data is crucial for designing effective cancer recurrence insurance products, necessitating collaboration with healthcare institutions [12][13]. - Recent regulatory changes in Shanghai have begun to facilitate data sharing between commercial insurers and healthcare providers, which is essential for product development [14][15]. - The collaboration between insurance companies and hospitals aims to enhance patient management and treatment outcomes, which could reduce future payout risks [10][14]. Group 5: Future Outlook - The recent easing of restrictions on insurance promotion within hospitals marks a significant step forward for the market, allowing for better product visibility and sales opportunities [15][16]. - The expansion of recurrence insurance will depend on the ability to cover more cancer types and other diseases with similar recurrence risks, presenting both opportunities and challenges for product development [17][18].