商保创新药目录完成协商，下一步谁来承接？

Core Viewpoint - The article discusses the recent establishment of a commercial health insurance (CHI) innovative drug directory in China, marking a significant shift towards a dual-track payment system for innovative drugs, alongside the traditional national medical insurance system [4][6][12]. Group 1: Introduction of Commercial Health Insurance Innovative Drug Directory - The CHI innovative drug directory focuses on high-innovation, clinically valuable drugs that cannot be included in the basic medical insurance directory due to their high costs [4][6]. - This directory aims to address the multi-layered payment challenges for innovative drugs, with the implementation of supportive measures still pending [4][6]. Group 2: Transition to Dual-Track Payment System - The introduction of the CHI innovative drug directory represents a historic transition from a single-track medical insurance system to a dual-track system combining both national medical insurance and commercial health insurance [6][12]. - The new policy is expected to alleviate the financial pressure on the basic medical insurance fund while enhancing access to innovative drugs [6][12]. Group 3: Current Challenges in Commercial Health Insurance - There are significant disparities in coverage provided by commercial health insurance for innovative drugs, with only 7.7% of the market being covered by CHI [7]. - The current commercial health insurance market is small, and expanding its scale is a pressing issue, with group insurance being a potential avenue for growth [12][13]. Group 4: Implementation and Operational Challenges - The successful implementation of the CHI innovative drug directory requires collaboration among the National Medical Insurance Administration, pharmaceutical companies, and insurance providers [10]. - There are concerns regarding the ability of existing commercial health insurance products, such as "Hui Min Bao," to adequately cover innovative drugs due to low reimbursement rates [11][12]. Group 5: Need for Improved Payment Mechanisms - The article emphasizes the need for improved payment mechanisms, such as direct settlement systems, to facilitate the integration of innovative drugs into hospitals [16]. - Establishing a collaborative mechanism between medical insurance and commercial health insurance is crucial for effective implementation and data sharing [16].