Core Points - The National Healthcare Security Administration (NHSA) announced that the new basic medical insurance drug list and the first version of the commercial insurance innovative drug list will be released online and offline in Guangzhou on the first weekend of December, with implementation starting January 1, 2024 [1] - The negotiation for the basic medical insurance drug list concluded on November 3, with 120 domestic and foreign companies participating, including 127 drugs outside the list and 24 drugs for the commercial insurance innovative drug list [3] - The commercial insurance innovative drug list was established to better meet the diverse medication needs of the public, with 121 high-value drugs approved through this new list [3][7] Industry Insights - The commercial health insurance market in China is experiencing rapid growth, with the original insurance premium income for commercial health insurance reaching 977.3 billion yuan in 2024, a year-on-year increase of 8.2% [7] - The total expenditure of the basic medical insurance fund is projected to reach 2.97 trillion yuan in 2024, providing solid support for public healthcare [7] - The NHSA is working to address challenges in synchronizing medical insurance and commercial insurance settlements, with initiatives like the establishment of a national "medical insurance + commercial insurance" clearing settlement center in Beijing [9]

Core Points - The new basic medical insurance drug catalog and the first version of the commercial insurance innovative drug catalog are set to be released in Guangzhou on the first weekend of December, with implementation starting on January 1, 2024 [1] - The recent negotiations involved 120 domestic and foreign enterprises, with 127 drugs outside the basic medical insurance catalog participating in the negotiations, and 24 drugs involved in price negotiations for the commercial insurance innovative drug catalog [3] - The commercial insurance innovative drug catalog was organized by the National Medical Insurance Administration, allowing companies to apply for inclusion in either the basic medical insurance catalog or the commercial insurance innovative drug catalog, or both [5] Industry Insights - The addition of the commercial insurance innovative drug catalog aims to better meet the diverse medication needs of the population, with 1.326 billion people covered by basic medical insurance in 2024, maintaining a coverage rate of 95% [6] - Total expenditure for the basic medical insurance fund is projected to reach 2.97 trillion yuan in 2024, providing solid support for healthcare access [6] - The commercial health insurance market is experiencing rapid growth, with premium income reaching 977.3 billion yuan in 2024, an increase of 8.2% year-on-year, although there remains significant room for improvement in coverage levels compared to basic medical insurance [6] - Challenges exist in synchronizing medical insurance and commercial insurance settlements across provinces, but initiatives like the "commercial insurance + medical insurance" one-stop settlement payment platforms have been launched in various regions [6]

Core Points - The National Healthcare Security Administration (NHSA) announced that the new basic medical insurance drug list and the first commercial insurance innovative drug list will be released online and offline in Guangzhou on the first weekend of December, with implementation starting January 1, 2024 [1] - The recent negotiations involved 120 domestic and foreign enterprises, with 127 drugs outside the basic medical insurance drug list and 24 drugs for the commercial insurance innovative drug list participating in price negotiations [3] - The commercial insurance innovative drug list was established to better meet the diverse medication needs of the public, with 121 high-value drugs approved through this new list [7] Industry Insights - The commercial health insurance market in China is experiencing rapid growth, with the original insurance premium income reaching 977.3 billion yuan in 2024, an increase of 8.2% year-on-year [7] - The total expenditure of the basic medical insurance fund is projected to reach 2.97 trillion yuan in 2024, providing solid support for healthcare services [7] - The NHSA is exploring solutions to synchronize settlements between basic medical insurance and commercial health insurance, with several regions already implementing one-stop payment platforms [9]

Core Points - The National Healthcare Security Administration (NHSA) is organizing negotiations for the 2025 National Basic Medical Insurance Drug List and the Commercial Insurance Innovative Drug List, with participation from 120 domestic and foreign companies [1] - The new Basic Medical Insurance Drug List and the first Commercial Insurance Innovative Drug List are set to be released online and offline in Guangzhou on the first weekend of December, with implementation starting January 1, 2025 [1] - The introduction of the Commercial Insurance Innovative Drug List aims to promote more innovative drugs into commercial insurance [3] Group 1 - The NHSA has established a Commercial Insurance Innovative Drug List for the first time, allowing companies to apply for inclusion in either the Basic Medical Insurance Drug List or the Commercial Insurance Innovative Drug List, or both [2][3] - The Commercial Insurance Innovative Drug List will respect the market position of commercial insurance companies, differing from the Basic Medical Insurance Drug List adjustments [3] - In 2024, the total expenditure of the Basic Medical Insurance Fund reached 2.97 trillion yuan, with a coverage rate of 95% among 1.326 billion insured individuals [5] Group 2 - The commercial health insurance market in China has been growing rapidly, with original insurance premium income reaching 977.3 billion yuan in 2024, a year-on-year increase of 8.2% [5] - There is significant room for improvement in the effectiveness and coverage of commercial health insurance compared to the over 95% utilization rate of basic medical insurance funds [5] - The NHSA is exploring the integration of commercial health insurance with basic medical insurance to address issues such as overlapping coverage and gaps in protection [7] Group 3 - The NHSA has initiated a one-stop settlement platform for commercial insurance and basic medical insurance in several provinces, allowing for automatic recognition of patient information and streamlined claims processes [7][8] - As of August this year, over 36 million transactions have been settled through the synchronized settlement platform in Shandong, totaling over 2.1 billion yuan [7] - A national "Insurance + Commercial Insurance" clearing and settlement center has been launched in Beijing to facilitate one-stop settlements for patients seeking care outside their home provinces [8]

Core Insights - The article discusses the efforts by the National Medical Insurance Administration to streamline the claims process for commercial health insurance by promoting synchronized settlement with medical insurance [1][3] - The implementation of "commercial insurance + medical insurance" one-stop settlement/payment platforms has been established in various cities, enhancing the efficiency of claims processing [3][5] - A nationwide "medical insurance + commercial insurance" clearing and settlement center has been launched to address the challenges faced by patients seeking cross-province medical services [7] Group 1 - The National Medical Insurance Administration has been advocating for synchronized settlement between medical insurance funds and commercial insurance to simplify the claims process for patients [3] - Cities such as Shanghai, Shandong, Hangzhou, and Xiamen have successfully implemented one-stop settlement/payment platforms, allowing automatic recognition of patients' insurance qualifications [3][5] - In Shandong, over 36 million synchronized settlements have been completed, totaling more than 2.1 billion yuan, benefiting 5.6 million insured individuals [5] Group 2 - The current limitation of medical insurance data sharing at the provincial level poses challenges for patients seeking medical services across provinces [7] - The newly launched national clearing and settlement center in Beijing allows patients receiving care in pilot hospitals to achieve one-stop settlement for both medical and commercial insurance [7]