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医保局明确下半年重点:创新药、长护险新政来了
Di Yi Cai Jing· 2025-08-19 08:43
Group 1: Healthcare Policy Focus - The core focus of healthcare policy in the second half of the year includes the development of medical institutions, innovation in the pharmaceutical industry, comprehensive implementation of long-term care insurance, and expansion of maternity insurance [1] - The meeting emphasized a shift in the healthcare system from "passive payment" to "active empowerment" and from "disease compensation" to "health investment" [1] - A series of new healthcare policies will be initiated or implemented, including the establishment of a commercial insurance innovative drug directory and the launch of the 3.0 version of the disease-based payment grouping scheme [1] Group 2: Drug Pricing and Innovation - The National Healthcare Security Administration announced a list of 534 drugs that passed the basic medical insurance directory review and 121 drugs that passed the commercial insurance innovative drug directory review [2] - The establishment of the commercial insurance innovative drug directory allows for the inclusion of high-innovation drugs that meet unmet needs and have confirmed clinical value, facilitating their entry into hospitals [2] - The policy aims to improve drug accessibility by not including these drugs in the basic medical insurance self-payment rate indicators and the monitoring scope of alternative drugs in centralized procurement [2] Group 3: Payment and Care Models - The meeting called for the initiation of the 3.0 version of the disease-based payment grouping scheme to enhance the quality and efficiency of medical institutions [3] - As of June, over 90% of coordinated areas in the country achieved instant settlement for medical insurance, with payment timelines reduced to within 20 working days after application [3] - The long-term care insurance, referred to as the "sixth insurance," will be fully implemented in the second half of the year, with a focus on planning and supporting long-term care service institutions [3] Group 4: Maternity Insurance Expansion - The maternity insurance system will undergo upgrades and expansions, encouraging the inclusion of flexible employment personnel, migrant workers, and new employment forms into the coverage [4] - As of now, the number of people covered by maternity insurance has reached 253 million, with maternity insurance benefit expenditures amounting to 67.832 billion yuan in the first half of the year [4] - Five provinces have achieved full coverage of hospitalization costs for childbirth within the policy scope, and 18 provinces have fully implemented direct payment of maternity allowances to insured individuals [4]
医保工作年中座谈会要求:赋能医药产业创新 完善生育保险制度
Group 1: Medical Insurance Development - The National Medical Security Administration emphasizes empowering the pharmaceutical industry and implementing measures to support high-quality development of innovative drugs [1][2] - By mid-2025, significant progress is expected in medical security, including an increase in the number of people covered by maternity insurance to 253 million and maternity insurance benefit expenditures reaching 67.832 billion yuan in the first half of the year [1] - The meeting highlights the need for a comprehensive adjustment of the national medical insurance drug catalog and the establishment of a commercial health insurance innovative drug catalog [2] Group 2: Maternity Insurance and Long-term Care - The meeting encourages regions to include flexible employment workers, migrant workers, and new employment forms in maternity insurance coverage, while also exploring basic service packages for prenatal check-ups [3] - Long-term care insurance will be fully implemented, with a focus on planning and configuring designated long-term care service institutions and encouraging commercial insurance products that align with long-term care services [3] Group 3: Digital Transformation in Medical Insurance - The meeting calls for a shift in medical insurance from passive payment to active empowerment, focusing on health investment rather than disease compensation [3] - There is an emphasis on integrating medical insurance with technology to promote new medical services, AI health management, and smart elderly care [3]
医药产业创新获政策加码,关注恒生创新药ETF(159316)、医药ETF(512010)等投资价值
Sou Hu Cai Jing· 2025-08-07 13:12
Group 1 - The Hang Seng Hong Kong Stock Connect Innovative Drug Index fell by 3.7%, while the CSI Hong Kong Stock Connect Pharmaceutical and Health Comprehensive Index decreased by 3.1% [1] - The CSI Innovative Drug Industry Index declined by 2%, and the CSI Biotechnology Theme Index dropped by 1.3% [1] - The CSI 300 Pharmaceutical and Health Index saw a decrease of 0.8% [1] Group 2 - As of yesterday, the Hang Seng Innovative Drug ETF (159316) experienced a net inflow of over 500 million yuan in the past month, reaching a record high of 1.08 billion yuan [1] - A joint initiative by seven departments in Shanghai was announced to promote the high-quality development of commercial health insurance, which includes 18 measures aimed at enhancing the insurance industry's ability to serve public health needs and improving the accessibility and affordability of innovative drugs and medical devices [1]