Core Viewpoint - Shanghai has introduced a new set of 18 measures aimed at promoting the high-quality development of commercial health insurance to support innovation in the biopharmaceutical industry, focusing on enhancing the multi-payment mechanism, particularly in commercial health insurance [1][2]. Group 1: Policy Overview - The new measures are a deepening upgrade of the previous "28 measures" and represent the first systematic policy document in China to construct a dual empowerment mechanism between commercial health insurance and biopharmaceutical innovation [1]. - The measures address long-standing issues of insufficient collaboration among multiple departments in the development of commercial health insurance, providing support and guidance for the standardized development and innovation of health insurance products [1][2]. Group 2: Data Sharing and Product Development - The new policies emphasize the establishment of a data-sharing mechanism among medical institutions, pharmaceutical companies, and commercial insurance companies to enhance product development and actuarial needs [2][3]. - The measures support the development of various health insurance products, including group insurance, welfare insurance, nursing insurance, and specialized products for specific populations, particularly focusing on the needs related to innovative drugs and medical devices [2][3]. Group 3: Targeted Support for Specific Populations - The new measures encourage insurance companies to include elderly individuals, those with pre-existing conditions, and chronic patients in their coverage, thereby broadening the service population of commercial health insurance [4]. - There is a focus on providing diversified customized services to new citizens and specific groups in new industries and business formats [4]. Group 4: Purchasing and Funding Mechanisms - The measures propose a matching engine for health insurance products based on individual profiles and characteristics, facilitating easier access to insurance products for consumers [5]. - Employers are encouraged to purchase group health insurance for employees, with provisions for shared premium payments between employers and employees, utilizing personal account balances for premium payments [5]. Group 5: Claims and Payment Innovations - The new measures aim to enhance the application of medical insurance data in commercial insurance settlements, optimizing the synchronization of settlements between medical insurance and commercial insurance [6]. - There is a focus on improving the accessibility and affordability of innovative drugs through collaborative mechanisms involving commercial insurance, medical insurance, charitable organizations, and pharmaceutical companies [6].

Core Viewpoint - Shanghai has introduced a new set of measures aimed at enhancing the development of commercial health insurance and supporting innovation in the biopharmaceutical industry, focusing on improving the multi-payment mechanism and data sharing among medical institutions, pharmaceutical companies, and insurance providers [1][2]. Group 1: Policy Measures - The new measures, referred to as "New 18 Measures," aim to strengthen the collaboration between basic medical insurance and commercial health insurance, addressing core issues related to the application of innovative medical devices and patient payment [1][3]. - The document emphasizes the importance of data sharing among medical institutions, pharmaceutical companies, and commercial insurance companies to facilitate product development and pricing [2][3]. - The measures encourage the development of innovative commercial health insurance products that can expand basic coverage and provide reasonable pricing [3][4]. Group 2: Data Sharing and Collaboration - The new policies establish a framework for a data-sharing mechanism among medical, insurance, and pharmaceutical sectors, ensuring data security and privacy while expanding the scope of data available for product design and risk assessment [2][3]. - Insurance companies are encouraged to access historical health data in a secure environment to support the development of targeted insurance products [3][4]. - The measures aim to enhance the interaction between insurance institutions and the biopharmaceutical industry, promoting collective procurement and payment mechanisms to improve the accessibility and affordability of innovative medical devices [7]. Group 3: Targeted Insurance Products - The new measures support the development of various health insurance products, including group insurance, special disease insurance, and high-end medical services, tailored to specific populations such as the elderly and those with pre-existing conditions [2][5]. - The policies also propose using personal account balances for purchasing insurance products, thereby facilitating access to health insurance for a broader audience [5][6]. - The measures highlight the importance of group insurance products, which do not differentiate based on pre-existing conditions, as a key growth area for the health insurance industry [6]. Group 4: Financial and Operational Support - Shanghai aims to address fundamental issues affecting the commercial health insurance sector, such as funding challenges and customer acquisition difficulties, through multi-departmental collaboration [4][6]. - The new measures propose financial incentives for employers to purchase group health insurance for employees, allowing for shared premium payments and tax deductions [6][7]. - The integration of commercial health insurance with basic medical insurance is emphasized, with a focus on optimizing claims processes and expanding the coverage of innovative medical devices [6][7].