Workflow
商业健康险与创新药械产业融合
icon
Search documents
商业健康险补位支付缺口 破解民众“用药贵”难题
Jin Rong Shi Bao· 2025-08-13 03:03
Core Viewpoint - The accessibility of innovative drugs and medical devices is crucial for patient health and the pharmaceutical industry's innovation development. Recent measures from Shanghai's financial regulatory authorities aim to enhance the role of commercial health insurance in this sector [1][4]. Group 1: Policy Measures - The Shanghai Financial Regulatory Bureau and seven other departments released 18 specific measures to promote the high-quality development of commercial health insurance, focusing on collaboration between basic medical insurance and commercial insurance [1][5]. - The measures clarify responsibilities among various departments and aim to quickly implement policies that will enhance the multi-layered medical security system [1][4]. Group 2: Market Dynamics - The innovative drug industry in China is experiencing rapid growth, with 43 innovative drugs approved in the first half of 2025, a 59% increase year-on-year [2]. - The current payment system for high-priced drugs shows structural deficiencies, with personal out-of-pocket expenses remaining high due to limited coverage from basic medical insurance [2][3]. Group 3: Role of Commercial Health Insurance - Commercial health insurance is identified as a key player in filling the payment gap for high-priced innovative drugs, providing more predictable payment solutions compared to charity or mutual aid [3][6]. - The growth of commercial health insurance premiums, which reached 622.3 billion yuan in the first half of 2025, indicates a growing market potential [2]. Group 4: Data Sharing and Product Innovation - The measures emphasize the importance of data sharing between medical institutions and insurance companies to enhance pricing accuracy and efficiency [8]. - Encouragement for the development of diverse health insurance products that cover innovative drugs is highlighted, aiming to meet the needs of different demographics [7][8]. Group 5: Future Outlook - The ongoing policy support and product innovation are expected to significantly enhance the role of commercial health insurance in improving the accessibility of innovative drugs [6][8]. - The collaboration between medical, insurance, and pharmaceutical sectors is anticipated to create a win-win situation, fostering a more robust multi-payment system for innovative drugs [6][7].