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关于发布商业健康险创新药品目录的点评:开辟医疗支付体系“第二战场”
Guoxin Securities· 2025-12-09 15:01
国信非银观点:此次商保创新药目录的发布,标志着我国商业健康保险在创新药支付领域迈出实质性步伐, 与基本医保目录形成错位互补,为创新药支付端开辟了"第二战场",同时有效缓解了医保控费压力与药企 创新需求之间的长期矛盾,为我国创新药产业的健康发展注入动力。对保险行业而言,相应政策不仅是产 品责任的扩容,更是商业模式升级、负债结构优化和估值逻辑重构的起点。国家通过统一目录把分散的特 药需求标准化、把碎片化的赔付数据集中化,为行业提供了可复用的"公共基础设施",使保险公司第一 次具备了在创新药领域进行可持续风险经营的基础设施条件。我们建议关注在健康险领域具备差异化优势 的中国财险、中国平安、中国太保、众安在线等。 评论: 政策定位:创新药支付端"第二战场"打开 |  行业研究·行业快评 | |  | 非银金融·保险Ⅱ |  | 投资评级:优于大市(维持) | | --- | --- | --- | --- | --- | --- | | 证券分析师: | 孔祥 | 021-60375452 | | kongxiang@guosen.com.cn | 执证编码:S0980523060004 | | 证券分析师: ...
事关你的社保、就医、养老……“两办”民生“10条”重点来了
3 6 Ke· 2025-06-10 03:56
Core Viewpoint - The recent policy document emphasizes the complete removal of household registration restrictions for participating in social insurance at the place of employment, aiming to enhance social security coverage and improve public services for citizens [1][4]. Group 1: Social Security and Employment - The policy aims to effectively expand social security coverage by removing household registration restrictions for social insurance participation, which will facilitate the free movement and optimal allocation of human resources [1][5]. - The document highlights the need for local governments to enhance fiscal capabilities and optimize transfer payment structures to support the implementation of these policies [2][6]. - The removal of household registration restrictions is expected to significantly benefit the 376 million mobile population in China, including 125 million inter-provincial migrants [5]. Group 2: Healthcare and Insurance - The policy outlines the establishment of a commercial health insurance innovation drug directory, which will address the gap in coverage for high-value clinical drugs not included in basic medical insurance [11][12]. - The commercial health insurance sector is projected to play a crucial role in supplementing the basic medical insurance system, particularly in the context of ongoing healthcare reforms [11][12]. - The document indicates that by 2023, the total payment for innovative drugs by commercial health insurance reached approximately 7.4 billion yuan, accounting for 5.3% of the overall market size [12]. Group 3: Elderly Care and Services - The policy emphasizes the need to increase the proportion of nursing beds in newly built elderly care institutions to at least 80%, focusing on the care of disabled elderly individuals [7][8]. - As of the end of 2023, there were 404,000 various elderly care institutions in China, with a total of 8.23 million beds, of which 58.9% were nursing beds [8]. - The document also highlights the importance of developing community-based elderly care services and improving the quality and accessibility of these services [9][10].