新华财经上海8月27日电（记者胡洁菲）近日，包括全球首个靶向Trop-2的ADC药物注射用戈沙妥珠单 抗、曾登顶全球"药王"的司美格鲁肽、国内首个血友病基因疗法波哌达可基注射液等在内，多款高 值"明星药物"在国家医保局公布的通过初步形式审查的商保创新药目录中亮相，引发行业对于多元支付 的关注。业内认为，这些高价值、高投入、获益显著的先进疗法，有望通过商保创新药目录这一路径， 开辟支付的新通道并惠及更广泛的患者群体。 从去年底国家医保局在全国医疗保障工作会议上多次提及"商保"，到今年国家医保目录调整首次增 设"商业健康保险创新药品目录"，系列，构建多层次、均衡化的支付格局逐渐迈入"进行时"。中信证券 近期研报指出，国家医保局启动商保创新药目录调整工作，标志着商保创新药目录进入实质性落地阶 段。医疗健康产业有望迎来戴维斯双击，估值体系有望重塑。 对此，在近日举办的陆家嘴金融沙龙上，镁信健康首席创新官冯昊认为，目录是很重要的基础。创新药 落地的"最后一公里"对于商业保险也非常重要，如何确保药品上市之后处方可流传、患者用药可及、最 终支付可以实现直付，都需要进一步去拓展。 业内人人士表示，平台企业"织网成链"系统性能 ...

Core Insights - The launch of the first national "Medical Insurance + Commercial Insurance" clearing and settlement center marks a significant shift in the payment landscape, allowing seamless integration between medical insurance and commercial insurance, reducing the burden on patients [1][2] - The integration of medical insurance and commercial insurance is entering a fast track, with various companies leveraging their strengths to innovate and enhance payment efficiency [2][4] Group 1: Policy and Technological Developments - The National Medical Insurance Administration has expressed a commitment to exploring the collaborative development of basic medical insurance and commercial medical insurance, with the recent establishment of the clearing center being a pilot project aimed at facilitating this integration [2] - Companies like Megxin Health have pioneered concepts such as "commercial insurance identity medical treatment," introducing platforms that allow for direct payment at public hospitals, enhancing user experience by enabling "pay after treatment" [2][4] Group 2: Innovations by Key Players - Alipay has introduced the "Commercial Insurance Code," which utilizes national medical insurance data to streamline the settlement process, significantly reducing the financial burden on patients [3][4] - Ping An Good Doctor has launched "Ping An Medical Payment," a product that leverages medical insurance data to achieve seamless and rapid claims processing, creating a closed-loop payment and service model [3][4] Group 3: Industry Transformation and Future Outlook - The integration of medical insurance and commercial insurance is redefining the concept of "innovative payment," enhancing payment efficiency and improving the quality of life for patients [5][6] - The shift from simple complementarity to a data and service ecosystem is driving competition in the health insurance sector, moving away from price wars to service-oriented competition [6][8] - The anticipated full implementation of the "Medical Insurance + Commercial Insurance" one-stop settlement model is projected to unlock a trillion-level health insurance market, fostering a new ecosystem of medical, insurance, and technology integration [7][8]

Core Viewpoint - Magnesium Health aims to transform China's medical payment system and has become the largest multi-payment platform in the country, with a valuation of 11.6775 billion RMB after the last round of financing before its IPO [1][11]. Group 1: Company Overview - Founded in 2017, Magnesium Health focuses on addressing financing and payment challenges faced by patients, insurers, and pharmaceutical companies [2]. - As of December 31, 2024, Magnesium Health has saved patients approximately 6.7 billion RMB in out-of-pocket expenses through its solutions [2]. - The company has developed two major industry solutions: Smart Drug Solutions and Smart Insurance Solutions, ranking first in China for innovative drug and health insurance solutions [2][4]. Group 2: Market Position and Reach - By the end of 2024, Magnesium Health has served around 1.6 million patients, with a total medical expenditure GPV of 39.7 billion RMB [4]. - The company collaborates with over 90 insurance companies, including the top 20 in China by premium income, and more than 140 pharmaceutical companies, covering 40% of listed Class 1 new drugs in China [4]. Group 3: Financial Performance - Revenue for Magnesium Health from 2022 to 2024 was 1.069 billion RMB, 1.255 billion RMB, and 2.035 billion RMB, respectively, with gross profit margins of 31.1%, 36.8%, and 35.8% [7]. - The adjusted net losses for the same period were 447 million RMB, 290 million RMB, and 80 million RMB, showing a significant narrowing trend in loss rates [8]. Group 4: Industry Growth Potential - The Chinese healthcare market is expected to continue growing, driven by favorable government policies, an aging population, and increasing public health awareness [9]. - The innovative drug and medical device market in China is projected to grow from 92.3 billion RMB in 2019 to 162 billion RMB in 2024, with a compound annual growth rate (CAGR) of 11.9% [9]. Group 5: Future Plans and Use of IPO Proceeds - The net proceeds from the IPO will be used to expand and upgrade services for pharmaceutical companies and insurers, develop the integrated payment platform, and enhance key infrastructure [11].

Core Insights - Shanghai Meixin Health Technology Group Co., Ltd. announced an upgrade to its "One Code Direct Payment" platform, aiming to address pain points in commercial health insurance such as low claims efficiency and complicated medical processes [1][2] - The upgraded platform will launch in 2024, featuring direct payment across multiple scenarios including outpatient, inpatient, and pharmacy services, thus creating a new business model for commercial insurance payments [1] - The platform's direct payment network currently covers 12,000 public hospitals and specialized clinics nationwide [1] Group 1 - The upgraded "One Code Direct Payment" platform innovates in three dimensions: "visualization of pay-after-treatment," "better access to quality medical resources," and "diverse payment options" [1] - AI technology has been integrated into the platform, introducing a smart dialogue box named "xiaofu" that provides users with various intelligent services related to pharmaceuticals, disease information, payment methods, and insurance claims [1] - The platform's claimmaster AI can automate the submission of insurance claim materials, enhance risk control, ensure precise claim calculations, and facilitate seamless payment settlements [1] Group 2 - The Chief Product Officer of Meixin Health stated that the "One Code Direct Payment" redefines the value of payment by transforming fragmented services into standardized, integrated, and efficient service norms [2] - The upgraded platform is described as an industry-level innovation that shifts payment from a mere tool to a connector of smart healthcare services, aiming to build an advanced medical security network [2] - The goal is to maximize the value of advanced pharmaceuticals and enhance accessibility to healthcare services for users [2]