今年1月1日，《国家基本医疗保险、生育保险和工伤保险药品目录（2025年）》（以下简称"新版 国家医保药品目录"）和首版《商业健康保险创新药品目录（2025年）》（以下简称"商保创新药目 录"）同步执行。其中，商保创新药目录共纳入19种药品，5款价格百万元级的CAR-T肿瘤治疗药品悉数 在列。随着这一政策正式落地，商业健康险能否接好高值药支付的"接力棒"，直接关乎多层次医疗保障 的惠民实效。 《金融时报》记者注意到，新年伊始，北京、河北、浙江、湖北等地纷纷开启首版医保"双目录"制 度，积极打通商业健康保险的衔接通道。在业内人士看来，这标志着医保与商保在破解高值创新药支付 难题上迈出实质步伐，商保补充作用被进一步激发，更多百姓有望用上"天价药"。政策利好下，商保公 司也可参照商保创新药目录加速产品创新、更新赔付范围，与基本医保形成保障合力。 商业保险填补创新药保障空白 进入2026年1月，医保商保药品"双目录"迎来启动关键节点，地方政策衔接、险企产品适配、技术 服务支撑的联动效应持续释放，"医保+商保"的协同医疗保障正从制度设计走向实操落地。 据《金融时报》记者观察，全国多地医保部门通过一系列政策举措为商保创新 ...

Core Insights - The release of the first edition of the Commercial Health Insurance Innovative Drug Directory marks a new phase in China's innovative drug security system, transitioning to a complementary model of "basic medical insurance + commercial insurance" [1][3] - The directory includes 19 drugs, which are characterized by high innovation, significant clinical value, and high costs, addressing the financial burden on patients, especially those with cancer and rare diseases [2][3] Group 1: Directory Overview - The selection process for the Commercial Health Insurance Innovative Drug Directory was rigorous, with only 19 out of 141 submitted drugs making it into the final list, resulting in an overall acceptance rate of 13.5% [2] - Nearly half of the selected drugs represent original innovations in biomedicine, filling treatment gaps in critical areas such as oncology and rare diseases [2][3] Group 2: Implications for Patients and Companies - The directory aims to alleviate the financial burden of high-priced innovative drugs for patients, ensuring that eligible patients can access necessary medications through commercial insurance [4][6] - For pharmaceutical companies, particularly those focused on cutting-edge innovations, the directory opens up a dual payment structure of "medical insurance + commercial insurance," facilitating the commercialization of innovative drugs [4][5] Group 3: Market Structure and Future Projections - Historically, China's innovative drug market has relied on a binary payment structure of "medical insurance fund + patient out-of-pocket," with commercial health insurance's role being underutilized [6][7] - By 2035, the market for innovative drugs is projected to reach 1 trillion yuan, with commercial health insurance expected to cover a significantly larger share of costs, increasing from approximately 12.4 billion yuan to around 440 billion yuan [6][7] Group 4: Challenges and Considerations - The implementation of the directory is just the first step, with concerns about how effectively the listed drugs will be utilized by patients and the potential impact on insurance premiums [8][9] - The directory's limited number of drugs and the complexity of some innovative treatments may pose challenges for insurance companies in terms of risk management and pricing [9][11]

Core Insights - The first national commercial insurance innovative drug directory for 2025 has been released, including 19 high-value innovative drugs covering key treatment areas such as oncology, rare diseases, and neurodegenerative diseases [1][3][4] - Shenzhen's "Shenzhen Huiminbao" has proactively included all 19 innovative drugs in its coverage for 2025, significantly reducing out-of-pocket expenses for insured residents when using these drugs [1][2][3] Summary by Sections National Drug Directory - The newly published commercial insurance innovative drug directory serves as a supplement to basic medical insurance, focusing on drugs with high innovation, significant clinical value, and substantial patient benefits that exceed the coverage of basic medical insurance [1][4] - Included drugs feature CAR-T therapies for cancer treatment, medications for rare diseases like Gaucher disease, and drugs for Alzheimer's disease, which has garnered significant public attention [1][4] Shenzhen Huiminbao - "Shenzhen Huiminbao" has achieved full coverage of the 19 innovative drugs, providing a crucial supplement to the existing medical insurance framework in Shenzhen [1][4] - The insurance plan supports a "one-stop settlement" service, alleviating the financial burden on insured individuals when seeking medical treatment [2][4] - The program has been operational for three years, maintaining a public welfare characteristic with no restrictions on age, occupation, or health status, allowing for an annual premium of 88 yuan for coverage exceeding 4 million yuan [5] - As of 2025, the number of insured individuals has surpassed 6.15 million, with a total of over 18 million insured instances in three years [5]

Core Insights - The first national commercial insurance innovation drug directory for 2025 was released in Guangzhou, including 19 high-value innovative drugs targeting key treatment areas such as oncology, rare diseases, and neurodegenerative diseases [1][3] - Shenzhen's "Hui Min Bao" has incorporated all 19 innovative drugs into its coverage for the 2025 fiscal year, enhancing access to these medications for local residents [1][3] Group 1: Drug Coverage - The 19 drugs included in the directory cover significant therapeutic areas, including CAR-T therapies for cancer, treatments for Gaucher disease, and Alzheimer's disease medications [3] - Specific drugs listed include "Daratumumab injection," "Naxitamab injection," and "Aducanumab injection," among others, from various pharmaceutical companies [2] Group 2: Insurance Benefits - All insured residents of Shenzhen using the listed innovative drugs can claim reimbursements, effectively reducing out-of-pocket expenses and improving access to these medications [3][4] - "Hui Min Bao" provides a crucial supplement to basic medical insurance, focusing on high-innovation drugs that offer significant clinical value and patient benefits beyond standard coverage [3] Group 3: Claims and Impact - Real-life claims demonstrate the effectiveness of the coverage, such as a case where a 5-year-old patient with malignant tumor received over 730,000 yuan in compensation for drug costs [3][4] - The insurance plan also supports "one-stop settlement" services, alleviating the financial burden on patients, including those with pre-existing conditions [4] Group 4: Growth and Accessibility - Since its launch three years ago, "Hui Min Bao" has maintained a public welfare characteristic, with no restrictions on age, occupation, or health status, allowing for a low annual premium of 88 yuan for over 4 million yuan in coverage [4] - As of 2025, the number of insured individuals has surpassed 6.15 million, with a total of over 18 million insured instances in three years [4]

Core Viewpoint - The aging population in China presents significant challenges, with a need for improved pension systems and commercial insurance solutions to ensure a dignified retirement for citizens [1][3]. Group 1: Aging Population and Pension System - China is facing the dual challenges of "aging before becoming wealthy" and "aging without preparation," with 19 provinces already in a moderate aging society [1]. - By the end of 2024, the elderly population (60 years and older) is projected to reach 310 million, with those aged 65 and older at 220 million [1]. - The current pension system is unbalanced, with basic pension insurance coverage at 95%, but only 3% of employees participating in enterprise annuities and 7% in personal pensions [1][3]. Group 2: Commercial Insurance Solutions - Basic pension insurance meets only the basic survival needs, while a high-quality retirement requires commercial insurance solutions [3]. - Key pension products include personal pension products, commercial pension insurance, and annuity insurance, which provide stable cash flow and flexible payment options [3][4]. - The integration of insurance with health management and community care is a growing focus, offering comprehensive solutions for aging [4]. Group 3: International Experience and Investment Strategies - Spain's "insurance + health care integration" model serves as a reference, emphasizing personal pensions and tax incentives for retirement savings [5]. - In a low-interest environment, insurance companies in China are encouraged to invest long-term, with regulatory support for capital market participation [6]. - The investment side is crucial for the insurance industry, as effective asset allocation directly impacts profitability and product viability [6]. Group 4: Local Market Characteristics in Shenzhen - Shenzhen, with an average population age of 32.5, has diverse insurance needs across different demographics, including high-net-worth individuals and migrant workers [7]. - The "Shenzhen Huimin Bao" project has seen significant participation, with over 18.19 million insured, reflecting a growing demand for affordable healthcare solutions [8]. - The company has tailored insurance products for small and medium enterprises, focusing on industry-specific risks and green insurance initiatives [9].

Core Insights - The aging population in China is a pressing issue, with 19 provinces already in a moderately aging society, and projections indicate that by the end of 2024, there will be 310 million individuals aged 60 and above, and 220 million aged 65 and above [1][2] - The current pension system in China, which consists of three pillars (basic pension insurance, occupational pensions, and personal pensions), faces significant imbalances in development [1][2] - The basic pension insurance can only meet the basic needs of survival, and achieving a high-quality, dignified retirement life requires reliance on commercial insurance products [2][3] Pension System and Products - The average replacement rate of basic pensions for enterprise employees is approximately 45%, which is below the International Labour Organization's recommended standard of 55% [2] - Personal pension products are a key focus under national planning, but there is a need for increased consumer awareness and product purchasing rates [2] - Commercial pension insurance, particularly dedicated commercial pension products, offers flexible design and various payment methods, balancing stability and returns [2] - Annuity insurance provides a steady cash flow, making it suitable for clients with clear and stable future cash flow needs [2] Integrated Services - The development of "insurance + health + pension" integrated services is a significant direction, combining insurance products with health management and community care [3] International Experience - Spain's "insurance + health integration" model is highlighted as a reference, where personal pensions are encouraged through substantial tax incentives, and insurance companies collaborate with strong fund management firms for asset allocation [4] - The cost of care in Spain, where the monthly fee for mid-to-high-end nursing homes is about three times the average retirement salary, is comparable to some first-tier cities in China [4] Investment Strategies - The asset allocation of insurance funds is closely tied to macroeconomic conditions, with regulatory support for long-term investments in capital markets [6] - The investment side is crucial for the insurance industry's development, as effective asset allocation and operation directly influence fund yield and support product guarantees and profitability [6] Consumer Demand in Shenzhen - Shenzhen's population is characterized by a complex structure with significant differences in insurance needs among various groups, including high-net-worth individuals and the general public [7] - There is a growing demand for integrated medical services among the general population, while younger consumers are more price-sensitive and inclined towards internet-based insurance products [7] Financial Services and Innovation - The company has actively participated in the "Shenzhen Huimin Bao" project, which has seen over 18.19 million participants since its launch, demonstrating a commitment to inclusive financial services [8][9] - The company has tailored insurance solutions for small and medium-sized enterprises, addressing their specific risks and needs, and has provided substantial risk coverage for green industries and emerging sectors [10]

从业务板块看，大数据平台和解决方案（AI for Medical）板块表现稳健，收入达人民币1.53亿元，同比 增长14.6%。该板块客户覆盖持续扩大，已服务于127家中国知名医院及44个监管机构和政策制定者。 生命科学解决方案（AI for Life Science）板块收入达1.38亿元，公司在该领域保持着高客户黏性，在头 部20家跨国药企中，客户覆盖率达17家，报告期内支持了多个具有重大临床价值的项目。受行业政策利 好的影响，健康管理平台和解决方案（AI for Care）板块收入同比激增30.3%至人民币6667万元，报告 期内，医渡科技连续三年主运营的"深圳惠民保"参保人数再创新高，突破615万人。 分析认为，医渡科技本财年上半年在营收稳步增长的同时，亏损大幅收窄、现金流显著改善，印证了其 战略聚焦与精细化运营的成效。在AI医疗行业从技术构建迈向体系化赋能的新周期中，其充裕的现金 储备和全链路生态布局，为其持续创新并最终实现可持续盈利提供了关键支撑。 在全球医疗人工智能产业进入规模化落地的关键阶段，AI医疗企业医渡科技（02158）交出了一份彰显 业务韧性与盈利质量提升的半年成绩单。根据其11月27 ...

Core Insights - Yidu Technology (02158) reported a revenue of approximately 358 million yuan for the six months ending September 30, 2025, representing a year-on-year growth of 8.7% [1] - Gross profit reached about 134 million yuan, up 14.2% year-on-year, while the loss for the period narrowed to 15.76 million yuan, a 72% improvement compared to the previous year [1] Revenue Breakdown - The big data platform and solutions segment generated revenue of 153 million yuan, an increase of 14.6% year-on-year, primarily driven by expanded business opportunities due to policy support [1] - The health management platform and solutions segment reported revenue of 66.6 million yuan, reflecting a 30.3% year-on-year increase, mainly due to changes in the product mix [1] Technological Advancements - YiduCore, the company's core algorithm engine, continued to advance the development and training of large language models in the medical vertical, utilizing over 500 billion high-quality tokens for training [1] - The model processed and analyzed over 1.3 billion patient visits and nearly 7 billion authorized medical records, creating a dataset system covering more than 98 specific diseases [1] Industry Engagement - During the reporting period, the company provided solutions to 127 top hospitals in China and 44 regulatory bodies and policymakers, covering over 10,000 hospitals cumulatively [2] - The company leveraged "data elements × AI technology" to solidify its data intelligence foundation and accelerate the scaling of intelligent applications [2] Client and Market Position - The number of life sciences clients served by the company reached 88, with 17 out of the top 20 multinational pharmaceutical companies as clients [2] - The health management platform maintained a leading position in core cities, serving as the main operating platform for "Shenzhen Huiminbao" for three consecutive years and "Beijing Huiminbao" for five years [2] User Engagement - The "Shenzhen Huiminbao" insurance volume reached a new high during the reporting period, with the number of insured individuals surpassing 6.15 million, cumulatively serving over 18 million people in three years [2] - The number of active users who completed at least one transaction on the health management platform exceeded 22 million [2]

Core Viewpoint - The AI medical company Yidu Tech (02158) has demonstrated business resilience and improved profitability in its interim results for the fiscal year 2026, with significant revenue growth and a substantial reduction in losses [1][2] Financial Performance - Total revenue reached RMB 358 million, representing an 8.7% increase compared to the same period last year [1] - Losses decreased sharply by 72%, nearing breakeven [1] Business Segments - The AI for Medical segment generated revenue of RMB 153 million, a year-on-year increase of 14.6%, with a customer base expanding to 127 well-known hospitals and 44 regulatory bodies [1] - The AI for Life Science segment reported revenue of RMB 138 million, maintaining high customer loyalty with a coverage rate of 17 out of the top 20 multinational pharmaceutical companies [1] - The AI for Care segment saw a revenue surge of 30.3% to RMB 66.67 million, with the "Shenzhen Huimin Insurance" program reaching over 6.15 million insured individuals [1] Strategic Focus - The company’s strategic focus and refined operations have led to steady revenue growth, significant loss reduction, and improved cash flow [2] - The ample cash reserves and comprehensive ecosystem layout support ongoing innovation and the pursuit of sustainable profitability in the evolving AI medical industry [2]

Group 1 - The company Yidu Technology (医渡科技) reported interim results for the six months ending September 30, 2025, with revenue of approximately 358 million yuan, an increase of 8.7% year-on-year; gross profit was about 134 million yuan, up 14.2% year-on-year; and the loss narrowed to 15.76 million yuan, a decrease of 72% year-on-year [1] - The big data platform and solutions segment generated revenue of 153 million yuan, a year-on-year increase of 14.6%, primarily benefiting from expanded business opportunities driven by policy support [1] - The health management platform and solutions segment reported revenue of 66.6 million yuan, a year-on-year increase of 30.3%, mainly due to changes in the product mix [1] Group 2 - YiduCore, the company's core algorithm engine, continued to advance the research and training of large language models in the medical vertical during the reporting period, training on over 500 billion high-quality tokens and analyzing nearly 7 billion authorized medical records from over 1.3 billion patient visits, creating a dataset system covering more than 98 specific diseases [2] - The model won the "Best Paper Award" and the championship in the "Medical NLP Code Auto-Generation Evaluation" at the 11th China Health Information Processing Conference (CHIP 2025) and also secured first place in the medical health track at the 2025 "Data Element ×" competition in Jiangxi [2] - As an important ecological partner in the national artificial intelligence application pilot base in Beijing's medical field, YiduCore achieved large-scale deployment across medical, pharmaceutical, and health insurance sectors through a "one base, multiple applications" model, fully implementing a comprehensive solution across "medicine - pharmaceuticals - insurance - patients" [2] Group 3 - During the reporting period, the company provided solutions to 127 top hospitals in China and 44 regulatory agencies and policymakers, covering over 10,000 hospitals in total [3] - The company utilized a dual-driven approach of "data elements × AI technology" to solidify its data intelligence foundation and accelerate the large-scale application of intelligent solutions [3] - The large model technology assisted multiple hospitals in upgrading their data governance and research platforms, with clinical research expanding into oncology, respiratory, and traditional Chinese medicine disciplines, while the doctor Copilot product matrix achieved full coverage of the diagnosis and treatment process, with over 50,000 uses in a single hospital [3]