Collaborative innovation of commercial health insurance and the pharmaceutical industry
2024-03-20
Recently, the China Insurance and Pension Research Center of the Wudaokou School of Finance at Tsinghua University released a research report on the collaborative innovation model of commercial health insurance and medicine. The report believes that the coordinated development of commercial health insurance and the pharmaceutical industry can not only promote the expansion of commercial health insurance's customer base, achieve innovative development, but also improve the accessibility of innovative drugs. According to statistics from research institutions, the scale of commercial health insurance premiums increased from 112.3 billion yuan to 865.3 billion yuan from 2013 to 2022, with a compound annual growth rate of over 25%. However, in the past two years, the growth rate of commercial health insurance has significantly slowed down. At present, the cooperation between commercial health insurance and the pharmaceutical industry mainly focuses on three areas: chronic non communicable diseases, tumors, and rare diseases. From the perspective of the relationship between the government and the market, cooperation models can be mainly divided into two types: one is the integration of social security and commercial insurance, and the most representative is the urban customized commercial medical insurance (welfare insurance). The second is commercial insurance cooperation, including special medicine and special disease insurance, drug welfare management, and managed healthcare. Traditional commercial health insurance mainly covers the personal self payment portion after basic medical insurance reimbursement, and mainly covers healthy individuals. Special disease and drug insurance provides protection for specific diseases and drugs, covering special drug liability beyond basic medical insurance, and covering patient groups. The special disease and drug insurance has opened up cooperation between the insurance industry and the pharmaceutical industry, and different exploration models have emerged in practice. With the acceleration of population aging, research institutions have calculated that the number of people with diseases in China is close to 400 million, and vigorously developing insurance for patients with diseases has become an industry consensus. In the practice of insurance products for the sick population, various parties involved in the fields of medicine, medicine, insurance, and patient management have gradually begun to explore interconnectivity and cooperation, jointly launching comprehensive risk protection products that include medical responsibility, drug responsibility, and health management, leveraging their professional advantages to jointly meet the diverse needs of the sick population. With the continuous deepening of insurance product development for the sick population, collaboration with medicine has become an important innovative direction for commercial health insurance. Chen Jinfu, former deputy director of the National Medical Security Administration, believes that the development and balance of medical insurance need to address both internal system shortcomings and enhance external functions. The shift from relying on a single system to building a multi-level system and functional connectivity in health security is an inevitable choice for achieving system balance and collective efficiency. The active development of commercial health insurance should be regarded as a strategic fulcrum for building a multi-level health insurance system, exploring functional design, business models, and policy support for high-energy, efficient, and high-quality development. Commercial health insurance should work together with social insurance and fly alongside medicine. Wei Yingning, former Vice Chairman of the China Insurance Regulatory Commission, believes that the country attaches great importance to and encourages the development of commercial health insurance. In recent years, the growth rate of health insurance has slowed down, and only through continuous innovation in products, services, and business models can we break through the bottleneck. Based on the development stage of health insurance in China, it is necessary to further subdivide the demand for commercial health insurance, develop insurance products with targeted measures, and achieve universal insurance coverage. The reporter learned during the interview that China's insurance industry has explored more in the field of managed healthcare. Like China Ping An, through an online doctor team, with member exclusive online family doctors as the entrance, covering 5 medical fields including health, sub-health, and disease, etc
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