"Drug God" catalyzed after the "special drug insurance": new products continue to emerge in the future market space to be tested

In addition to optimistic about the health insurance market prospects, what makes insurance companies "unanimous" aimed at "special drug insurance" this sub-sector? "Daily Economic News" reporter recently interviewed several insurance companies operating "special drug insurance", and TPA (Third Party Administrator for Medical Insurance, a third-party company in medical management), to understand the "special drug insurance" to consumers of the actual utility, and whether the current low-cost marketing strategy to stimulate the market "real demand.""1 yuan", big promotion or gimmick?in July 2018, Ping An Pension Insurance launched "specific disease-targeted drug group medical insurance", "special drug insurance" new products gradually introduced"Daily Economic News" reporter incomplete statistics show that, so far, Ping An, Taikang, Taiping's subsidiaries have launched related products, plus some in the innovative health insurance products market sensitive small and medium-sized insurance companies, involved in more than 20 insurance companies, products have dozensThe supply side has ushered in a small wave of high tide, the special drug insurance is about 10% of the million medical insuranceAccording to industry insiders, almost all companies that have done millions of medical insurance have plans to introduce special drug insurance, so the market size of special drug insurance is expected to be about 10% of the million medical insuranceHuge market space is attracting more and more insurance companiesAt the same time, low rates have become a lot of "special drug insurance" to attract market attention to a "ace."at present, the market's best-selling special drug insurance coverage is more than a million, but the price of products are mostly within a hundred yuanTaikang Online Joint Microinsurance launched in April, "Drug God Protection Anti-Cancer Special Drug Protection Plan", in which the basic version of the price is reduced to nearly free 1 yuan / month, and Hengqin Life recently launched the drug worry-free basic version of premiums are also as low as 12 yuan / year" as low as 1 yuan of product design, there is a low-cost eyeball"A person familiar with the actuarial told reporters that from the point of view of pricing specialty insurance products alone, the cost of the basic version of the product should be more than 1 yuan, but this part of the loss can be offset by the sale of other productsin fact, from the previous public disclosure of micro-insurance data can also be seen "low-cost" flow effect: the conversion rate of special drug insurance is four times the conversion rate of micro-insurance insurance, per capita single number of 1.37Taikang online response said: "Drug God insurance, the basic version of the premium is only 1 yuan / month, although the price is low, but will not have entered the social security directory of the 12 special drugs fully included in the scope of protection, can be said to be a practical and valuable protection." "So, how much difference does the actual protection of special drug insurance designed by different companies on the market make?coverage of the types of drugs varywidely
For patients, "special drug insurance" is "good news" or "chicken ribs", the actual effectiveness of the drug to be protected is worth paying attention to At present, the market of special drug insurance coverage of the types of drugs vary greatly, fewer than a dozen, more have covered the current market social security inside and outside all the treatment drugs, and with the market continued to update "Daily Economic News" reporter compared two coverage of the drug types of special drug insurance products, one covering 15 kinds of anti-cancer drugs, the other covered 16 kinds of drugs; in addition to the above-mentioned main "low-cost" products, many products are also continuing to expand the coverage of targeted drugs, but for consumers who do not have professional medical knowledge, the name of the drug is dazzling, only "quantity" theory is desirable? Is it certainthat better to cover 66 specialty drugs than 56? In order to protect the rights and interests of consumers, the China Insurance Industry Association has developed a standardized definition of disease for serious illness insurance According to the norms, today's commercial serious illness insurance on the market is 25 major diseases as the core of protection, excluding a small number of insurance companies in the list of disease types to increase rare diseases, split diseases and other operations, which means that different serious illness insurance products appear to cover different diseases, the substance will not be significantly different but the birth of only over a year of special drug insurance has not yet been uniform provisions According to the requirements of the insurance company's safeguard settings, in principle, any number of drugs can be provided, but the upper limit does not exceed the list of drugs approved by the CFDA (State Food and Drug Administration) for domestic marketing However, an industry insider told the Daily Economic News: "There is no official definition of tumor specials, so some drugs can treat diseases but whether they belong to the tumor specialty, there is a gray area." "In addition, differences in the specifications of the special drug list can also affect the statistics of drug types " list of special drugs can be divided into two specifications, the first is counted by the generic name of the drug, the second is a list of mixed generic and commodity names "Sipai Health Products Director Tan Jinxuan, for example, "I am not a drug god", mentioned in the treatment of slow-grain leukemia, the drug Imatini, is a generic name, the generic name corresponds to a number of manufacturers produced by the commodity name, such as Grewe (import), Weiwei, Gnico, Nolinin and other products, will also be counted as multiple drugs the industry calls for rational pricing " different rates for special drug insurance, based on different customer characteristics, sales scenarios, protection coverage, through strict reinsurance pricing logic based on the estimated price Wu Yan, general manager of Huatai Financial Insurance Health Business Department, believes that the vast majority of similar products in the market are priced more rationally special drug insurance is the result of joint cooperation between insurance companies, reinsurance companies and TPA, and the three parties play their respective roles in the operation of special drug insurance Among them, reinsurance companies in the product design process to provide empirical data support, while with the direct insurance company to share the risk Huaxia Life said that the company and the world's leading reinsurance companies, "in the product development process to take full account of the incidence of cancer and targeted drug use." as medical technology advances, more diseases will be treated with targeted drugs in the future, does this mean that special drug insurance may be at risk of rising payouts? this, a Ping An pension insurance related to the person in charge of analysis, with the reform of health insurance policy, if more targeted drugs into health insurance reimbursement, the cost of entering commercial insurance will be reduced "Future payout changes are related to advances in medical technology and national policies, depending on the degree of impact of both aspects, it is not expected that compensation should be significantly increased in the short term." it is understood that the risk of special drug insurance is divided into cancer incidence risk and cancer diagnosis of drug cost risk Relative to the incidence risk, drug cost risk is more controllable, can be controlled by the preferred doctor network, prescription audit, special drug flow and cost closed ring and other professional services Because the tumor special drug indicationis is very clear, the drug specification is clear, the above four wind control measures are done well that can effectively control the risk of drug costs after diagnosis "TPA, which provides special drug services, will review the application of the drug according to the patient's situation to avoid increased medical costs such as moral risk and substance abuse," said the head of china's national health care in On the other hand, although the target drugs and immunodrugs needed to fight cancer are expensive, TPA, which provides special drug services, may be able to get more drug benefits from pharmaceutical companies to help insurance companies control the cost of compensation "
Magnesium Letter Health Innovation Business Department Wan Xiaolong told the Daily Economic News reporter: "With the U.S PBM business model, TPA in the future can connect insurance companies and major pharmaceutical companies, in the amount of insurance policies and drug prices to reach a deep cooperation, and ultimately benefit consumers." "There are already a lot of insurance companies and TPA involved in the 'special drug insurance' area "A Chinese life insurance person told the Daily Economic News reporter: "The 'special drug insurance' hot phenomenon behind, is fundamentally to meet customer demand, this is the most important baton of product innovation." relife calls on market peers to consider various risk factors when developing similar products, adhere to scientificity, and avoid excessive price downs to obtain business "This is not only irresponsible to customers, it is difficult to ensure that the company can continue to operate with high quality." "