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    Home > Active Ingredient News > Drugs Articles > In the second round of "gene test + insurance", if the drug is invalid, the claim will be settled. Who will buy this form?

    In the second round of "gene test + insurance", if the drug is invalid, the claim will be settled. Who will buy this form?

    • Last Update: 2019-08-07
    • Source: Internet
    • Author: User
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    At the end of July, Zhenhe technology announced a strategic cooperation with Nuowei medical and Beijing health insurance Through advantage integration, Zhenhe technology will build a four-dimensional integrated platform of "gene testing + clinical diagnosis and treatment + insurance + patients", and jointly build a "lung cancer ngs detection combined medication guarantee plan" with Nuowei medical and Beijing health insurance Zhenhe technology is not the first cancer detection company to launch such products in China Half a year ago, another cancer detection company also announced an innovative payment insurance plan for cancer detection and diagnosis and treatment drugs Through the deep integration of gene testing, clinical diagnosis and insurance, further promote the innovation and development of precision medicine in China, which seems to be becoming a product model discussed by tumor detection companies In fact, as early as 2016, there has been an upsurge of "gene + insurance" portfolio products in the field of gene detection Large companies such as Huada gene, Da'an gene, Nuohe Zhiyuan, Zhong'an, Taikang and Pacific Insurance have participated in the water test But at that time, most of the products launched were consumer testing, among which gene testing companies mainly provided testing products, and more initiative was controlled by insurance companies As the connection between biotechnology and insurance payment is not close, this water test did not work The products launched this time are more breakthroughs in patients' medication and commercial insurance payment As an exploration of commercial insurance integrating tumor gene detection and drug payment, these products are expected to be innovated through the combination of technology and payment business model In this paper, we interviewed companies and other professionals who are exploring "gene testing + insurance" products, trying to answer the following four questions: 1 What problem does "drug insurance" solve and who pays? 2 How can all parties benefit? 3 Who's doing it? 4 How to develop in the future? The core of cancer drug insurance is to solve the problem of patients' payment If we say that the insurance products of consumption level detection focus on the risk of future diseases, the drug insurance focuses on the current diseases and protects the sick groups This is a multi-faceted integration hub, and patients, insurance companies and testing companies have the opportunity to benefit from it After the first test, patients, family members and doctors are unable to know whether the drug is effective or not, so this is essentially a risk choice behavior In this process, the insurance products will be packaged and sold along with the testing products If the patient continues to progress or metastasize after taking the targeted drug according to the guidance of the test results, the insurance company will compensate the patient Although the research on mutation gene and targeted drug of lung cancer has been mature, there are still some cases of mutation but ineffective drug use in clinic The birth of drug insurance products, the core is to solve the payment problem of patients here, if the drug is invalid, the insurance company claims can also support patients to carry out the second test These are the preconditions for the existence of "drug insurance" products Only by solving this pain can the product logic work In addition, insurance technology companies and health management companies are also gradually complying with the market demand, hoping to build a bridge between insurance enterprises and medical enterprises, and create a full process service of payment diagnosis treatment, which leads to the emergence of drug insurance products In general, the cost of insurance for patients is paid by the testing company, which does not increase the burden of patients The cost of tumor drug testing and follow-up treatment is relatively high If the cost is increased to patients and their families in this process, it will undoubtedly increase the difficulty of product promotion How can all parties benefit? For insurance companies, the introduction of "drug insurance" is a new attempt, and the insured are not healthy people In addition, in the traditional commercial insurance, the proportion of the insurance company's expenditure on the channel and market personnel is very high, most of the insurance sales personnel are more inclined to the sales attribute, most of them do not have the medical and health industry background If gene testing companies promote products and promote insurance through the channel of gene testing, their sales personnel not only have stronger professional background, but also the insurance companies can save a lot of channel costs Not only that, insurance companies and health management companies can also obtain the first-hand diagnosis and treatment and prognosis data of the insured population in this process, which is very valuable for health management companies and insurance companies, and has important value in the future design of other health insurance product processes For doctors, this additional insurance service will also help ease the concerns about the follow-up treatment plan and improve the patients' compliance with doctors In the case that the patient is in real danger, the insurance company can effectively pay certain compensation to the patient To support further treatment options in the future "In this cooperation, doctors and patients are the direct beneficiaries." Dr Wang Fanping, vice president of Zhenhe technology business development, told arteria.com For testing companies, insurance companies can cooperate with them to launch drug insurance products, which means that the insurance companies recognize the accuracy of their products The launch of cooperative products means that the test results have been endorsed by the insurance company At the same time, because the insurance product itself does not increase the cost to patients, it is just like the added value given by the gene testing company to patients Under the same conditions, such models and products will be more competitive More importantly, such cross-border cooperation has strengthened the penetration of testing companies into industrial tourism, so that testing companies can further reach the forefront of the industry in terms of insurance payment, drug clinical application and efficacy tracking, explore the industrial experience of "medical insurance combination" path, and build a four-dimensional integrated platform of "gene testing + clinical diagnosis and treatment + insurance + patients" Who is doing it? At present, two companies have launched drug insurance products in the market Focusing on the high incidence of cancer in China, they took the first step in the participation of commercial insurance in precision medicine From this medical technology to its establishment and 2016, it focuses on international high-tech research and development and clinical application transformation in the field of tumor In February 2019, our medical technology launched the first innovative payment insurance plan for cancer detection and diagnosis and treatment drugs in China in combination with Beijing health insurance and Shanghai Nuowei medical The name of the project is "cancer detection combined drug diagnosis and treatment insurance", which is underwritten by a well-known life insurance company in China The first phase of the insurance will be used to protect breast cancer patients with erbB2 (HER2) and BRCA1 / 2 gene mutations, as well as lung cancer patients with EGFR, ALK and ros1 gene mutations After patients use the second-generation sequencing of this medical technology for tumor gene detection and agree to participate in the insurance, they can get the commercial diagnosis and treatment insurance free of charge During the insurance period, if the patient still develops tumor after receiving treatment according to the diagnosis and treatment guidance, the maximum compensation of 20000 yuan can be obtained Zhenhe technology is a cancer precision treatment company, which is engaged in non-invasive cancer precision diagnosis and treatment and accompanying diagnosis, providing individual health guidance for patients In July 2019, Zhenhe technology and Nuowei jointly designed and developed the lung cancer drug insurance product - "lung cancer ngs detection combined drug use guarantee plan", which currently covers lung cancer patients who have been tested by Zhenhe technology for "baishibo" drug use guidance gene This insurance service can be given to these patients when they are tested with boshiba If the patient uses one of the nine anti-cancer targeted drugs recommended in the report, such as Iressa, Teresa, and ansanza, and the tumor has progressed or metastasized within two months, corresponding compensation can be obtained according to the different targeted drugs used It is understood that these claims are made in the form of "supplementary medical insurance", which can be used to pay for the self paid targeted drug costs of patients beyond the coverage of social insurance and its own commercial insurance "We have always believed that the greatest significance of testing is to help doctors make clinical decisions, so as to guide patients to use drugs more effectively." Wang said The design of drug insurance is to help those lung cancer patients who still have progress or metastasis after using targeted drugs according to the results of gene test due to drug effectiveness, complexity of gene mutation and other reasons, starting from the needs of doctors and patients They hope to support their follow-up diagnosis and treatment through certain insurance compensation It has been revealed that at present, shinami mutual insurance, an insurance company of Zhenhe technology cooperation, is an insurance company under Ali In addition, Zhenhe technology currently has other "gene detection + insurance" projects in contact with a number of insurance companies They plan to develop insurance plans for more cancers and more insurance programs with more partners in the industry in the future >Founded in November 2018 and headquartered in Shanghai, Novartis healthcare is a professional and innovative provider of medical payment and insurance solutions It mainly exports medical reimbursement, efficacy guarantee, medication guarantee and other commercial health insurance schemes and payment schemes for major diseases, aiming to reduce patients' own expenses and improve medication access and compliance Different from the previous insurance product design and the drugs and treatment services included according to the insurance terms, Nuowei medical regards disease treatment itself as the starting point of insurance product design Based on professional medical knowledge and rich clinical experience, Nuowei medical accurately meets the core demands of patients to reduce medical expenses and ensure the treatment effect They are more like a bridge between insurance companies and enterprises, making the whole medical system form a complete closed loop " This company is actually the designer behind the medical technology and Zhenhe technology "drug insurance" products Most of its team comes from the medical resource side, and some of its members have been responsible for the core product development of insurance institutions They have the experience and resources of pharmaceutical enterprises, and at the same time, they also ensure that the insurance products exported by Nuo Hui medical have scientific financial models and reasonable terms At present, Nuowei medical has completed two rounds of financing successively, including Lenovo star and bv Baidu venture capital In the future, it may not be difficult to find that the drug insurance products launched by the above two companies are related to lung cancer Whether it is mutation sites or targeted drugs, lung cancer related research and products are more abundant Lung cancer is the highest incidence rate in China, and the cancer is the first choice for the drug users Breast cancer is the highest incidence rate of cancer in China, and the target therapy products are also abundant However, such products are only the first step In an interview with Zhenhe technology, they repeatedly emphasized their intention to develop "gene detection + insurance" products In addition to more cancer species, more drug treatment insurance products will be launched, "gene detection + insurance" in the future, how to develop and advance? Before that, Mr Shi shangliu, a reader of aori, once contributed an article about "how to innovate the business model of tumor targeted drug testing companies", in which there are a lot of imagination about the future of "tumor drug testing and insurance" We interviewed Mr Shi shangliu again, hoping to explore more possibilities for the combination of NGS technology and insurance According to Shi shangliu, what insurance guarantees is a kind of wind
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