Eli Lilly, Pfizer land on Chinas first private insurance list

Summary

The new catalog aims to expand commercial insurances role in funding innovative drugs.

Source: thehindubusinessline.com

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Q1: What is the significance of Eli Lilly and Pfizer being included in China's first private insurance list for innovative drugs?

A1: Eli Lilly and Pfizer's inclusion in China's first private insurance list for innovative drugs highlights a pivotal shift in China's healthcare policy. This initiative aims to expand the role of commercial insurance in funding innovative and high-cost drugs, thereby reducing the financial burden on patients. It signals China's commitment to promoting access to advanced medical treatments and fostering pharmaceutical innovation within the country.

Q2: How has China's policy on innovative drug funding evolved in recent years?

A2: China’s policy on innovative drug funding has evolved significantly, with an increased focus on integrating commercial health insurance into the healthcare system. In 2023, the National Healthcare Security Administration (NHSA) made strides by allocating savings from generic drug procurement to fund innovative drugs, thereby allowing these high-cost treatments greater access to the National Reimbursement Drug List (NRDL). This move is part of a broader effort to encourage the development and accessibility of innovative therapies in China.

Q3: What challenges do multinational pharmaceutical companies face in getting their drugs included in China's National Reimbursement Drug List?

A3: Multinational pharmaceutical companies often face challenges in getting their innovative drugs included in China's National Reimbursement Drug List (NRDL) due to stringent pricing negotiations and the prioritization of domestic innovation. High-priced products, particularly those in areas like CAR-T and PD-1 therapies, struggle for inclusion as Chinese policymakers aim to balance cost control with encouraging local pharmaceutical advancements.

Q4: What role does commercial health insurance play in China's healthcare system, particularly regarding innovative drugs?

A4: Commercial health insurance in China plays a limited but growing role in supporting the healthcare system, especially for innovative drugs. In 2023, commercial insurance accounted for RMB 384.8 billion in claims, complementing the National Medical Insurance's expenditures. This sector is increasingly encouraged to cover high-cost treatments not reimbursed by national insurance, thus facilitating broader access to innovative therapies.

Q5: What are the implications of China's new reimbursement category for innovative drugs set to be implemented in 2025?

A5: The introduction of a new reimbursement category for innovative drugs in China, planned for 2025, indicates a strategic shift to accommodate high-cost, cutting-edge therapies within the healthcare system. This Category C will not be covered by national insurance, but the government will promote its use through commercial insurance channels. This reform aims to enhance the availability of groundbreaking treatments, particularly for rare diseases and complex conditions.

Q6: How has the Chinese market for innovative drugs changed between 2013 and 2023?

A6: Between 2013 and 2023, China's market for innovative drugs has expanded dramatically. The country's share of the global drug development pipeline increased from 3% to 28%, reflecting robust growth in pharmaceutical innovation. This expansion is supported by policy reforms encouraging domestic drug development and international collaborations, making China a significant player in the global pharmaceutical industry.

Q7: What are the potential benefits and risks associated with integrating IoT in the insurance domain, particularly within healthcare?

A7: Integrating IoT in the insurance domain, especially within healthcare, offers numerous benefits, such as enhanced data collection for risk assessment and personalized insurance products. IoT devices, like wearables, can provide real-time health data, improving policyholder engagement and preventive care. However, challenges include data privacy concerns, security risks, and the need for robust data analytics infrastructure. These aspects must be carefully managed to maximize IoT's potential in transforming healthcare insurance.