The Current Status,Issues,and Policy Recommendations for the Cooperation between Private Health Insurance and the Pharmaceutical Industry:A Case Study of Shanghai
- VernacularTitle:商业健康保险与医药产业合作现状、问题以及协同发展建议:以上海市为例
- Author:
Jiayun WANG
1
;
Chunlin JIN
;
Wenhua SONG
;
Linan WANG
;
Minxing CHEN
Author Information
1. 上海市卫生和健康发展研究中心(上海市医学科学技术情报研究所) 上海 200040
- Keywords:
private health insurance;
pharmaceutical industry;
cooperation model;
coordinated development;
Shanghai
- From:
Chinese Health Economics
2024;43(10):15-19
- CountryChina
- Language:Chinese
-
Abstract:
Based on on-site research in Shanghai,it takes a supply-side perspective to examine the current status of cooperation between Private Health Insurance(PHI)and the pharmaceutical industry.It discusses the issues existing in the cooperation and proposes policy recommendations for their coordinated development.It identifies three main cooperation models and products,which are the public-private integrated product"Hui Min Bao",the special drug insurance led by insurance companies,and the disease insurance for patients led by pharmaceutical enterprises.However,these models commonly face challenges such as the limited policy support,a lack of standardized cooperation between the two sectors,insufficient information and data exchange,immature innovative payment models,and difficulties in the application of innovative drugs.It argues that the key to coordinated development lies in leveraging the strategic purchasing power of PHI,devising rational payment strategies and standards to achieve a win-win situation for insurers,enterprises,healthcare providers and patients.Therefore,policy recommendations are proposed from the perspectives of establishing mechanisms,breaking barriers,strategic procurement,and supporting measures.