Futu Securities APP learned that, Everbright Securities issued a research report stating that the national unified medical insurance system platform and big data empower commercial health insurance, or promote the diversification of payment methods. Recently, frequent medical insurance policies reflect that China's medical reform has entered deep waters, touching the deep structure of the payment system, reshaping past intra-hospital interest relationships and social structures. The gradual advancement of the prepayment system is expected to improve the overall account period of the industry chain, with distribution companies benefiting more directly. The establishment of a diversified payment structure will open up new space for innovative drugs and medical devices.

Event:

On November 7, 2024, the National Medical Insurance Administration held a forum on the development of commercial health insurance empowered by medical insurance platform data.

On November 11, 2024, the office of the National Medical Insurance Administration, together with the Ministry of Finance office, issued the notice 'On Doing a Good Job in the Prepayment of Medical Insurance Funds'.

The main points of view of Everbright Securities are as follows:

The national unified medical insurance system platform and big data empower commercial health insurance, promoting the diversification of payment methods.

The main payment providers in the domestic medical market are mainly centered around basic medical insurance, with the domestic development of commercial health insurance relatively lacking in the past, and one of the important reasons is the scarcity of medical data.

The medical insurance system platform has the advantages of national unity, extensive coverage, standard specifications, and large-scale medical insurance big data with good structure and rapid updates. It actively empowers commercial insurance to accelerate development, continuously improves the construction of a multi-level medical security system of "1+3+N", and is expected to provide insurance companies with real-time, comprehensive data support to better design commercial health insurance products, increase insurance coverage for the people, promote the diversification of payment methods, open up new payment channels in clinical medical scenarios, and expand sales opportunities for innovative drugs and medical devices.

The medical insurance prepayment system improves the efficiency of medical insurance fund utilization and alleviates the funding pressure on medical institutions.

The advance payment is the turnover fund for medical expenses such as drugs and medical consumables provided by the medical insurance department to designated medical institutions. It may not be used for non-medical expenses such as investment in medical institution infrastructure, daily operations, debt repayment, etc. The centralized procurement of drugs and medical consumables using the medical insurance fund is carried out as originally stipulated. Eligible designated medical institutions voluntarily apply to the medical insurance department of the pooling area for advance payments in early January of each year. After examination by the medical insurance department, the financial department determines the scope and scale of advance payments to medical institutions and, in principle, disburses the advance payments to designated medical institutions as specified by the end of the first quarter each year.

After the implementation of the medical insurance prepayment system, it is expected to effectively alleviate the financial pressure of medical institutions in the corresponding areas, thereby improving the enterprise account payment status of pharmaceutical procurement and consumables channels, conducive to the overall development of the cash flow chain of medical institutions-pharmaceutical distribution-pharmaceutical manufacturing.

Investment advice:

Recommended to pay attention to sinopharm (01099), sh pharma (601607.SH), chinares pharma (03320), jointown pharmaceutical group (600998.SH), etc.;

Recommended to pay attention to jiangsu hengrui pharmaceuticals (600276.SH), innovent bio (01801), beigene (06160), apt medical inc. (688617.SH), microport-U (688351.SH), xintai medical (02291), jiangsu yuyue medical equipment & supply (002223.SZ), sinocare inc. (300298.SZ), etc.

Risk Analysis: Risks of policy advancement falling short of expectations; risks of lower-than-expected willingness of the public to purchase insurance.