By Fineline Cube 
The Insurance Association of China (IAC) has unveiled its inaugural draft for the Commercial Health Insurance Drug List – A-Series, marking a pivotal step in standardizing coverage frameworks for supplemental health plans. The initiative aims to address gaps in China’s National Reimbursement Drug List (NRDL) by integrating high-frequency, high-demand therapies into commercial insurance products like Huiminbao and mid-tier medical policies. By pooling data from 2,619 drug lists across 29 provincial-level regions, the IAC seeks to harmonize fragmented local schemes into a unified, consumer-centric system.
Current Progress and Framework
The draft A-Series catalog identifies 30 drugs and 19 indications prioritized for coverage based on frequency of inclusion in regional Huiminbao plans and alignment with NRDL reimbursement trends. Key features include:
- Multi-tiered Structure: Segmented catalogs for City Customized Commercial Health Insurance (Huiminbao, A-series), million-yuan medical insurance (B-series), and mid-tier plans (C-series).
- Negative List Flexibility: Insurers retain authority to exclude specific drugs while expanding coverage to all domestically/globally approved therapies.
- Data-Driven Adjustments: Dynamic updates informed by provincial premium volumes, claim patterns, and stakeholder feedback.
Next Steps and Industry Collaboration
The IAC working group will refine the A-Series framework through Q3 2024, focusing on:
- Dynamic Adjustment Mechanisms: Annual reviews to incorporate new therapies and clinical guidelines.
- Cross-Sector Partnerships: Streamlining hospital-pharmacy-insurer coordination for direct claims processing.
- Consumer Education: Enhancing transparency around coverage tiers and out-of-pocket costs.
Market Implications
- Pharma Access: Non-NRDL drugs gain pathways to reimbursement via commercial plans.
- Insurer Differentiation: Carriers may compete on catalog breadth and claim efficiency.
- Regulatory Synergy: Aligns with Beijing’s push to reduce household healthcare burdens.-Fineline Info & Tech