By Fineline Cube 
On August 6, 2025, seven Shanghai-based authorities jointly issued a notice titled “Several Measures on Promoting High-Quality Development of Commercial Health Insurance to Support Innovation in the Biopharmaceutical Industry.” The notice outlines a comprehensive approach to enhance commercial health insurance development for the biopharmaceutical sector.
Expand Commercial Health Insurance Coverage
The new policies aim to broaden the scope of commercial health insurance to include high-demand new medical technologies, drugs, devices, and consumables. Insurers are encouraged to diversify their product offerings. The popular “Huibao” program will be enhanced by incorporating innovative drugs and medical devices, supported by foundational data to increase its reach. The policies also seek to accelerate the development of commercial long-term care insurance to support the eldercare industry.
Broaden the Insured Population and Service Scope
The measures will extend coverage to seniors, people with pre-existing conditions, and individuals with chronic diseases. The policies aim to expand services by exploring collaborations between insurance companies and pharmaceutical firms on drug procurement price negotiations, new drug release communication, outcome-based payments, and installment payments. This will improve accessibility and affordability of innovative drugs and medical devices. Insurers are encouraged to partner with medical institutions, physical examination centers, rehabilitation and nursing facilities, and contracted family doctors. They are also encouraged to participate in government-funded health projects.
Encourage Innovation in Commercial Health Insurance
The notice promotes the use of individual medical insurance account funds to purchase commercial health insurance, fostering complementary development between commercial and basic medical insurance. It encourages the development of group health insurance products that cover innovative drugs and medical devices, offer simultaneous settlement with basic medical insurance, and are purchased by employers with a contribution ratio that meets a specific minimum. The policies also reinforce compliance oversight for innovative commercial health insurance to prevent policy arbitrage.
Strengthen Policy Support
The policies explore establishing a multi-payer and multi-party coordination mechanism involving medical insurance payments, commercial insurance reimbursements, charitable organizations, and pharmaceutical companies. Innovative drugs included in the commercial health insurance catalog will not be factored into the basic medical insurance out-of-pocket rate index or monitored as alternative varieties for centralized procurement. The policies also explore promoting a cross-border payment model for international medical services.-Fineline Info & Tech