Days after the first edition of the "Commercial Health Insurance Innovative Drug Catalog" was released, listing 19 innovative drugs for commercial health insurance coverage, the industry eagerly awaited which insurer would be the first to adopt them. Fosun United Health Insurance initially made headlines with a high-profile announcement that nine of its medical insurance products would cover these innovative drugs.
However, the excitement was short-lived. On December 18, it was discovered that the announcement had been deleted from the company’s official WeChat account, leaving only a "deleted" notice. The sudden withdrawal raised questions about the reasons behind this reversal and what it signifies for the broader health insurance market.
When contacted, Fosun United Health Insurance’s consumer protection hotline confirmed the withdrawal, stating that the decision was made because the details had not yet been finalized. The company declined to comment on whether a revised announcement would follow.
According to the deleted post, Fosun United Health Insurance had planned to update nine insurance products, including its mid-tier and long-term medical insurance plans, to include coverage for drugs listed in the new catalog, effective January 1, 2026.
Industry experts speculate that the withdrawal may be due to unresolved details regarding product terms, reimbursement rules, or partnerships with pharmaceutical companies. Long Ge, co-founder of Zhongtuo Bang, noted that while covering innovative drugs is beneficial—reducing financial burdens on patients and encouraging drug development—the lack of historical data makes pricing and risk management challenging.
Liu Chunsheng, an associate professor at the Central University of Finance and Economics, emphasized that integrating innovative drugs into insurance plans enhances product value but requires careful risk control. The abrupt withdrawal could raise concerns about internal decision-making, but transparency and a timely resolution could mitigate negative impacts.
The Commercial Health Insurance Innovative Drug Catalog, introduced on December 7, includes 19 high-value drugs for cancer, rare diseases, and Alzheimer’s treatment. While this presents opportunities for insurers to differentiate their offerings, the high costs and uncertain pricing models pose significant challenges.
Fosun United Health Insurance, established in 2017, has shown fluctuating profitability in recent years, with net profits ranging from ¥20 million to ¥63 million between 2021 and 2024. The company recently secured regulatory approval for a ¥316.41 million capital increase, which could strengthen its financial position and support expansion into innovative drug coverage.
The capital injection also introduces new international investors, potentially enhancing Fosun’s "insurance + healthcare" ecosystem. However, with its chairman position still vacant following a resignation in September 2024, the company faces leadership uncertainties amid its strategic shifts.
The episode highlights both the potential and complexities of integrating high-cost innovative drugs into health insurance, requiring insurers to balance innovation with financial sustainability.
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