Analysis of Drug Medical Insurance Access Pricing Based on the Perspective of Binary Equilibrium

Objective To study the influencing factors in the process of national medical insurance negotiation and drug pricing from the dualistic equilibrium perspective,and to provide reference for the harmonious management of drug pricing in China.Methods Through the literature analysis and policy review,the pricing subject,pricing basis and price control system in the pricing process of medical-accessed medicines were analyzed from the perspective of binary equilibrium and harmonious management.Results and Conclusion It is found that four balances in the drug pricing process,two balances in pricing basis and three balances in price control system need to be considered,respectively.Drug pricing is the key content of national medical insurance access,which is also the hotspot of the policy in the pharmaceutical fields in recent years.Drug pricing not only reflects the value of drugs,but also reflects a lot of top-level designs of binary equilibriums in medical insurance policy.While the rational design of drug pricing requires the joint efforts of the government,pharmaceutical companies and relevant experts to comprehensively consider many equilibriums,so as to improve the relevant systems.

Inspiration of Foreign Innovative Drug Pricing Methods and Medical Insurance Payment Standards to China

Objective To study the innovative drug pricing methods and medical insurance payment standards in foreign countries and to provide reference for China’s government.Methods The official websites were searched for information and related literature,and literature review was used.Results and Conclusion In foreign countries,the clinical value of innovative drugs and their impact on medical insurance funds were comprehensively evaluated based on factors such as quality-adjusted life years,clinical benefit,and improvement of clinical benefit.Then,the evaluation results were taken as an important basis for whether innovative drugs were admitted to the medical insurance catalog and establishing medical insurance payment standards.By using international experience for reference,innovative drug pricing methods and medical insurance payment standards for China’s national conditions can be improved by establishing a basic database of clinical value and drug economic evaluation of innovative drugs,as well as innovative drug payment models based on decision thresholds.

Feasibility Analysis of Agricultural Product Price Index Insurance Based on Pilot Cases

Agricultural product price index insurance is a kind of index insurance. It avoids defects of traditional agricultural insurance,such as moral hazards,adverse selection,and high management cost. On the basis of studying agricultural product price index insurance of all areas of China,this paper analyzed characteristics of agricultural product price index insurance from object selection,product object,premium design,and policy support,and discussed feasibility of extending agricultural product price index insurance in an all-round way.

Using Big Data to Discriminate Charged Price in the Car Insurance Industry: Evidence from United States

The purpose of this paper is to examinethe gender-based discrimination in car insurance ratesand whether the reasons provided by the car insurancecompanies for the different rates are valid or not. Thepaper studies the average annual premiums paid bymen and women across different age groups from 16years old to over 56 years old along with the percentagedifferences. Additionally, the concept of big data andhow it is utilized by businesses to apply personalizeprice discrimination is investigated. The researchdesign is conclusive and secondary data is used in bothqualitative and quantitative forms. Qualitative data iscollected from articles for the literature review andas for the quantitative data it is in the form of reportsand surveys. The data shows that at lower age groupswomen pay less than men for car insurance but as theage increase men start paying less. The paper reaches aconclusion that gender is not necessarily a crucial riskfactoras the regular factors such as driving record canprovided accurate risk determinants.

GAMES ANALYSIS OF INSURANCE PRICING UNDER CONSIDERING MORAL HAZARD

This paper first gives an explanation of moral hazard in the insurance field,and then offers a game theory model about insurance pricing according to the non zero sum game analysis between the insurer and the insured when moral hazard exists.On the basis of the game analysis,this paper also presents a lowest pricing formula and studies the cost of moral hazard simultaneously.

Mileage-based pricing insurance and its impact on China

Mileage-based pricing insurance,such as PAYD,is known as the"green insurance"because it is low-carbon and environmentally effective,which is the biggest innovation in the global auto insurance industry seen in the past decade.Starting from the perspective of economic externalities,vehicle negative externalities in China are described.In order to introduce mileage-based pricing insurance to the Chinese insurance industry,this paper reviews the current practice of PAYD insurance and its impacts on transport externalities,including air pollution,climate change,energy dependency,congestion,accidents,and others.Finally,enlightenment and policy suggestions are proposed,in the hope of better promoting the low-carbon economy development over the whole of China.

Research on Insurance Pricing

In this paper, by analysing relationship between insurance premium and insurance compensation, the derivative assets pricing theory and the partial differential equation are used to studythe pricing of insurance products and establish insurance price models. In addition, insurance priceformulas for several general insurance types are also presented. The insurance pricing method thatis given in the paper doesn't depend on mortality ratio and the probability distribution of losses.It is an obvious difference between the insurance pricing method in the paper and the traditionalinsurance pricing methods. Thereby, this paper serves to develop a insurance pricing method, andhas important practical or immediate significance. Finally, the application of the method is given.

Research on problem about technology insurance pricing based on backward stochastic differential equation theory

The development of Backward Stochastic Differential Equation Theory is just a thing happened in the past years. Although its development and application is far behind Forward Stochastic Differential Equation, its wide application prospect on financial mathematics gets more and more attention. The meaning of Backward Stochastic Differential Equation is that change a already-known final （usually uncertain） goal into a present certain answer to make a present resolution. But Insurance Pricing happens to know the final result, it＇ s certain that the result is uncertain, that is to say, to get out of danger or not. And then make present insurance price according to the future uncertain result. The Insurance Pricing just follows the meaning of Backward Stochastic Differential Equation. Insurance Pricing itself is also a research field sprang up in past scores of years, because insurance pricing is the indisputable core of insurance work, and gets quite a few researchers＇ attention. This article adopts backward stochastic differential equation theory and do research on problem about technology insurance pricing.

Applied Research of IoV in Insurance Industry

A vehicle intelligent terminal is designed to collect vehicle state information and driver behavior information based on the application of Internet of Vehicle in the insurance industry, and data of 12 risk factors affecting the traffic safety is extracted from the information. The Principal Component Analysis is improved and PCA based on the index significant priority is proposed, using which the data of risk factors is processed and 3 principal components are obtained as the pricing factor of the insurance industry.

中国社会医疗保险制度未来发展的挑战与创新建议

中国社会医疗保险制度发展至今,已覆盖了95%以上的人口,筹资和报销待遇都达到了与国民经济所处的中等收入国家地位相称的水平,但也存在不同人群待遇相差悬殊、医保基金使用效率不高的问题。未来需要从实现公平的国民待遇、进行科学的医保筹资规划、制定统一的医疗服务价格、设计合理的医保报销政策、明确划分中央与地方政府的职责等方面,正视挑战,创新发展,避免医保制度发展的中等收入陷阱。

中国智能网联车险之现实困境与创新路径

在智慧交通新时代,智能网联车险面临着新的机遇和挑战。本文分析了国内外智能网联车险的发展现状和特征;从智能网联汽车衍生的新兴风险、车险市场经营管理面临的挑战、车险产品和服务的创新需求三方面,探讨了智能网联车险发展的现实困境。基于国外智能网联车险模式的经验借鉴,提出政府、监管部门、保险公司与科技公司合作共赢,进一步完善智能网联车险相关法律体系,创新监管模式,完善车险生态环境,提供优质车险产品与服务等政策建议。

典型国家和地区原研药医保支付标准设计对我国的启示

目的:为国家药品集中采购政策背景下的药品医保支付标准管理提供参考。方法:对典型国家和地区的药品医保支付标准管理经验进行研究。结果:选取的典型国家和地区具有较为完备的药品医保支付标准管理体系,参考市场实际交易价格等多重因素,仿制药与原研药医保支付标准存在差异。建议:完善相关政策文件,建立科学的药品医保支付标准管理体系,通过药品市场价格交易监测机制,构建以市场为导向的医保支付标准形成机制,根据仿制药与原研药等不同药品的不同属性进行精细化分类管理;同时,在当前国家药品集中采购品种同通用名实行同一医保支付标准的政策前提下,继续推进并优化仿制药一致性评价工作,实现仿制药与原研药临床疗效一致,以符合当前仿制药与原研药实行同一医保支付标准的政策导向。

碳排放权交易价格保险产品设计探索——基于“保险+期货”模式

国际上碳保险产品随着碳交易的兴起而兴起,已有近十年历史。我国碳保险产品目前还处于起步阶段,但前景广阔。借鉴农产品“保险+期货”模式创新碳期货保险产品,以其中4种保险产品为例在蒙特卡洛方法下进行定价及敏感性分析,最后对A企业进行个案分析。研究发现:保险产品的避险效果明显,其中我国碳交易市场保险费率最低,欧盟碳交易市场保险费率最高。目标价格和市场波动率对4种保险费率影响明显;无风险利率的影响较小;障碍期权“触碰式”敲出价格和价差期权托底赔付价对保险费率影响明显,而封顶结算价影响较小。

甘肃省苹果“保险+期货”价格风险管理研究

采用EGARCH模型实证分析了2017—2021年甘肃省苹果价格波动特征,结果表明,甘肃省苹果价格序列呈现“尖峰厚尾”特征,当期苹果价格上涨对下期市价波动的影响更大。甘肃省通过建立苹果“保险+期货”价格风险管理机制增强了苹果产业链规避价格风险的能力,为农户防范苹果价格波动风险构筑了屏障。甘肃省全面推行苹果“保险+期货”还存在制约因素:资金不足,补贴依赖性强,期货基差风险、期货对冲风险影响保险效果。全面推广苹果“保险+期货”业务需要进一步增加政府资金支持、拓宽保险资金筹集渠道、创新保单设计和场外期权产品、加强农户的金融知识培训、优化参与主体的协同机制及加强新一代信息技术应用。

消费者风险厌恶的运费险分担机制与供应链定价研究

考虑消费者的退货行为、风险厌恶态度和运费险价值敏感,建立零售商承担、消费者承担、零售商与消费者共同承担、零售商与制造商共同承担4种不同运费险承担方式的Stackelberg价格博弈模型,研究供应链的定价决策和在线零售商的最优退货运费险策略。研究表明:低退货率和高运费险敏感性有助于提高供应链的整体利润;低退货率时,在线零售商主动为消费者购买运费险优于消费者自行购买;运费险的分担机制不能实现供应链协调。

房价对家庭商业保险参与的影响——基于CFPS的实证研究

基于2016年与2018年中国家庭追踪调查(CFPS)数据,利用Probit和Tobit模型实证研究了房价波动对家庭商业保险参与的影响。实证结果表明,房价变动显著地提高了家庭对商业保险购买的概率,且主要通过房价变动所带来的财富效应促进了家庭保险参与。通过倾向得分匹配法(PSM)控制内生性以后,研究结果依然显著,利用更换估计方法和扩充样本的方式进行了稳健性检验,结果仍然稳健。异质性分析表明,房价变动对家庭商业保险参与的促进作用更明显地体现在高收入、城镇地区和较高教育水平的家庭群体中。最后,提出了具体的对策建议。

双寡头在线零售商的退货运费险策略研究

在线零售商提供的免费退货运费险能有效解决顾客线上购物的退货风险,提升其购买意愿,但同时也提高了退货率,增加了在线零售商的运营成本,因此退货运费险受到广泛关注。文章假设双寡头在线零售商分别向同一市场的顾客销售高、低质量的产品,同时决策是否向顾客免费提供退货运费险,在4种策略组合下分别构建以零售商各自利润最大化的数学模型,得到最优零售价格、需求及利润,求出两零售商的纳什均衡策略,并对保费等关键参数进行了灵敏度分析。

创新医疗技术收费立项、定价与医保目录准入

加快创新医疗技术立项、规范收费定价与医保准入是支持技术创新的体现。本文在回顾国家层面新增医疗服务价格项目与医保准入文件的基础上,比较各地支持创新医疗技术实践做法,并提出规范创新医疗技术收费立项、定价与医保准入管理的相关建议。即进一步厘清技术规范、立项指南与新增医疗服务价格项目申报的关系,做好工作流程对接;按医疗技术创新程度设置绿色通道与常规通道兼备的新增项目申报通道;综合运用成本定价、价值定价和参考定价法,促进新增项目价格合理形成;明确转归核定医疗服务价格项目医保支付目录准入的申报、评价、遴选规则等。

乌克兰危机后全球油气“影子船队”的现状、影响及建议

乌克兰危机升级后,因西方制裁导致出现运输受制裁的石油或其他商品的“影子船队”现象。在广义概念里,“影子船队”包括已经遭受制裁或正在采取相关措施规避西方制裁影响的船只。西方国家对俄罗斯海运原油和成品油设置的价格上限政策,大大刺激了“影子船队”的发展,相应地,“影子船队”严重削弱了西方对俄的制裁效力,使价格上限政策名存实亡。当前,“影子船队”正从石油拓展到LNG等其他领域,将面临制裁和监管升级的长期压力,放大安全、环保等航运不可控风险。“影子船队”的成功经验不可复制,在实际运行中,俄罗斯与石油进口国围绕“影子船队”的运行也出现一些分歧。面对美西方在航运领域的涉华风险,航运保险正成为突出的“卡脖子”风险领域。对此,我国应增强海运保险承保能力,打造自主可控的“国险”服务体系。