Medical assistance serves as a fundamental institutional arrangement safeguarding the basic healthcare rights of disadvantaged populations. Technologies such as big data and artificial intelligence are driving the digital and intelligent transformation of medical assistance. Drawing on case studies, this paper constructs a theoretical analytical framework centered on core elements—needs identification, service provision, and outcome feedback—to systematically elucidate the logic of how digital and intelligent technologies empower medical assistance governance. Research findings reveal that digital and intelligent empowerment has yielded significant outcomes in medical assistance governance: the policy framework has been continuously refined, digital and intelligent infrastructure development has progressed steadily, and administration services have been consistently optimized. However, challenges persist, including the digital divide and equity gaps, insufficient information sharing and institutional coordination, incomplete rules for technology integration, and underdeveloped digital governance mechanisms. Based on this analysis, the paper proposes pathways for digital and intelligent empowerment in medical assistance governance: bridging the digital divide and promoting service equity at the value level, deepening governance coordination and information sharing among stakeholders at the governance entity level, advancing the deep integration of technology and services at the governance process level, and strengthening safeguards for digital and intelligent governance mechanisms at the governance mechanism level.

Objective: Focusing on the stage of volume reporting for centralized procurement of medical consumables, the paper analyzes the practical difficulties and management bottlenecks in the process, providing empirical evidence for improving the accuracy, timeliness, and standardization of volume reporting work. Method: Using semi-structured in-depth interviews, five representative public hospitals in a city were selected to conduct research and analysis around core contents such as volume reporting process, data review, exception handling, and policy implementation. Result: The study found that there are three major problems in the volume reporting work, including underreporting, untimely reporting, and insufficient accuracy. The root causes involve multiple factors such as deficiencies in hospital system and process, insufficient prioritization, and the lack of incentive mechanisms. Conclusion: It is recommended to optimize the in-hospital volume reporting system and process framework, solidify the main responsibility for management, customize a reasonable incentive and restraint mechanism, and enhance the informatization management level of medical consumables in the hospital.

Accurately identifying and effectively managing the risks involved in the implementation of the medical insurance benefits list system is a key component in ensuring its smooth and successful implementation and effectiveness. The study finds that among the policy adjustments involved in the medical insurance benefits list system, four are high-risk and eleven are moderate-risk. Factors contributing to these risks include loss of interests, unscientific and unjust decision-making, implementation deviations, policy gaps, differences in risk perception, and timing of reforms. It is recommended that each coordinating region, in the process of implementing the medical insurance benefits list system, should focus on actively preventing risks, improving the risk-bearing mechanism, strengthening scientific and democratic decision-making, enhancing policy communication, perfecting incentive and restraint mechanisms, accelerating the development of medical insurance, and deepening comprehensive medical insurance reform.

The 20th National Congress of the Communist Party of China explicitly called for the "establishment of a long-term care insurance system". In 2016, China initiated a pilot project for the long-term care insurance system, and in 2020, the pilot project was further expanded. In the pilot cities, designated management of care institutions has been widely implemented, accompanied by the introduction of relevant management policies. This has alleviated the economic and transactional burdens on disabled individuals, especially those with severe disabilities, and their families. It has also promoted the development of industries related to elderly care. This article is based on survey data from designated care institutions in national long-term care pilot areas (2022), analyzing home-based service institutions, elderly care institutions, and medical institutions that provide long-term care insurance services in terms of operational aspects, service scale, service personnel, and service management. The results indicate that, currently, overall long-term care insurance services are predominantly provided by home-based service institutions, with the number of elderly care institutions and medical institutions providing institutional nursing services being roughly equivalent. There are differences in the development level and service capacity among the three types of institutions, and there is imbalance among regions. Standardization in terms of institution types, quantity, and management requirements needs improvement across different regions. This article puts forth recommendations for strategies in managing designated institutions, building the workforce of service personnel, and enhancing regulatory capabilities.

Multiple factors such as information asymmetry and suppression of potential supply and demand have constrained the further development and growth of commercial health insurance industry in China. In order to fully meet the diverse health needs of the people and promote the development of "medical insurance, medical services, and pharmaceuticals" plus health finance industry, this article proposes to develop "medical insurance plus commercial insurance" one-stop settlement, analyzes the problems that constrain the development of commercial health insurance in China, and proposes policy thinking and feasible paths, in order to provide a reference for the innovative development of medical service, medical insurance, pharmaceuticals and commercial health insurance.

The transition period for poverty alleviation is coming to an end, and with the increasing personal contributions to medical insurance, the enthusiasm and sustainability of rural low-income population's participation in insurance pose huge challenges to the full coverage of basic medical insurance in China. This paper proposes a method to quickly estimate individual income distribution based on grouped macro data published by the National Bureau of Statistics. It estimates the scale of the low-income rural population in China under different standards and calculates the cost required for subsidized medical insurance enrollment under various subsidy schemes. The results indicate that in 2023, the national rural low-income population is approximately between 76 million and 109 million. If the personal medical insurance contributions for the entire low-income population are fully subsidized, the burden would be about between 28.9 billion to 41.3 billion yuan. If subsidies are provided to the low-income population based on categories, the burden would be about between 11.9 billion to 20.6 billion yuan, accounting for 0.53%~0.92% of the health expenditure portion in the national general public budget, about 1.95%~3.39% of the total fiscal subsidies for medical insurance financing and about 15.95%~27.72% of the expenditures on medical assistance funds.

Objective: The paper analyzes the impact of the centralized volume-based procurement policy on the use of liver function biochemical test reagents in hospitals of Jiangxi Province, and provides a reference for improving procurement policies for in vitro diagnostic reagents. Methods: Monthly data on the use of six types of liver function biochemical test reagents in five hospitals of Jiangxi Province were collected from July 2022 to June 2024. An interrupted time-series analysis was conducted to evaluate changes in the number of patients, reagent usage volume, and per capita usage before and after the implementation of the centralized procurement policy. Results: After the implementation of the centralized procurement policy, there was a significant decrease in the number of patients using the six types of liver function biochemical test reagents (β₃ = -5678.00, P = 0.022) and in the total reagent usage volume (β₃ = -12556.26, P = 0.014). Although the per capita usage showed a downward trend, the difference was not statistically significant (β₃ = -0.0140, P = 0.207). Additionally, the policy led to a significant reduction in the number of patients and reagent usage for each type of reagent, while its impact on per capita usage was not significant. Conclusion: The centralized volume-based procurement policy had a significant impact on the use of liver function biochemical test reagents, helping to reduce the economic burden on patients and meeting their clinical testing needs.

Since 2016, the number of pilot cities (regions) for long-term care insurance have expanded to 49 and long-term care insurance made significant progress. Each pilot city (region) has introduced many institutional innovations tailored to local conditions, but there is also obvious policy fragmentation. This article focuses on four issues related to the fragmentation of the long-term care insurance system, including the target population benefiting from the policy, the supply structure of service modes, the focus of service projects, and the coverage boundaries of the two major institutional sectors. Emphasis was placed on analyzing four different approaches of mode selection, including operation mode, guarantee mode, financing mode, and administration mode, and corresponding policy recommendations were proposed one by one. According to the methodology of "crossing the river by feeling the stones and combining it with top-level design", this article proposes that the pilot should be completed as soon as possible and enter the top-level design stage to reduce sunk costs. According to the time nodes of establishing long-term care insurance in different countries, the establishment of long-term care insurance system in China fully reflects the basic principle of "do everything within our capacity", which is an important measure to promote Chinese path to modernization and achieve common prosperity. With the trend of population aging, it is recommended to carry out a "two-stage promotion" with the year of 2035 as the boundary to smoothly transit to a unified system for the whole country.

Objective: The paper attempts to provide guidance and reference for dynamically adjusting the prices of general medical services in various regions, and taking the most concerned examination fee as an example, to analyze the price comparison relationship between regions and items. Methods: In terms of price comparison between regions, descriptive statistical analysis methods are used. In terms of the price comparison relationship between items, the median or median value of the price comparison coefficient between other examination fees and the outpatient examination fees of attending physician is used to determine a reasonable price comparison coefficient. Results: The price comparison relationship between regions is not reasonable enough, and more than half of the provincial item prices do not match the price range. Some examination fee items have a large coefficient of price difference between provinces. The price comparison relationship between items is not reasonable enough, and the range of price comparison coefficient between other examination fees and outpatient examination fees of attending physicians is relatively large. Conclusion: For examination fee items with unreasonable price comparisons between regions and items, it is recommended that each region reasonably set the price benchmark for outpatient examination fees of attending physicians based on the suggested price zone, and use the reasonable price comparison coefficient between items to synchronously adjust the prices of other examination fee items.

Objective: The paper explores the motivations and influencing factors in the implementation of integrating retail pharmacies into basic medical insurance outpatient pooling fund policy, the attitudes of various stakeholders towards the policy, and put forwards targeted suggestions to promote the policy smoothly. Methods: Semi-structured interviews were conducted with the decision-makers of healthcare security departments, managers of medical institution and outpatient doctors, retail pharmacy managers and staff, and employees' basic medical insurance participants in the capital cities of three provinces in eastern, central and western regions of China. The stakeholders theory was used to analyze three core variables: the degree of interest correlation, the influence of policies, and the willingness to implement policies, and the core-variable matrix was further used to identify the motivations and influencing factors during the policy implementation. Results: All stakeholders have a strong interest correlation with the policy, and the healthcare security departments have a strong influence in policy and hopes to actively promote the implementation of the policy. The managers of hospitals and retail pharmacies have a strong willingness to implement the policy, but outpatient doctors and pharmacy staff are less motivated. Patients' attitudes towards the policy vary in different regions, but with the implementation of policies, the willingness of the insured people to implement policies will generally increase. Conclusion: The healthcare security departments need to provide strong technical support and supervision. The managers of medical institutions and retail pharmacies need to improve the management mode to enhance the professional competence and motivations of employees. Meanwhile, the publicity of the policy, especially the effectiveness of the policy should be strengthened to ensure that the insured people can fully understand the benefits of the policy, and implement the outpatient mutual aid policies.

Objective: The paper compares the clinical efficacy and safety of levofloxacin and sodium chloride injection in the national centralized procurement with that of the original drug for the treatment of community-acquired pneumonia (CAP). Methods: Clinical information related to patients diagnosed with CAP and using levofloxacin and sodium chloride injection in a large tertiary hospital of Fujian Province from October 20, 2020 to October 20, 2022 was retrospectively collected, and the propensity score matching method was used to adjust the differences between the groups and to compare the efficacy and safety of the two groups. Results: After propensity score matching, 117 patients were included in the generic group and 117 patients were included in the original group. There was no statistically significant difference between the two groups in terms of clinical response rate, leukocytes, neutrophil percentage, C-reactive protein, calcitoninogen, body temperature, and the duration of drug administration (days) between the two groups on the seventh day of medication. There was no statistically significant difference in liver and kidney function abnormalities between the two groups after medication. Conclusion: The efficacy and safety of levofloxacin and sodium chloride injection national centralized procurement is equivalent to that of the original drug for the treatment of CAP.

Objective: The paper attempts to study the impact of national centralized drug procurement on the stock prices of pharmaceutical listed companies. Methods: Using the event study method, nine batches of centralized drug procurement policies were taken as the research objects, and the impact of centralized drug procurement policies on stock prices was explored from the perspectives of selected enterprises and pharmaceutical industry. Results: The results showed that after the occurrence of each batch of centralized drug procurement, the stocks of the selected enterprises and pharmaceutical industry index produced significant abnormal returns. In terms of stock price, the policies had a negative impact on the selected companies to some extent and an overall positive impact on the pharmaceutical industry in the short term. However, this study did not compare selected drugs with the drugs that were not selected and did not participate in the centralized drug procurement. There is also no comparative analysis of stock price changes with other industries in the capital market. Conclusion: The study believes that the stock prices of the selected companies and the inverse movement of the pharmaceutical industry index lead to some arbitrage space, which is a good opportunity for long-term value investors to build positions. It is suggested that government departments should adhere to the normalization of the centralized drug procurement system, strengthen quality management and cost control of pharmaceutical listed companies, and cultivate a rational value investment concept among investors in the securities market.

Objective: The paper analyzed the operational logic and conditions for the quantity-price tradeoff in the negotiation of medical insurance drug access in China. Methods: Based on theories from management, economics, and related disciplines, this study explored the interactive relationship between quantity and price in market operations. It combined the characteristics of quantity-price relationships in the negotiation of medical insurance drug access to expound on the conditions and mechanisms for the realization of policy intentions in this work. It also discussed the measurement of various obstacles. Conclusions: The quantity-price relationship in the negotiation of medical insurance drug access is highly complex. Both the healthcare security departments and manufacturers need to have a clear understanding of the obstacles to subsequent operations, in order to make reasonable decisions, promote the smooth implementation of this work, and benefit the general public.

With the continuous construction of the national unified market, the national unified pharmaceutical market is becoming increasingly prominent as an indispensable component. As a link between government macroeconomic regulation and market mechanisms with efficient interactions, medical insurance plays a core catalytic role in promoting the construction of a unified national pharmaceutical market. Starting from the functional positioning and responsibility scope of the Healthcare security department, this article systematically analyzes how medical insurance reform can effectively empower the development of the pharmaceutical industry, in order to propose strategic thinking and practical suggestions for accelerating the construction of a unified national pharmaceutical market.

This study takes international experience and local practice as the two supporting points, systematically sorting out the DRG performance evaluation practice of countries such as the United States, Germany, and Australia, as well as the practice of Diagnosis Related Groups (DRG) / Diagnosis-Intervention Packet (DIP) performance evaluation in three regions of China. Through multiple rounds of discussions and demonstrations participated by healthcare security authorities, medical institutions, experts and scholars, two regions were finally selected for trial evaluation, and a performance evaluation system for payment by DRG/DIP (hereinafter referred to as the performance evaluation system) was ultimately constructed. This performance evaluation system adopts a method combining quantitative and qualitative analysis. Starting from four dimensions, namely reform coverage, implementation quality, diagnosis and treatment services, and patient benefits, 15 indicators are set up, which can comprehensively and scientifically evaluate the progress and effectiveness of the payment method reform. This study not only provides an important reference for healthcare security authorities to evaluate the effectiveness of the reform and adjust reform policies, but also provides a decision-making basis for medical institutions to optimize internal management and improve service quality. It has important theoretical value and practical significance for promoting the high-quality development of payment method reform in China.

Objective: This study attempts to explore the impact of urban and rural residents’ medical insurance (URRMI) on rural labor supply and its underlying mechanisms. Methods: Using the four-period panel data of the China Family Panel Studies (CFPS), this study applies Logit model and multiple linear regression model, and adopts instrumental variable methods and entropy balance matching method to address endogeneity issues. Results: URRMI significantly promotes rural labor participation and supply time, through the pathway of improving employees’ health. Further analysis shows that URRMI exerts stronger positive impacts on labor supply in the western region and the youth group (16~44 years old). Meanwhile, it can improve the quality of labor supply and break the "low-skill lock-in" dilemma. Conclusion: It is suggested to strengthen publicity and guidance, as well as provide incentives for insurance participation, and continuously expand the coverage of URRMI, enhance the allocation of primary healthcare resources and service capabilities, and consolidate the foundation of health security, optimize the design of URRMI system, and increase the protection for key groups, improve the vocational skills training system and enhance the quality of rural labor supply.

"Accelerating the completion of the shortcomings of rural elderly care services" is a major strategic deployment proposed by the third plenary session of the 20th Central Committee of the Communist Party of China. This article uses questionnaire surveys and case interviews, as well as the data of the fourth and fifth sampling surveys of the living conditions of elderly people in urban and rural areas in China, to analyze the problems and challenges faced by rural elderly care in China, based on the analysis of the changes in China's traditional rural elderly care system. The paper proposes to build a rural elderly care service system with township health centers as the main body. First, encourage qualified township health centers to provide long-term care services and make up for the shortcomings of rural elderly care services. Second, strengthen departmental linkage and financial subsidies to reduce the transformation cost of township health centers. Third, accelerate the coverage of long-term care insurance to all residents and improve the supply capacity of rural long-term care services. Fourth, rationally design long-term care insurance and medical insurance payment policies to improve the enthusiasm for service supply.

This article systematically reviews the policy texts and practical cases related to the management of excluded medical consumable charge across various provinces. It conducts a historical analysis and examines current characteristics and future development prospects of management models for excluded medical consumable charge in China. The research shows that in terms of the evolution of management models, each province has used "excluded content" as the core management framework in the past, and adapted policies based on local practical needs. However, there are differences in the management standards for excluding charges for the same medical consumables among provinces. During the implementation of the “separation of technology and consumable” reform and the introduction of relevant guides for project initiation, three management models have been initially formed nationwide, namely supporting chargeable consumables for the guides, compiling a catalog (list) of separately chargeable consumables, and implementing the national nonbasic material consumption list. These three models, in order, show the practical characteristics of steady transition, system optimization, and one-step implementation. At the same time, research has found that the boundaries and attributes of charging for a few basic consumables still need to be further clarified. Based on those findings, this paper recommends that we advance the national standardized management of excluded medical consumable charge in a phased and prudent manner, following the operational logic of “transition first, integration next, followed by fine-tuning”. Concurrently, we should establish and refine a dynamic adjustment mechanism for excluded consumable charge, in order to provide practical guidance for enhancing the efficiency of medical consumable charge management and balancing the interests of multiple stakeholders.

Objective: The paper attempts to analyze the practical experience of the United Kingdom, Canada, and the United States in applying real-world data (RWD) to health insurance access (reimbursement) decision-making, and, in light of China's current policy context, propose a construction pathway for an RWD-driven comprehensive value assessment system for pharmaceuticals to inform the improvement of China's reimbursement policy. Methods: Twenty-six orphan drugs that had been included in the UK National Health Service (NHS) through the Highly Specialised Technologies (HST) evaluations conducted by the National Institute for Health and Care Excellence (NICE) before May 2025 were selected as the study samples. The reimbursement assessment reports issued by NICE, the Canadian Agency for Drugs and Technologies in Health (CADTH), and the US Institute for Clinical and Economic Review (ICER) were analyzed. Combining specific application cases, the study examined the use of RWD from two perspectives—companies (P1) and assessment agencies (P2)—to explore the specific purposes, data sources, and assessment agencies' considerations of RWD in addressing uncertainties related to effectiveness (D1), cost (D2), population and market share (D3). Results: RWD was used in the reimbursement assessments of 96%, 62%, and 19% of the drugs evaluated by NICE, CADTH, and ICER, respectively. Its primary applications were in evaluating four dimensions of pharmaceutical value: economic efficiency, effectiveness, safety, and accessibility. Specifically, RWD was employed to address three main categories of uncertainty: effectiveness uncertainty (D1), cost uncertainty (D2), and population and market share uncertainty (D3) . The main purposes included providing data on disease management costs, patient outcomes, and target populations. RWD was most widely applied in addressing cost (D2) and effectiveness (D1) uncertainties. All types of RWD were used by both companies (P1) and assessment agencies (P2), though some datasets were challenged by assessment agencies due to concerns about their applicability or low evidence level. Conclusion: The application of RWD in reimbursement decision-making has been increasingly adopted by assessment agencies. However, differences remain in the degree of acceptance across different purposes and RWD types. Overall, RWD plays a crucial role in the reimbursement process, yet its application still requires clarification of specific use scenarios, alignment of data-source grading with appropriate purposes, and the establishment of standardized guidelines to enhance scientific rigor and standardization of its application.

The coordinated development of the "1+3+N" multi-level healthcare security system is an important measure to improve the level of healthcare security treatment. The optimization of the payment order fundamentally depends on the misplacement and coordinated development of the "triple security" and "other security forces" levels by analyzing the formation path of the treatment payment order of various levels. We must adhere to the principles of “goal synergy, functional misplacement, and content complementation” between "3" and "N". Specifically, the "triple security" should be guided by system integration, continue to promote the reform of medical insurance financing mechanism and payment methods, and further promote health equity on the basis of the goal of “adequate security of basic medical needs”. Traditional commercial health insurance should adhere to the misplacement development with “diversified medical needs satisfaction” as the core, and strive to meet the differentiated medical needs of the public. City-customized commercial health insurance and mutual aid insurance for employees should adhere to the misplacement development with “basic medical expense compensation” as the core to make up for the gap in the basic system for major diseases.

Objective: The paper analyzes the current status of price governance for typical laboratory test items and provides references for the standardization of medical service price governance. Methods: Taking the four laboratory test items in the first batch of national price governance as the research objects, this paper analyzes the problems of current laboratory test items, uses descriptive statistical analysis methods to compare the dynamic evolution of price levels before and after price governance, and the price relations among regions and items. Results: There is heterogeneity in laboratory test price items in various regions. Before standardized governance, the regional difference of price levels was obvious. After the implementation of the policy, the price system of laboratory test items showed a trend of overall downward price levels and narrowing of inter-provincial price differences. The price comparison of detection methodologies shows overall optimization but regional imbalance. Conclusion: The standardization and governance of price have basically achieved the goal of relatively balanced prices among regions, but there is still room for improvement in the optimization of price relations of methodologies for similar items. It is suggested to establish a unified national standard system and project initiation guidelines for price of laboratory test items, a price optimization mechanism guided by the value of technology and labor services, and a comparison and calibration mechanism for similar items based on clinical value.

Objective: To enhance the accessibility of high-value innovative drugs for patients, to guarantee the sustainability of medical insurance funds, to support industrial innovation, this study aims to explore an innovative multi-payment system that supplements, refines the existing national negotiation framework. Specifically, it seeks to identify scientific, reasonable methodologies, implementation pathways for determiningthe patient payment price, the medical insurance payment, the muti-layer security. Methods: This study adopts a multi-disciplinary approach such as literature review, expert interviews, small-group workshops, integrating theories from health management, health economics to refine proposals for the innovative multi-payment system, its implementation strategies. Results: The Component A should be based on patients' affordability, actual costs of alternative therapies, international benchmarks. The Component B should follow the existing National Insurance Drug Listrules, the medical insurance price is calculated, negotiated by pharmacoeconomic methods. Medical insurance determines the levels of Component A, B by balancing the affordability of patients with medical insurance funds. Subtracting Component A, B from the drug price is Component C. For Component C, innovative pharmaceutical companies play a leading role by providing part of the funds, leveraging various social resources to build a collaborative, resource-sharing multi-stakeholder payment system. Simultaneously, the government ensures the effective functioning of Component A, B, C through organizational coordination, policy guidance, financial support, enhancing the overall security capacity, effectiveness of the payment system. Conclusion: This study explores a social diversified payment system that combines patient payment price, medical insurance payment price for expensive drugs with high clinical benefits. This approach provides a viable pathway for balancing patients' accessibility, the security of medical insurance funds, the sustainability of the pharmaceutical industry innovation. Future efforts will focus on local pilot programs, wherein the specific structures of Components A, B, C will be tailored to regional conditions. Lessons learned from these pilots will inform the refinement of the payment system, the development of scalable demonstration models for broader implementation

Commercial health insurance is an important component in the construction of a multi-level healthcare security system. This study takes the social-commercial cooperation in critical illness insurance for urban and rural residents as the entry point, reveals the key issues of participation of commercial insurance in the critical illness insurance operation and analyzes the causes, through field research and a comprehensive analysis of the critical illness insurance operation and social-commercial cooperation models in sample regions. The study finds that while the critical illness insurance system has effectively alleviated the financial burden on patients with severe illnesses, it still faces numerous challenges, including unclear boundaries of stakeholder responsibilities, unequal distribution of profit and loss risks, inadequate incentive mechanisms, and unresolved information barriers. Based on these issues, this study proposes recommendations such as strengthening top-level design to clarify the functional positioning of stakeholders, improving cooperative mechanisms to fully leverage the advantages of commercial insurance, and optimizing supply-demand matching to reinforce the supplementary role of commercial insurance. These suggestions can provide practical insights and decision-making references for promoting the participation of commercial insurance in the construction of a multi-level healthcare security system.

Based on the experience of local outpatient payment method reform in China, the paper systematically compares the relevant policies in various regions, mainly analyzes the problems and challenges in the reform, and provides policy recommendations for improving the reform. The research shows that pilot regions in China have formed a diversified composite payment mechanism for outpatient services, including four types of payment methods under total budget: fee-for-service, capitation, value-based payment, and APG (Ambulatory Payment Group). However, there are still external challenges, including the aging population and worsening chronic disease trends, cross-region medical treatment and imbalance in the supply and demand of medical services, as well as conflicts between coordinated development and regulation of medical insurance, medical services, and pharmaceuticals and multi-party management. Internal institutional issues include the risks of extensive total budget management, the difficulties of refined management in diversified composite payments, and the difficulties in the integrated management of outpatient mutual aid reform policies. In the next phase, we should continue to innovate the concept of outpatient payment method reform based on the fundamental ideas of "people first" "health-centered" and "service-oriented" .Then the reform should combine the main functions of family doctors and capitation payment under total budget, leveraging the institutional advantages of new payment methods in refined management, and continuously optimize the reform measures of outpatient payment methods. Finally, the reform should adapt to the changes in current diagnosis and treatment models, incentivize medical institutions to provide high-quality medical services, reduce the burden of outpatient care on patients, guide the rational allocation of resources and promote the construction of a new orderly medical treatment and diagnosis system, comprehensively understanding the evolution trend of outpatient payment method reform.

Monopoly agreements for active pharmaceutical ingredients (API) occur from time to time. In the first half of 2025, The Supreme People's Court of the People’s Republic of China and Administration for Market Regulation have disclosed two cases of horizontal monopoly agreements in the API sector. Among them, the CP camphor case resulted in penalties and multiple remedial measures, offering valuable insights. The API market has become a hotbed for monopoly agreements due to the low cost and ease of maintaining such agreements among API operators, coupled with the broad profit margins available to the parties involved. The essential elements of an API monopoly agreement encompass subject element, form element, and effect element. The subject element should be defined primarily through demand substitution analysis. The form element should be assessed by examining the operators' collusive intent and shifts in competitive advantage. The effect element analysis should emphasize the operators' market share and API market price. With the deepening of anti-monopoly enforcement in the field of API, it is necessary to improve the anti-monopoly regulatory system of API by increasing the enforcement efforts, enhancing the precision of law enforcement and promoting the whole-chain supervision, optimize the regulatory system of the API industry in terms of streamlining the overall approval process and strengthening the bargaining power of downstream preparation enterprises, and implement a fair competition review system in this area, with a view to effectively enhancing the quality and effectiveness of the regulation of monopoly agreements on API.