Exclusive Interview with Zhan Haitao of Ruiyi Yaoda: Navigating the Future in a New Market Landscape

In recent years, with the sustained growth of the national economy and the intensifying trend of population aging, people have developed higher-level health needs. The State Council’s “14th Five-Year Plan for National Medical Security” mandates the improvement of a multi-tiered medical security system and encourages the coordinated development of commercial health insurance, charitable donations, and mutual medical aid. As a result, commercial health insurance has gained unprecedented space for development and new opportunities. However, traditional commercial health insurance products remain relatively homogeneous in form, while single-disease insurance and insurance for individuals with pre-existing conditions exhibit substantial market demand and development potential.

In this context, VCBeatZhan Haitao, Founder and Chairman of SOPHMEDConducted in-depth exclusive interviews, aiming to bring new perspectives and insights to the industry.

Zhan Haitao, Founder and Chairman of SOPHMED

The primary pain point for innovative integrated commercial health insurance entering the healthcare sector is the lack of products that simultaneously comply with insurance industry regulations and meet the specific requirements of the healthcare field. Balancing the interests and demands of all stakeholders under healthcare industry regulations has become the core challenge in the development of innovative integrated commercial health insurance.

Zhan Haitao stated that the government requires the improvement of a multi-tiered medical security system, hoping that commercial insurance will become an important component of this framework and provide robust supplementation. Patients are more concerned with the accessibility and diversity of pharmaceuticals; beyond ensuring the availability of treatments, there must be alternative drug combinations to offer more therapeutic options. Insurance companies aim to achieve refined management of overall funds by expanding their policyholder base. Meanwhile, the key demand for pharmaceutical companies is the rapid recovery of R&D costs to ensure a virtuous cycle of medical innovation.

Meanwhile, the deepening of healthcare reform has intensified competition in the pharmaceutical market, while changes in living standards and lifestyles have led to a continuous upgrade in people’s health awareness. However, “most commercial health insurance products still rely on the traditional logic of life and property insurance, focusing on dimensions such as insurance design and coverage items, with limited consideration from a medical and health perspective. For instance, the majority of current commercial health insurance policies only cover healthy individuals, while the development of health insurance products tailored for those with pre-existing conditions lags behind. In fact, it is precisely this group that has stronger demand,” said Zhan Haitao.

Therefore, to balance the diverse needs of multiple stakeholders, innovative integrated commercial health insurance must truly adopt a patient-centric approach and build a pharmaceutical-patient-insurance ecosystem that complies with healthcare industry regulations. This is also the core focus area of SOPHMED.

The development and upgrading of the industry present an opportunity for SOPHMED.

SOPHMED’s core team hails primarily from the pharmaceutical and healthcare sectors. Throughout their professional journeys, they identified the multifaceted needs of pharmaceutical companies, patients, and insurance providers, recognizing the urgent need for the industry to establish a new ecosystem driven by commercial health insurance. This ecosystem aims to launch more innovative, comprehensive commercial health insurance products that align with patients’ actual needs and comply with industry regulatory requirements.

Driven by the needs of pharmaceutical companies and patients, SOPHMED leverages commercial insurance tools and channels to build an ecosystem that deeply integrates pharmaceuticals, healthcare, and insurance, thereby empowering industry innovation and development.

To this end, SOPHMED has deeply cultivated three core sectors: innovative integrated commercial insurance solutions, patient management, and digital clinical research. By innovatively integrating and implementing these three business lines, the company is committed to meeting the diverse needs of various stakeholders at different stages, thereby enhancing the accessibility and affordability of medications for patients.

In terms of collaboration with pharmaceutical companies, SOPHMED has successfully provided innovative integrated commercial insurance solutions and patient management services to numerous large listed pharmaceutical companies and multinational pharmaceutical corporations. These services help enterprises improve patient adherence, extend duration of treatment (DOT), and enable patients to achieve better and more cost-effective therapeutic outcomes. Meanwhile, its digital clinical research services have helped biotech companies enhance their product development efficiency.

On the other hand, SOPHMED collaborates with leading insurance companies to innovate integrated commercial health insurance solutions and patient management, thereby assisting insurers in offering more insurance products that align with medical scenarios and patient needs.

For patients, innovative integrated commercial insurance solutions and patient management not only significantly improve the accessibility and affordability of high-value medications, enabling them to benefit from higher-quality, multi-tiered coverage services, but digital clinical trials also provide more therapeutic options, thereby enhancing patients’ trust and sense of security.

By connecting and serving various partners, SOPHMED truly aims to build an ecosystem with deep integration of medicine, patients, and insurance, designed to better serve patients and contribute to the government’s promotion of multi-tiered security system development.

According to Zhan Haitao, SOPHMED has completed the development of its foundational capabilities and system upgrades. It has established a patient-physician integrated management system with independent intellectual property rights. Centered on patients, this system enables a multi-party collaborative management model and offers “trinity” service capabilities encompassing commercial insurance integration innovation, health management, and digital clinical research.

“Despite the current environment, we have still achieved strong operational performance. Furthermore, our enhanced fulfillment capabilities now enable us to address diverse industry needs and design customized health insurance products.”

Currently, the healthcare sector is undergoing deepening reforms, and SOPHMED remains optimistic about the future development of the medical industry. “Once national standards and regulations are clearly defined, we will follow policy guidance, adhere to compliance requirements, and align with new industry standards and norms to embrace a brighter future for the sector,” concluded Zhan Haitao.

SOPHMED will serve as a bridge between the health industry and insurance companies, connecting diverse stakeholders—including pharmaceutical providers, patients, and insurers—to build a new ecosystem driven by commercial insurance payments, thereby fostering the healthy development of the industry.