Strategic Insights into the Integration of Internet Platforms, Pharmaceutical Companies, and Insurance Groups in the Greater Health Industry: A User-Centric and Ecosystem-Driven Approach
Editor’s Note: This article was written by Yi Ran and published with authorization from VCBeat.
Author Background: Formerly Head of Patient Community and Private Domain Traffic Operations at Baidu Health; General Manager of the Healthcare Division at Qingsongchou (Easy Fundraising); Vice President at Yuanxin Huibao; Director of Product Design and Business Development at Taikang Online. Served as a consultant to CITIC and other fund management firms and consulting companies. Participated in the design of China’s earliest PBM insurance programs for pharmaceutical companies and genetic testing services, and pioneered the design and implementation of patient-centric private domain traffic operation models.
As internet integration deepens and the aging population trend accelerates, the healthcare sector is becoming increasingly vibrant. Gaining insights into the characteristics of the broader health industry and implementing effective practices are central to driving the strategic flywheel. Formulating a comprehensive health strategy requires a deep understanding of users, encompassing not only individual consumers on the C-end but also collaborative partners across the upstream and downstream of the industrial chain. This article attempts to analyze the core strategies of various enterprises in the broader health sector by examining the user mindset of internet healthcare companies, pharmaceutical firms, and insurance companies, as well as their industrial convergence.
1. Healthcare Decision-Making
Medical care decision-making refers to the decision phase spanning from when users experience physical discomfort and seek to understand treatment options to when they actually visit a hospital. As representative content-search platforms, Baidu and Toutiao are the go-to choices for users with health and medical information needs. Leveraging hundreds of millions of page views (PV) for health- and medical-related content searches, search-based platforms possess a source of precise, proprietary users that other platforms cannot match.
The advertising-driven revenue model of such companies is rapid and effective; however, as search traffic has nearly reached its ceiling, this business model lacks further growth potential. From a strategic development perspective, it is essential to further uncover user needs and provide precise, reliable services, thereby achieving integration with the industrial sector. To achieve this goal—transforming short-term users driven by search queries into long-term users seeking healthcare services and decision support—the product architecture must facilitate more efficient user retention and engagement. This involves continuously refining dynamic user profiles to more accurately match users with relevant information and services, thereby steadily building user trust and enhancing the overall user experience.
The commercialization model for consumer-facing services relies on traffic, which may, to some extent, impact existing advertising revenue. In the face of business transformation and the evolution of industrial collaboration models, strategic decisions must be clearly defined and supported by a series of measures to ensure their effective implementation. Meanwhile, platforms must also prioritize ensuring that the commercialization of internet-based services is advanced in a lawful and compliant manner.
2. Pharmaceutical E-commerce
Compared with users in the medical decision-making phase who conduct information searches on search platforms, users of Alibaba Health and JD Health have more clearly defined demands for pharmaceutical products, as they are typically referred or treated by offline hospitals. Pharmaceutical e-commerce platforms provide B2C product solutions; their user base is smaller in scale but exhibits higher adherence and stronger willingness to pay compared to users in the medical decision-making phase.
For e-commerce platforms, the core strategic directions are enriching SKUs, cultivating user perception of completing transactions on the platform, and integrating and optimizing payment methods.
Enriching SKUs and building user awareness are often intertwined. This involves not only opening online stores but also conducting a more comprehensive analysis of the current status and demands of core SKUs in collaboration with pharmaceutical companies to formulate communication strategies for building user awareness and establishing a robust basic service operations network. For products commonly used in clinical settings, operational cooperation with physicians should be strengthened. For products that have not yet achieved full coverage in retail terminals, better communication strategies should be developed for lower-tier markets. For traditional Chinese medicine (TCM) products aiming to enter overseas markets, efforts should be made jointly to improve logistics and customs clearance for direct TCM purchases from abroad, followed by effective communication targeting overseas Chinese communities.
Another core focus is the establishment of payment mechanisms. Compared with other platforms, e-commerce platforms should take the lead in innovating payment methods to reduce users’ transaction costs. For drugs covered by basic medical insurance, integrating online pooled fund payments and personal medical insurance account payments is undoubtedly the priority of government-oriented (To G) initiatives. For drugs not covered by basic medical insurance, pursuing innovative PBM (Pharmacy Benefit Management) payment collaborations with health insurers and pharmaceutical companies, and implementing multi-stakeholder solutions within hospitals, should be key areas of emphasis.
3. Pharmaceutical O2O
Compared with e-commerce platforms whose logistics cycles are approximately one day, the O2O model connects retail pharmacies to meet users’ daily medication needs more rapidly. During the pandemic, demand for medications treating common colds and gastrointestinal disorders surged on food-delivery platforms, prompting manufacturers—particularly those producing over-the-counter (OTC) traditional Chinese medicine products—to place greater emphasis on online sales volumes.
For O2O platforms, their core strengths lie in regional user reach, pharmacy connectivity, and the delivery capacity of millions of riders; their strategy should therefore be shaped around these core advantages.
Based on regional user reach and pharmacy connectivity, priority should be given to building a digital pharmaceutical retail network to empower regional retail pharmacies. Establishing such a digital retail network can create new growth avenues similar to the U.S. CVS Pharmacy PBM model. On the product side, the system connects with pharmacy sales systems to drive online incremental sales for retail pharmacies while providing demand analysis modules to optimize inventory management. Simultaneously, it integrates with B2B supply chain systems to enable intelligent product selection for pharmacies through digital tools. This approach helps pharmaceutical companies cost-effectively access non-chain retail terminals and accelerate pharmacy coverage. At the data level, unlike currently underutilized data siloed within chain pharmacies or large distributors, Meituan leverages its supply chain data analytics capabilities to provide real-time strategic decision support for pharmaceutical companies’ retail business units. On the commercial front, collaborations with pharmaceutical companies on retail-related SKUs can innovate PBM insurance models, implement solutions in retail pharmacies, and enhance medication repurchase rates.
Leveraging the delivery capacity of millions of riders, O2O platforms hold a distinct "dimensional advantage" over other platforms in the field of chronic disease management. Taking diabetes as an example, simple online check-ins fail to ensure effective adherence management. Practical experience from many chronic disease management companies has demonstrated that among the "five pillars" of chronic disease care, dietary and exercise management are both the most critical and the most challenging. These two interventions require community-based, physical solutions for effective implementation. O2O platforms can collaborate with nutrition experts to develop diabetic-friendly meals, partnering with merchants for production and home delivery. Exercise management can be effectively implemented offline through community health activities organized by local community leaders. Similarly, individuals struggling with obesity can achieve weight management goals through professional dietary planning and customized weight-loss meal packages.
4. WeChat-Based Patient Management
For pharmaceutical companies, patient repurchases, clinical research on drugs, and patient recruitment all depend on effective patient management programs. Managing patients with chronic and critical illnesses requires effective outreach tools and strategies, and WeCom is the most effective tool for patient management through private domain traffic. Meanwhile, Tencent’s investments in the medical industry all possess patient entry points specific to medical scenarios: Medlinker in medical service scenarios, Shuidi in critical care hospitalization scenarios, and Yuanxin and Simcere in DTP pharmacy scenarios. How to effectively integrate patient resources from these companies, combine them with Tencent Medical Encyclopedia’s rich professional medical content in existing industrial sectors, and create synergy in areas such as patient enrollment, operational strategies, and pharmaceutical marketing to form an efficient patient service system, is the core of Tencent’s strategic thinking on integrated digital health.
With an established patient base, a vibrant doctor-patient community can be further developed to identify pain points in out-of-hospital care. This will create a self-sustaining platform that integrates patient experience sharing, follow-up management, and medical services. By applying early-stage patient management operational strategies for tiered patient engagement, the platform ensures patients receive continuous long-term value. Such a platform will generate significant value for both society and the industry.
For industrial enterprises, the tightening external policy environment necessitates lean operations. Digital transformation helps improve internal personnel efficiency while leveraging the internet and commercial health insurance to expand externally, with the aim of increasing market share and extending Duration of Therapy (DOT), among other objectives. To achieve a comprehensive digital transformation from the inside out, Digital Heads must integrate their own products, gain a deep understanding of internal and external digital opportunities, and develop corresponding collaborative strategies.
1. Internal Digital Transformation
Internal digital transformation can simultaneously empower diverse business units (BUs). For the Hospital BU, tool-based products such as virtual representatives can empower existing sales personnel by facilitating efficient communication with physicians, while enabling intuitive management of staff performance through data analytics. For the Retail BU, leveraging external B2B platforms can effectively reach a substantial number of long-tail, non-large-chain pharmacies that are inaccessible to direct sales teams, thereby enhancing product coverage in the retail sector; furthermore, operational strategies can be analyzed and iteratively optimized based on supply chain data. For middle- and back-office departments, process-oriented management via internal business management systems can improve staff efficiency, ultimately achieving an overall increase in workforce productivity.
2. External Industrial Integration
Pharmaceutical companies need to determine their collaboration models with internet healthcare providers and commercial health insurers based on their own product formats. By understanding the distinct characteristics and attributes of internet healthcare platforms (as referenced above), as well as their phased strategic priorities and resource endowments, companies can identify suitable platforms in areas such as retail, prescription drugs covered by medical insurance, and innovative payment services and products. They should clearly define strategies for each stage—including user acquisition, product reach, transaction methods, disease course management, and repeat purchases—to implement a marketing model that achieves mutual benefits.
The primary models of collaboration in commercial health insurance include drug efficacy insurance, innovative payment insurance, and specialty drug insurance. For in-hospital medications, we can collaborate with insurers to design drug efficacy insurance products. For instance, in our past practice, we designed an efficacy insurance product for a renowned multinational pharmaceutical company, which significantly improved medication adherence duration from the original three months to six months. For retail medications not covered by basic medical insurance, innovative payment insurance can replace the existing Patient Assistance Program (PAP) model. This approach helps establish long-term relationships with patients, extends Days on Therapy (DOT), and enables effective patient tracking and management through online methods such as private-domain traffic operations. For pharmaceutical companies focusing on the treatment of common diseases, they can co-design single-disease insurance products with insurers. Alternatively, adopting a model similar to specialty drug insurance, medications for common conditions can be incorporated into insurance policies as coverage liabilities, thereby achieving pre-diagnosis sales binding of drugs to users.
Insurers’ grand health strategies can be divided into two dimensions. One dimension involves providing comprehensive medical service guarantees to users who have filed claims or have pre-existing conditions, such as TPA services including green-channel access to medical care and advance payment/direct billing, as well as the innovative payment insurance models developed through collaborations with pharmaceutical companies and retailers mentioned earlier (which will not be reiterated here). The other dimension focuses on daily health management for policyholding insurance customers.
As commercial health insurance takes flight with the aid of the internet, its penetration rate continues to deepen, making post-policy services for customers a fiercely contested arena among major insurance companies. A policy delivered with warmth and care can enhance customer loyalty to an insurance brand, thereby boosting renewal rates. Ping An Group leverages its comprehensive financial licenses across the entire industry chain to meet users’ multidimensional needs through a suite of financial services. Meanwhile, Taikang Group has launched the Health and Wealth Planner (HWP) program, adding a health services segment to its core businesses in medical-elderly care integration and asset management.
Insurance companies have two major strategic directions for health services: one is to position them as profit centers and new growth drivers; the other is to treat them as cost centers, serving as middle-office units that enhance customer loyalty.
The core value of health services for insurance companies lies in enhancing user stickiness and experience; therefore, they should be treated as cost centers rather than profit centers. Insurance groups should empower their millions of agents across China with health service capabilities by formulating strategies such as private-domain traffic operations, continuously improving health product solutions as a key means of daily customer relationship maintenance, and sharing health concepts with users through continuous and proactive health management to boost customer loyalty.
There are two core elements to implementing the above strategy:
One approach is user outreach. If products like health e-commerce platforms rely on passive traffic-driven strategies, waiting for users to search for related services, the inherently low frequency of health-related needs will result in extremely low product activation and usage rates. In contrast, by leveraging existing agent networks and initiating proactive interactions through topics such as daily health tips—serving as conversation starters—companies can effectively harness offline agents’ traffic and trust to reach users and enhance service experience. The most suitable strategy here is private-domain traffic operations: centralizing the production of daily content, enabling agents to segment users, and matching layered content accordingly. This allows agents to authorize distribution with a single click, ensuring customers with different needs receive tailored, valuable information, thereby improving operational efficiency.
Second, select appropriate products and services that deliver value to users, thereby enhancing their trust in Dai Ren Li. For instance, during the summer months, while sharing daily tips on dampness removal, we can offer related solutions such as coix seed (Job’s tears) as complimentary gifts. Additionally, these items can be made available on the Health Mall at cost price, enabling customers to gift them to their family members. Precise push-notification strategies will make users feel cared for and warmed, akin to a native of Shaanxi receiving steamed buns and chili peppers from their hometown—low in cost yet high in experiential value. When users require more professional consultation regarding diseases or medical care, such as for metabolic disorders like obesity, we can introduce specialized service teams, including registered dietitians, to provide authoritative and free professional consultations, thereby offering a comprehensive solution to users’ healthcare concerns.
When daily content and product solutions possess self-propagating attributes, it indicates that the value of health services to users is recognized. Helping users develop healthy habits and enabling early intervention for health issues not only enhances user experience and improves policy renewal and retention rates, but also supports users in maintaining physical and mental well-being through health management, thereby reducing insurance claims payouts.
The above content merely reflects some of the author’s reflections from working in the broader health and wellness sector. It is shared with the hope of sparking further discussion and providing inspiration to readers. Industry professionals are welcome to engage in dialogue and share their insights.