Understanding MedTrust Health: Why can a company charge fees from both pharmaceutical enterprises and insurance companies at the same time?

It is not uncommon for an enterprise to charge both upstream and downstream players in the industrial chain.

Amazon sells products to consumers while charging platform fees from merchants; AWS serves developers and enterprise clients, and connects software vendors with enterprises through Marketplace at the same time; Salesforce builds AppExchange around enterprise clients, allowing third-party developers to enter its ecosystem and generate revenue from commercialization.

The common point of these companies is not that they "please both sides", but that they occupy a special position:

What they provide is not a single product, but a set of infrastructure that enables participants in the industrial chain to complete transactions more efficiently.

But the situation in the medical payment industry is more complicated.

A pharmaceutical company hopes its innovative drugs can be used by as many patients as possible, while insurance companies must control compensation risks and medical costs.

One cares more about "how to sell the drugs", and the other cares more about "how to keep risks under control".

Then, why can an enterprise serving both pharmaceutical companies and insurance companies make both ends of the industrial chain willing to pay?

This is an entry point to understand the business model of MedTrust.

Up to now, MedTrust has cooperated with more than 100 insurance companies, fully covering all major leading insurance enterprises in China, with a total of 443 million serviced insurance policies; at the same time, it has established cooperative relations with more than 140 pharmaceutical companies, including 90% of the world's top 20.

There is a question worth asking behind these numbers:

What on earth is MedTrust selling?

If the answer is only "connecting pharmaceutical companies and insurance companies", it is not enough to explain why both sides are willing to pay continuously.

A more reasonable answer may be:

It is selling an increasingly scarce capability in the medical payment system — organizing scattered resources, rules and payment demands to enable the complex pharmaceutical payment to be truly implemented.

01 Why do pharmaceutical companies and insurance companies become clients at the same time?

First, put MedTrust back into the medical payment industrial chain.

For a long time in the past, the logic of innovative drug commercialization was relatively simple: pharmaceutical companies were responsible for R&D and production, hospitals for diagnosis and treatment, medical insurance for basic payment, and patients for the remaining expenses.

However, after more and more innovative drugs come out, this chain begins to show an obvious problem.

Having a drug does not mean patients can access it.

Especially for high-value innovative drugs, rare disease drugs, CAR-T and other products, R&D and launch are only the beginning of commercialization. Pharmaceutical companies also need to answer a series of questions:

Who will pay for this drug? Can it be covered by basic medical insurance? Can it be included in commercial insurance? Which insurance products are suitable? How much pressure do patients have to pay out of their own pockets? If patients cannot afford it, how to design payment and assistance plans? How to ensure continuous medication after patients start treatment?

These issues did not belong to the core capabilities of traditional pharmaceutical companies in the past, but they are increasingly directly determining the commercialization efficiency of innovative drugs.

Therefore, what pharmaceutical companies need is no longer just "sales channels", but something else:

Payment channels.

MedTrust's intelligent pharmaceutical solution cuts in at this level.

It provides pharmaceutical companies with commercial solutions covering the whole life cycle of drugs, helps them understand commercial insurance, design diversified payment paths, and further connect patient services and payment scenarios. The InsRx platform launched in 2026 further structurally connects the data of innovative drugs and devices, indications, insurance products, protection responsibilities, payment rules and settlement processes, to provide pharmaceutical companies with decision support for commercial insurance access and diversified payment.

In other words:

Pharmaceutical companies pay to make it easier for a drug that has been developed to find a payment path.

The problems faced by insurance companies are completely different.

What insurance companies lack is not drugs, but the understanding of medical scenarios.

To design health insurance products, they need to know how diseases are treated, which drugs are entering clinical trials, how medical expenses change, and how risks are distributed among different groups of people; claim settlement requires understanding of medical science and insurance clauses; health management requires connecting hospitals, pharmacies, doctors and patients.

As innovative drugs are included in commercial insurance, it is increasingly difficult for insurance companies to complete these things only with their traditional insurance capabilities.

They need a partner who can understand all of the following at the same time:

Insurance + healthcare + service + payment.

This is the value of MedTrust's intelligent insurance solution.

From product design and pricing support, to claim settlement operation and health management, to connection of medical resources and drug resources, MedTrust tries to reorganize the capabilities that were previously scattered inside and outside insurance companies.

Thus, this diversified business model begins to make sense:

Although pharmaceutical companies and insurance companies are at two ends of the industrial chain, they share a common pain point — medical payment is becoming more and more complex, and neither side can solve all the complexity on its own.

02 What MedTrust is really selling may not be "resources", but the efficiency of complex transactions

The word "platform" is often used in the business world.

A company connecting several types of clients does not mean it is a platform.

The real condition for a platform to be established is:

It reduces transaction costs among participants and makes transactions that could not originally happen efficiently sustainable.

If you only regard MedTrust as a "connector between pharmaceutical companies and insurance companies", you still underestimate this business.

Because simple matchmaking is not difficult.

What is really difficult is:

Turning a single cooperation into a set of repeatable systems.

Suppose an innovative pharmaceutical company wants a new drug to be included in commercial insurance.

The traditional way may be:

Find insurance companies, negotiate on products, responsibilities, payment, claim settlement and patient services, and then connect with hospitals and pharmacies.

Every time an additional insurance company is added, the whole process needs to be repeated.

Conversely, if an insurance company wants to increase innovative drug coverage, it also needs to find pharmaceutical companies on its own, study drugs, understand diseases, design responsibilities, and then build a service system from scratch.

Both sides are repeating the same thing.

This is a cost that is often overlooked in the medical payment industry:

Connection cost.

It is not a specific expense item on the financial statement, but it will directly determine whether a business can be scaled up.

The value of MedTrust lies precisely in gradually turning this one-time connection into reusable underlying capabilities.

After a pharmaceutical company accesses the platform, it does not need to understand every insurance company from scratch; after an insurance company accesses the platform, it does not need to study every innovative drug from scratch.

The platform precipitates the knowledge, data, rules and service capabilities that were originally scattered in different enterprises.

This is also why the number of MedTrust's clients is not the most noteworthy figure itself.

The really important point of these numbers is not just that "the scale is very large".

Instead:

The more participants on the platform, the greater the value of the platform to each participant in theory.

The increase of pharmaceutical companies means that insurance companies can access more innovative drugs; the increase of insurance companies means that pharmaceutical companies can enter more payment scenarios.

The two ends are not simply added up, but mutually enhanced.

This is the difference between a platform-based business model and a traditional service company.

With this understanding, the logic of MedTrust "charging from both sides" is relatively clear.

What pharmaceutical companies pay for is: the efficiency of innovative drug commercialization and payment implementation. What insurance companies pay for is: the efficiency of long-term customer operation and medical services.

The two do not buy the same product, but use the same set of underlying capabilities.

03 From connection to infrastructure: How can a business go deeper and deeper?

If you break down MedTrust's past development, you will find that it has actually gone through a very typical path.

The first stage is connection.

Connect pharmaceutical companies, insurance companies, hospitals, pharmacies and patients.

The second stage is transaction.

Enable payment, claim settlement and services to truly happen online.

The third stage is precipitation.

Precipitate the data, rules and experience generated in a large number of transaction processes.

The fourth stage is intelligentization.

Use AI to turn these experiences into capabilities that can be replicated on a large scale.

This path is very important. What MedTrust is currently trying to do is to gradually turn the large number of pharmaceutical payment collaborations that used to rely on manpower into a set of data-driven, rule-driven and AI-driven infrastructure. MedTrust's current AI architecture has formed an obvious three-layer structure:

The bottom layer is data capabilities such as InsRx; the middle layer is medical and health vertical models such as mind42.ai; the upper layer is scenario-specific Agents such as KnowDrug.ai and KnowIns for specific business scenarios.

In the past, a project required a team. In the future, an Agent may handle a large number of standardized judgments in it.

In the past, pharmaceutical companies needed to ask: "Which commercial insurance products are suitable for this drug?" In the future, the system can directly find answers from drug, disease, crowd, insurance responsibility and payment data.

In the past, insurance companies needed to manually study: "How to design protection for a certain disease, a certain drug and a certain type of patients?" In the future, AI can assist in risk identification, product analysis and service path design.

Therefore, AI is not a new business line that MedTrust suddenly launched.

It is more like a tool to solve complexity after the platform develops to a certain stage.

This also explains why its business extends to both pharmaceutical companies and insurance companies. Because both sides are actually using the same set of underlying capabilities:

The understanding of drugs, the understanding of insurance, the understanding of payment rules, and the understanding of real medical scenarios.

Therefore, the question "why can an enterprise charge both pharmaceutical companies and insurance companies" may be wrong in itself. The real question should be:

Why are pharmaceutical companies and insurance companies willing to pay for this set of infrastructure together?

The answer is not because MedTrust stands between them.

On the contrary.

It is because after medical payment becomes more and more complex, both ends of the industrial chain need someone to step forward to reorganize the scattered rules, resources and transactions.

When an enterprise begins to become the infrastructure that the entire industrial chain needs, it no longer belongs to a certain side of the industrial chain.

What it serves is how the entire industrial chain can operate more efficiently.

This article is written based on public materials, for information exchange only, and does not constitute any investment advice.

This article is from WeChat official account "YiYao", written by Wang Zhe, and authorized for release by 36Kr.