China Cuts New Path for Commercial Insurance Holders to Get Pricey Drugs
Listen to the full version
China’s top health care security regulator has unveiled a new framework to help patients access expensive innovative drugs, establishing a formal list that encourages commercial health insurance to cover medicines deemed too costly for the state’s basic plan.
The measures, released July 1 by the National Healthcare Security Administration (NHSA), aim to bridge the gap between the high price of cutting-edge pharmaceuticals and the budget constraints of the national insurance fund. At the core of the policy is a new Commercial Health Insurance Innovative Drug List, designed to operate alongside the country’s primary reimbursement system.
Unlock exclusive discounts with a Caixin group subscription — ideal for teams and organizations.
Subscribe to both Caixin Global and The Wall Street Journal — for the price of one.
- RELATED
- DIGEST HUB
Digest Hub
Back
- China’s NHSA launched a "Commercial Health Insurance Innovative Drug List" (Category C) on July 1, 2024, to help patients access costly innovative drugs outside basic coverage.
- The policy enables price negotiations between insurers and drugmakers, offers exemptions from some price controls, and enhances price confidentiality to boost participation.
- Criteria for drug inclusion are still pending, but benefits include exclusion from DRG bundles and a focus on real-world studies for reimbursement decisions.
- Caixin Media
- Unfortunately, the provided article content does not contain information about Caixin Media. Therefore, I cannot answer your question.
- 2018：
- NHSA was established.
- By May 2025：
- NHSA had successfully negotiated prices for 149 innovative drugs with state funds paying over 410 billion yuan (about $56 billion) for them.
- Before July 1, 2025：
- The rollout of the new initiative was initially expected in April 2025 but was delayed due to negotiations among stakeholders.
- July 1, 2025：
- National Healthcare Security Administration (NHSA) released new measures and unveiled the 'Commercial Health Insurance Innovative Drug List.'
- PODCAST
- MOST POPULAR
Sign in with Google
Sign in with Facebook
Sign in with 财新