CHINA

China Struggles to Expand Commercial Insurance Coverage for Innovative Drugs, Report Says

Published: May. 29, 2026 6:37 p.m. GMT+8

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Commercial insurers covered just 7.8% of the country’s innovative drug and device market last year, as pricing, data and access barriers continue to constrain growth. Photo: IC photo

Commercial health insurance in China paid for less than 10% of innovative drugs and medical devices last year, highlighting the persistent challenges the country faces in building a multi-tiered healthcare system to ease the burden on its state-run basic medical insurance.

In 2025, the scale of commercial health insurance payments for innovative drugs and medical devices reached 15.2 billion yuan ($2.2 billion), up 23% from the previous year, according to a white paper released recently by China Life Reinsurance Co. Ltd. and medical payment service provider MediTrust Health.

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Commercial health insurance paid only 7.8% (15.2 billion yuan) of China’s innovative drug/device market in 2025, up 23% from 2024.
Basic insurance (46.4%) and out-of-pocket payments (45.8%) dominate; issues include weak data sharing, poor actuarial pricing, and patient access barriers.
White paper recommends systematic catalog management, classified pricing, dynamic adjustments, and AI for claims verification to address gaps.

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Who’s Who

China Life Reinsurance Co. Ltd.: China Life Reinsurance Co. Ltd. co-released a 2025 white paper on commercial health insurance payments for innovative drugs. The report found these payments reached 15.2 billion yuan, covering less than 10% of the market, and urged improved drug coverage management and risk-sharing mechanisms.

MediTrust Health: MediTrust Health (镁信健康) is a medical payment service provider in China. In 2025, it co-published a white paper with China Life Reinsurance Co. Ltd., highlighting that commercial health insurance paid less than 10% of innovative drug and device costs. MediTrust Health aims to improve multi-tiered healthcare and data-sharing in China's insurance industry.

AI generated, for reference only