The Chinese National Reimbursement Drug List (NRDL) was established in the early 2000’s and includes the drugs both fully and partially covered by National Basic Medicine Insurance. As China’s health system has been reformed over the past decade, it is important for manufacturers to understand the ever-changing reimbursement process and its implications on newly launched drugs. This study provides an updated overview of the process based on research conducted in 2021.

Targeted secondary research was undertaken to evaluate the pricing and reimbursement landscape in China. Primary research was conducted to assess the perspectives of three payers and one policy expert.

National listing remains the most viable and exclusive pathway to get a product reimbursed by public health insurance in China. Since 2017, the NRDL has been updated annually, and revisions are managed by the National Healthcare Security Administration (NHSA). Insights from 2021 suggests that the process of listing a new product on the NRDL lasts five months (July to November). Manufacturers should ensure that submissions are made when the annual NRDL process formally begins, and clinical and health economic evidence is compulsory. If a successful opinion is made by the assessment board, the manufacturer will be invited to negotiate a price with the NHSA. Data from the NHSA indicated that a total of 704 applications were made in 2020. In addition, 138 exclusive drugs were eligible for price negotiation, of which 96 drugs were successful and added to the NRDL. Findings also suggested that the average discount rate increased from 44.0 percent in 2017 to 50.6 percent in 2020.

The national reimbursement process in China has become more transparent overtime. Even so, NRDL listing remains a challenge, with decisions driven by clinical and pharmacoeconomic evidence, and price. Significant price cuts should be considered and anticipated to ensure successful negotiation outcomes.