Progress on drug pricing negotiations in China

Abstract

On November 28 th , 2019, the National Healthcare Security Administration (NHSA) and the Ministry of Human Resources and Social Security (MOHRSS) of China announced the results of drug pricing negotiations. Seventy first-negotiated drugs with 60.7% average price decrease and twenty-seven re-negotiated medicines with 26.4% average price fall, involving 11 disease categories, were successfully incorporated into National Reimbursement Drug List (NRDL). Medicines that successfully get accessed to NRDL are mostly new listings with high clinical value, and more than half of them are manufactured by Chinese enterprises. Compared to the negotiated drug list of 2017, the biggest increase in western medicines is the alimentary tract and metabolism (10 drugs added), and the traditional Chinese medicine is internal medicine (17 drugs added). The negotiation follows the process including preparation, examination, negotiation, and announcement. There are several innovations in the procedure, such as the parallel calculation of the floor price, the introduction of competitive negotiations, allowing companies to apply for price confidentiality, and increasing government-enterprise communication before negotiations. Incorporating patented drugs into NRDL by negotiation not only helps patients reduce the economic burden, but also encourages pharmaceutical companies to innovate.

The impacts of government reimbursement negotiation on targeted anticancer medication price, volume and spending in China

“…5 To improve patient and system affordability and decrease health inequity, the Chinese government implemented a series of policies, including reimbursement-linked central medication price negotiations. 7 We found that after national medication price negotiations in 2017, procurement volumes of all pricenegotiated anticancer medications increased abruptly and significantly, except for bortezomib for which use increased initially and declined in 2018. Nonetheless, cost per DDD of all price-negotiated medication decreased between 17.3% and 78.5% by the end of the study period regardless of duration of the drugs on the Chinese market.…”

“…6 All price-negotiated medications are mandated to be listed in the PRDLs. 7 Public sector hospitals must purchase these medications via the provincial procurement websites and negotiated prices are maximum prices. City or county-level insurance funding is then required to reimburse medication costs based on the negotiated prices (minus beneficiaries' copayments).…”

Impact of DRGS-based Inpatient Service Management on the Performance of Regional Inpatient Services in Shanghai, China: an Interrupted Time Series Study, 2013-2019

“…However, considering that no major adjustment was made, the impact should be minor. Finally, as China's health reform has lasted for 10 years [26], and a number of reforms have been launched, such as zero mark-up drug and drug pricing negotiations [18,27]. These policies may also have some impact on the performance indicators evaluated in our study, enlarging or distorting our research results.…”

Impact of DRGs-based inpatient service management on the performance of regional inpatient services in Shanghai, China: an interrupted time series study, 2013–2019

“…However, considering that no major adjustment was made, the impact should be minor. Finally, as China’s health reform has lasted for 10 years [ 31 ], and a number of reforms have been launched, such as zero mark-up drug and drug pricing negotiations [ 18 , 32 ]. These policies may also have some impact on the performance indicators evaluated in our study, enlarging or distorting our research results.…”