PRICENTRIC BRIEF:
- China’s National Healthcare Security Administration (NHSA) and Ministry of Human Resources and Social Security (MOHRSS) have issued the 2020 Edition of the National Reimbursement Drug List (NRDL)
- The finalized 2020 NRDL, which comes into effect on March 1, 2021, contains 119 additional drugs across 31 therapeutic classes compared to the 2017 list, but has also removed 29
- The three-day NRDL negotiations were held on December 17, 2020 in Beijing, and the most notable discussions were for PD-1 inhibitors
THE DETAILS
BEIJING, China – China’s National Healthcare Security Administration (NHSA) and Ministry of Human Resources and Social Security (MOHRSS) have issued the 2020 Edition of the National Reimbursement Drug List (NRDL).
In November 2019, China made another major step in the direction of affordable, economical healthcare in the shape of expanding – rather generously – its NRDL, and the re-issued 2020 list is even wider-reaching.
The Chinese market’s promise of quantity ultimately makes up for the offset of the price cuts required to be on the NRDL, leading multiple multi-billion dollar companies to fight for a place in what is now the second-largest pharmaceutical market in the world after the USA.
The NHSA initially issued its official work plan for revisions to the 2020 NRDL in August, including application guidelines for revision of the list.
The scope of the 2020 NRDL considers what basic medical service (BMI) funds can afford and the clinical demand for drugs. Eligible drugs must meet provisions outlined in Articles 7 and 8 of the Interim Measures for the Administration of BMI Medicines.
2020 Inclusions
The finalized 2020 NRDL, which comes into effect on March 1, 2021, contains 119 additional drugs across 31 therapeutic classes compared to the 2017 list – when the NHSA took hold of procurement – but has also removed 29. On average, pharma companies agreed to cut drug prices by 51% in order to gain access to the list.
On the release of the list, the NHSA noted that a total of 704 non-2017 NRDL-listed drugs passed the initial application process for the review of the 2020 list, among them 23 drugs (non-exclusive) were added to it directly and 138 exclusive drugs were eligible for negotiation towards addition.
The organization also confirmed that the 2020 list is ultimately made up of a total of 2,800 Western medicines and proprietary Chinese medicines, including 1,264 Western medicines, 1,315 Chinese patent medicines, and 221 medicines negotiated during the agreement period.
The three-day NRDL negotiations were held on December 17, 2020 in Beijing, and the most notable discussions were for PD-1 inhibitors, including those from pharma giants Merck, AstraZeneca, Bristol-Myers Squibb (BMS), and Roche.
In the newly released list, home-grown PD-1 efforts from Shanghai Junshi Biosciences, Beigene Ltd and Jiangsu Hengrui Medicine feature, but no PD-1 products from multinational companies made the final cut.
Some key Western drugs that made the list include Novartis’ Cosentyx (secukinumab), Teva Pharmaceutical’s Austedo (deutetrabenazine) for Huntington’s disease; AstraZeneca’s oncology drug Zoladex (goserelin) and GlaxoSmithKline’s Benlysta (belimumab) and Volibris (ambrisentan), for lupus and high blood pressure in the lungs, respectively.
This year a number of COVID-19 therapy recommendations are also now covered by the 2020 NRDL, including Arbidol and Ribavirin, which can be used to treat COVID-19 in China.
NRDL Expansion
Since 2018, the newly established NHSA Administration has greatly expanded access to medical care and drugs for the general population in China, with the NRDL being a key part of the success.
Speaking at ISPOR Asia Pacific’s virtual broadcast earlier this year, Gordon G Liu, PhD., National School of Development, Peking University, listed several other recent initiatives including Centralized Drug Negotiation, which consolidated drug price negotiation power at the national level, leveraging purchasing power and phased out PRDL.
He went on to highlight the now annual update of NRDL which expanded coverage for high cost and innovative drugs to alleviate the burden on patients due to previously high out of pocket costs, and Unified risk and funding pool which combined urban and rural residents’ basic healthcare coverage and reduce coverage disparity.
The NRDL has been updated annually since 2017 and has included some innovative therapies across various diseases to address clinical needs. Volume-based purchasing has been expanded nationwide, leading to a significant price reduction in the procurement.
Learn more about Pricentric ONE and our Global Pricing Solutions!
Contact us with your questions and global pricing needs, and an expert will follow up shortly.