On November 28, 2024, China's National Healthcare Security Administration (NHSA) unveiled the 2024 National Reimbursement Drug List (NRDL), with implementation scheduled to begin on January 1, 2025.
A total of 91 new drugs have been added to the 2024 NRDL, while 43 drugs that are clinically replaced, no longer produced or no longer supplied have been removed. Following this adjustment, the total number of drugs listed in the NRDL stands at 3,159, including 1,765 chemical drugs and biological products, 1,394 Chinese patent medicines, and 892 types of traditional Chinese medicine pieces for decoction.
The categories of the 91 newly added drugs are as follows:
Categories | Number | Notes |
Oncology drugs | 26 | Including 4 for rare diseases |
Drugs for chronic conditions like diabetes | 15 | Including 2 for rare diseases |
Drugs for rare diseases | 13 | |
Antibiotics | 7 | |
Chinese patent medicines | 11 | |
Psychiatric medications | 4 | |
Drugs for other therapeutic areas | 21 | |
Notes: As some drugs are used in multiple therapeutic areas, the totalnumber of categories exceeds 91. | ||
According to NHSA, 117 off-list drugs took part in the negotiation and bidding process this year, with 89 successfully negotiated, achieving a success rate of 76% and an average price reduction of 63%.
1. Highlights of the 2024 NRDL
Prioritization of New Drug
The 2024 NRDL inclusion prioritizes new drugs. Out of the 91 drugs added, 90 were launched in the past five years, with 38 classified as "global new" innovative drugs. Both the proportion and total number of innovative drugs have hit a record high. In the negotiation phase, the success rate of innovative drugs surpassed 90%, outperforming the overall success rate of 76%.
High Proportion of Domestic Drugs
Supported by various policies, China's domestic pharmaceutical innovation has seen great progress in recent years. Among the 91 new drugs, 65 are developed locally, accounting for more than 70%. This proportion has been steadily growing year on year.
Mandatory Drug Traceability Codes
To enhance regulatory oversight and protect the security of the healthcare fund, the NHSA has required companies to implement drug traceability codes before the NRDL list was implemented, ensuring complete traceability of drugs throughout the entire process.
2. Review of China's NRDL Negotiations
China's NRDL negotiations were initially piloted in 2015 and have approximately occurred on an annual basis. During these negotiations, pharma companies lower drug prices to secure a place on the NRDL.
As a result of price cuts and subsequent reimbursements by the national basic healthcare insurance fund, NRDL-listed drugs become affordable for a larger number of patients, potentially leading to increased sales volumes in public hospitals and designated drugstores.
It is expected that by the end of 2025, Chinese patients will see a reduction of more than 50 billion yuan in their costs.
Year | Number of drugs entering negotiation | Number of drugs added to NRDL + drugs staying in NRDL via contract renewal | Negotiation success rate | Average price reduction rate |
2015 (pilot) | 5 | 3 | 60% | 58.7% |
2017 | 44 | 36 | 81.82% | 44% |
2018 | 18 | 17 | 94.44% | 56.7% |
2019 | 150 | 97 (70+27) | 64.67% | 60.7% |
2020 | 162 | 119 (96+23) | 73.46% | 50.64% |
2021 | 117 | 94 (67+27) | 80.34% | 61.71% |
2022 | 147 | 121 (108+13) | 82.31% | 60.1% |
2023 | 143 | 121 | 84.6% | 61.7% |
2024 | 117 | 91 | 76% | 63% |
Contact BaiPharm if you would like to know more details about China's NRDL.
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