China releases 2025 NRDL and first commercial insurance drug list

In early December, the 2025 updates of China’s National Reimbursement Drug List (NRDL) were finalised with a total of 114 drugs, including Western drugs and traditional Chinese medicines, being newly introduced. Among the newly listed products, 50 are Class 1 innovative drugs, meaning that they have not been marketed anywhere in the world before receiving marketing authorisation in China. Apart from the NRDL annual update, the most significant change is the introduction of the country’s first Commercial Insurance Innovative Drug List, which includes a total of 19 high-cost innovative drugs targeting diseases across cancer, Alzheimer’s disease, and rare genetic disorders. The 2025 NRDL and the Commercial Insurance Innovative Drug List will take effect from 1 January 2026. In Nation Healthcare Security Administration’s (NHSA’s) announcement for the 2025 NRDL, the government’s support for improving the accessibility of innovative drugs with significant clinical value was highlighted. Unlike previous annual NRDL updates, the NHSA did not disclose the average price reduction rate on the price for the newly listed drugs. This may mark a turning point for China’s drug reimbursement policy, as lowering drug costs would not be weighted as significantly as it was for the NHSA to form the country’s medical health insurance benefit packages. This tendency can be observed in public drug procurement as well. In the 11th round of the centralised drug procurement scheme, the National Joint Drug Procurement Office stated that the winning bids were decided based on a comprehensive evaluation that takes drug quality, price, stable supply, and clinical needs into account, instead of highly prioritising products with the lowest costs. As a result, the average price gap between winning bids became smaller. Imported drugs with a high number of domestic competitors still face barriers to being listed on the NRDL. For example, no imported PD-1 inhibitors have been listed on the NRDL and the Commercial Insurance Innovative Drug List. The director of the Medical Services Management Department of the NHSA, Huang Xinyu, explained that there are about 10 PD-1 inhibitors listed on the NRDL. The primary reason that no new PD-1 inhibitor was added to the 2025 NRDL is due to “very high price”. Imported drugs without, or with limited, domestic competitors have made progress and are more likely to be listed on the NRDL. These include Eli Lilly’s (US) Jaypirca (pirtobrutinib) as the only non-covalent (reversible) Bruton’s tyrosine kinase (BTK) inhibitor available in China for mantle cell lymphoma (MCL) and AstraZeneca’s (UK) Fasenra (benralizumab) as the only available interleukin (IL)-5 Receptor alpha (IL-5Rα) to deplete eosinophils (EOS) in severe asthma. Notably, Eli Lilly’s GLP-1/GIP agonist Mounjaro (tirzepatide) was added to the NRDL for type 2 diabetes. Its competitor, Novo Nordisk’s (Denmark) Ozempic (semaglutide), was already listed on the 2023 NRDL for the same indication. Based on an administration notification issued by the NHSA in 2020, named Temporary Measures for Basic Medical Insurance Drug Management, the NRDL should not include treatments for lifestyle purposes, including weight loss. Therefore, patients would need to seek private health insurance, if any, for the reimbursement of the two active ingredients to be used for weight loss. Lunan Pharmaceutical’s (China) sapropterin dihydrochloride is the only generic drug to be listed in the first Commercial Insurance Innovative Drug List. Its originator, BioMarin Pharmaceutical’s (US) Kuvan, was already withdrawn from China, leaving unmet medical needs for hyperphenylalaninemia (HPA) patients. Among the 19 drugs on the list, 14 of them are cancer drugs, including five chimeric antigen receptor (CAR)-T therapies. However, only one of them, Gilead Sciences’ (US) Yescarta (axicabtagene ciloleucel), originated from an overseas developer while the CAR-T therapy is commercialised in China by Fosun Kite Biotechnology, a local joint venture of Gilead Sciences and Chinese manufacturer Fosun Pharma. Additionally, the Commercial Insurance Innovative Drug List covers two disease-modifying drugs for early Alzheimer’s disease: Eli Lilly’s Kisunla (donanemab) and Eisai (Japan)/Biogen’s (US) Leqembi (lecanemab). Although the Commercial Insurance Innovative Drug List may be a positive for facilitating access to expensive drugs, private healthcare providers have expressed reservations. Some shared concerns about pricing and regulation compliance to form new insurance schemes. While the NHSA stated that it will “encourage” and “support” private health insurers, including listed innovative drugs in their products, there is no clear roadmap to promote the new policy at the national level. At the local level, some local Health Security Administrations (HSAs) in wealthy regions, such as Shanghai, already issued notifications with more detailed policies. Another wealthy city, Shenzhen, announced in early December that all 19 drugs on the Commercial Insurance Innovative Drug List will be covered under the city’s supplementary commercial health insurance (known as Hui Min Bao in Mandarin). GlobalData Strategic Intelligence Don’t let policy changes catch you off guard. Stay proactive with real-time data and expert analysis. By GlobalData It is not a surprise that the Chinese Government has been more enthusiastic to fund or support private sectors to reimburse expensive drugs. The new trend in the country’s drug reimbursement and procurement policy is likely to reflect the government’s aim to promote domestic R&D activities to catch up with the innovative drug industry in the US and EU. In 2024, the government included support for innovative drug development in the national policy outline for the first time, providing a basis for future policy to encourage local R&D on “me-better” and first-in-class treatments. Previously, the Chinese pharma industry was more focused on developing generics or “me-too” drugs as cheaper options to imported products. To meet local medical needs and support domestic new drug development, the government is likely to maintain its policy to improve innovative drug accessibility through national medical health insurance and public drug procurement. This article is produced as part of GlobalData’s Price Intelligence (POLI) service, the world’s leading resource for global pharmaceutical pricing, HTA and market access intelligence integrated with the broader epidemiology, disease, clinical trials and manufacturing expertise of GlobalData’s Pharmaceutical Intelligence Center. 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