China introduces Commercial Insurance Innovative Drug Catalogue
In July 2025, China’s National Healthcare Security Administration (NHSA) introduced the Commercial Insurance Innovative Drug Catalogue for the first time, extending coverage to a broader range of drugs, including innovative drugs not previously listed on the Basic Insurance Catalogue. This is considered as a major development in China’s multi-tiered health insurance system.
Supplementary and recommended nature
In China, the Basic Insurance Catalogue mentioned above covers essential, safe, effective, and affordable drugs, reimbursed by the national medical insurance fund, while non-listed drugs are generally paid for by patients or through private insurance. To gain inclusion, many innovative drugs have drastically cut prices while others are excluded due to high costs. Negotiated low prices may also be used by reimbursement authorities in other countries as reference points, driving down prices in those markets. While the Basic Insurance Catalogue safeguards basic healthcare needs, the NHSA’s pricing position has resulted in less coverage of innovative drugs, which, in turn, has a knock-on effect on the development of pharmaceutical innovation.
The newly introduced Commercial Insurance Catalogue, as a supplementary and market-oriented catalogue, focuses on high-clinical-value, innovative drugs and serves as a recommendation, leaving commercial insurers free to decide on their reimbursement coverage.
Dual application route and confidential price negotiation
The formulation of the Commercial Insurance Catalogue follows a five-stage procedure similar to the Basic Insurance Catalogue. These stages include policy preparation, application and formal review, expert review, price negotiation, and the final catalogue release.
Dual application route – Eligible drugs for the Commercial Insurance Catalogue include innovative drugs approved in China between 1 January 2020 and 30 June 2025 and rare disease treatments approved before 30 June 2025. Drugs already submitted for inclusion in the Basic Insurance Catalogue remain eligible to apply while the review standards are different.
Confidential price negotiation – During price negotiations, drugs applied for and recommended by experts for potential inclusion in both catalogues must first undergo Basic Insurance Catalogue negotiations. If unsuccessful, they move to the Commercial Insurance Catalogue’s price negotiation stage. Unlike the Basic Insurance Catalogue’s public bidding, the Commercial Insurance Catalogue adopts a confidential negotiation mechanism with final prices kept undisclosed to avoid their use as reference prices abroad.
Periodical update – Both catalogues are expected to be finalised and released in October or November 2025. Going forward, the Commercial Insurance Catalogue will be updated periodically in line with the Basic Insurance Catalogue.
Conclusion
The introduction of the Commercial Insurance Catalogue, following multiple Chinese policies supporting the development of innovative drugs, is expected to open up new market opportunities for international pharmaceutical companies. This is particularly beneficial for companies developing high-cost innovative drugs who often face barriers to entering China’s Basic Insurance Catalogue due to strict price reduction requirements and concerns that low prices in China could be used as reference points in other markets.
Since this is the first time the Commercial Insurance Catalogue has been introduced, it remains to be seen how the selection, evaluation, and price negotiation processes will unfold in practice. It is still unclear how many commercial insurance providers will use it as a reference and include these drugs in their product offerings.
The original publication can be found here. (Chinese only)
For more information on the policies in healthcare sectors in China, contact your CMS client partner or these CMS experts.
Co-authored by Amy Dong and Shaohong Cui.
