The Contribution of Innovative Drugs and the National Reimbursement Drug List to Human and Physical Capital in the Social Economy: A Case of Blood Cancer in China

OBJECTIVES: Innovative drugs not only confer health benefits but also have a profound impact on social economy. Including new drugs in health insurance reimbursement amplifies this influence. Since 2018, China's National Reimbursement Drug List (NRDL) has endorsed 665 new drugs, reducing their prices by 50-60% and saving $68 billion in medical expenses. However, whether this will promote labor recovery, physical capital accumulation, and generate more investment returns remains uncertain.

METHODS: Using a macroeconomic model, we calculated the contribution of NRDL and no NRDL for blood cancer innovative drugs to human and physical capital in China from 2018 to 2024. Two counterfactual scenarios were assumed. Data on disease burden, clinical outcomes, sales revenue, pricing, usage, launch timing, and NRDL status were sourced from the Global Burden of Disease, clinical trials, package inserts, and Menet website. Demographic and economic parameters were derived from the China Statistical Yearbook.

RESULTS: From 2018 to February 2024, mainland China launched 27 blood cancer drugs, with 20 included in the NRDL covering 13 indications. An investment of $20 billion in R&D resulted in a return of $9.8 billion. In terms of physical capital, NRDL and no NRDL saved $7.1 billion and -$2.3 billion in medical expenses, respectively. In terms of human capital, NRDL and no NRDL preserved $0.11 billion and $0.065 billion, equivalent to saving the labor force of 3,404 and 1,897 fully healthy individuals out of 1,021,453 patients, respectively.

CONCLUSIONS: The NRDL reduced overall industry investment returns through saving medical expenses, granting higher returns only to leading manufacturers to force competition. The greater benefit lies in increased market share of effective drugs, enhancing overall health, preserving human capital, reducing medical expenses, and promoting physical capital accumulation, thereby positively impacting the social economy. Even half of such benefits would not be achieved under individual willingness to pay.