Presentation (CTI)

OBJECTIVES: China’s drug pricing system is undergoing a major transformation following April 2026 State Council guidance on drug price formation. This study assesses how the reform shifts pricing logic across the product lifecycle and implications for pricing predictability, evidence requirements, and innovative drug access.
METHODS: A structured policy and literature review was conducted using April-June 2026 national guidance, policy commentary, and secondary analyses. The reform was assessed against the historical framework across three dimensions: (1) launch pricing formation, (2) post-launch price evolution and NRDL integration, and (3) evidence requirements and governance mechanisms.
RESULTS: Historically, China’s P&R system has been characterized by free pricing at launch followed by significant price compression through NRDL negotiations, with reported price reductions of ~60% post-NRDL reimbursement. The 2026 reform introduces a more structured, value-based launch pricing approach. A unified quantitative scoring framework (170-point scale) classifies products into three tiers, aligning innovation level, clinical value, and pricing flexibility. This shifts the system from reactive price correction toward front-end value-based price setting. At a system level, the reform reduces pricing fragmentation by moving from province-level processes toward coordinated national mechanisms, with expected reductions in time to listing and improved launch predictability. Pricing is increasingly managed over the lifecycle rather than at a single timepoint. High-value products may benefit from multi-year price stability and potential upward reassessment based on real-world evidence, while lower-value or competitive products remain subject to ongoing price erosion. This indicates a more explicit balancing of innovation reward versus long-term cost containment.
CONCLUSIONS: China’s 2026 reform represents a strategic shift from front-loaded price compression toward lifecycle-based value governance. While it may improve early pricing visibility and differentiate true innovation, it also requires sustained value demonstration across the lifecycle. Success will increasingly depend on integrating launch pricing, evidence generation, and reimbursement strategy into a coordinated, long-term approach.