OBJECTIVES: China National Reimbursement Drug List (NRDL) negotiation was piloted in 2015 and has been implemented for four times so far, which had contributed to the 36% lower price in China comparing to neighboring countries. We aimed to investigate the NRDL policy evolution and the price change of the oncology drugs listed through negotiation.

METHODS: We analyzed the process and results of previous NRDL negotiations via the information retrieved from official website of the Central People's Government, National Health and Security Administration (NHSA), Beijing Medicine Sunshine Purchasing and the Industry Research Report.

RESULTS: In terms of the indication, non-small cell lung cancer and lymphoma are the two most common indications among the included oncology drugs over the past five years. Price decrease ranges from 48% in 2017 to 64% in 2019 and the average decrease was 55%. Nine drugs succeeded in the negotiation for contract renewal and the . Off-patent d If selected by centralized procurement, up to 77% of price cut was struck for oncology drugs with competitors that passed the consistency evaluation.

CONCLUSIONS: In conclusion, our findings suggest that the NRDL negotiation mechanism implemented in China has significantly brought down the price of oncology drugs from 2015 to 2019 Further price cut can be anticipated once the drugs are due to contract renewal or off-patent. However, the long-term impact of such measures on innovative drugs market in China remains unclear and in need of future investigation.