OBJECTIVE: This research aims to assess recent development of CDI (critical disease insurance) and RD (rare disease) fund in China, as well as future outlook.

METHODS: Policy analysis has been conducted at both national and regional level through desk research, case studies and primary insights collected from expert interviews were also included.

RESULTS: While CDI has always been a public reimbursement mechanism at regional level in China, provinces like Shandong, Shaanxi and Shanxi have launched additional CDI formularies for non-NRDL items. In parallel, RD fund offers alternative coverage for RD drugs outside of NRDL in Zhejiang, Chengdu and Jiangsu. Recent policies may bring uncertainties to CDI and RD funds going forward, as National Healthcare Security Administration, Ministry of Finance and State Council released guidance on regional adherence to BMI (basic medical insurance) coverage. At the same time, there have been discussions on national RD fund potentially to be rolled out across regions.

CONCLUSION: There have been some recent changes and uncertainties with CDI and RD fund, despite the initial successes with earlier pilots. At the same time, national RD fund may be launched in near future to improve access at a more uniform level. Taking into account the dynamic nature of China access opportunities, pharma majors will need to closely monitor latest development and plan accordingly.