OBJECTIVES: This study aims to understand current risk sharing scheme landscape for innovative pharmaceuticals in some typical provinces and cities of China. METHODS: Risk sharing schemes for pharmaceuticals in four provinces (Guangdong, Zhejiang, Jiangsu and Sichuan) and three cities (Guangzhou, Hangzhou and Chengdu) were systematically collected through visiting social health insurance bureau websites, literature review and key informant interview. Case study and comparison analysis were conducted among these schemes. RESULTS: Two kinds of risk sharing schemes, performance based scheme and financial based scheme, were employed in sampling provinces and cities, with the latter model more often implemented. Performance based scheme has only been developed in one city (Guangzhou) for a non-small-cell lung cancer drug. Patients eligible for inclusion criteria and treated in one of three designated hospitals could be qualified to reimburse for more than one year treatment if they were responsive to the drug. Other provinces and cities has adopted the financial based scheme, mainly focusing on increasing patients access to expensive drugs, usually for breast cancer, leukemia and non-small-cell lung cancer and not covered by health insurance schemes. For instance, local health insurance fund of Zhejiang and Jiangsu province would only reimburse patients’ five to six months treatment and pharmaceutical company should sponsor patients’ treatment for the next six months. Besides, cities like Qingdao and Chengdu implemented the price volume scheme for special drugs and medical materials in order to control fund expenditure. CONCLUSIONS: By risk sharing scheme, some innovative drugs, previously not covered by social health insurance, can be reimbursed, which will increase patients’ access, reduce patients economic burden, and help expending pharmaceutical companies’ market share. However, as risk sharing scheme in China has only been adopted for only one or two years, long-term impact still needs to be observed and evaluated.