OBJECTIVES: Reference pricing has been popular used in many countries as a reimbursement policy to contain raising pharmaceutical expenditures since Germany first introduced in1989. China is under discussion concerning implementation of reference pricing for innovative drug pricing. This study is designed to overview the effects of reference pricing on health care helps to provide reference evidence to estimate the potential role of reference pricing for policy strategy making, and deliver the suggestion on benefit/risk analysis when adopting reference pricing in China. METHODS: We systematic reviewed published review studies or literatures based on empirical outcome effects analysis of reference pricing and present the common assess conclusion or views on the effect of reference pricing across all experiences, selected research covered different countries and backgrounds have little coverage to keep the references outcomes diversity and little overlap.  RESULTS: Results shows that reference pricing could decreases drug prices include in system and original and generic drug price reductions are different according to pharmaceutical markets power. Reference pricing increases drug use of priced below or at the reference price. Reference pricing could save drug expenditures limited in the short-run but no sufficient evidence showed on the long-term expenditures reduction. Besides, no adverse effect was clearly found on patient access pharmaceutical services by reference pricing.   CONCLUSIONS: Evidences indicates that reference pricing seems to be effective for governments to contain pharmaceutical expenditures and more research is need on the long-term effects and impact on different healthcare systems of reference pricing.