OBJECTIVES: Based on strong growth underpinned by a host of macro-economic drivers, the pharmaceutical market in China is now the world’s second largest. At the same time, market access for new pharmaceutical products still represents one of the most salient challenges especially for MNCs. Examining how oncology drugs have gained access to the Chinese market over the last decade, this research explores the essential elements that must be considered in order to reach the most patients who can benefit.  METHODS: This analysis is based on a review of secondary data from the introduction of new oncology drugs launched by MNCs into China in the last decade. Primary research also was conducted with commercial and private insurers and national, regional and local decision-makers to assess affordability pathways in the presence of access and registration barriers.  RESULTS: Successful market access strategies for new oncology agents in China must address two critical challenges: time to market and affordability to patients and other stakeholders. Time to market can be shortened by partnering locally to further accelerate clinical trials and increase the awareness of regional/local key opinion leaders who inform the regulatory approval and reimbursement processes. Additionally, four approaches can be utilized to help to increase affordability for patients: listing on the Provincial Drug Reimbursement List prior to the listing of National Drug Reimbursement List, utilizing the Serious Illness Insurance Program, gaining coverage by Commercial insurance and providing a Patient Assistant Program. Data showed patient access to new oncology drugs was improved dramatically with the adoption of those approaches.  CONCLUSIONS: Access to new oncology drugs is significantly improved with initiatives to shorten the time-to-market and improve affordability in China.