China Unveils Measures to Boost Innovative Drug Development With Insurance Data Support

China Unveils Measures to Boost Innovative Drug Development With Insurance Data Support

China’s National Healthcare Security Administration (NHSA) and National Health Commission (NHC) jointly released the “Several Measures to Support High-Quality Development of Innovative Drugs.” These measures introduce comprehensive support across the entire drug development chain.

Data Utilization for R&D
The document supports the use of medical insurance data for innovative drug research and development (R&D). It emphasizes strengthening information exchange and collaboration among healthcare, medical insurance, and pharmaceutical sectors. Effective management of medical insurance data resources and promotion of public data resource utilization in the medical insurance field are highlighted. Under the premise of ensuring data security, legality, and compliance, the government will explore providing necessary medical insurance data services for innovative drug R&D. Commercial health insurance companies are encouraged to support innovative drug R&D through innovative drug investment funds and other means.

Policy Consultation and R&D Initiatives
Companies with New Drug Applications (NDAs) accepted by the National Medical Products Administration (NMPA) can request concurrent policy consultation from NHSA. National R&D initiatives will prioritize major infectious diseases, high-prevalence chronic conditions, pediatric medicines, and rare diseases, supported by a multi-departmental collaboration mechanism.

Flexible Payment Adjustments
The document introduces flexible payment standard adjustments for National Reimbursement Drug List (NRDL)-listed drugs that exceed sales expectations or gain new indications. Price reductions should not exceed simplified renewal thresholds, and non-NRDL institutions may procure drugs without reimbursement restrictions.

Institutional Support
Medical insurance designated medical institutions are encouraged to hold pharmaceutical meetings within three months after the NRDL update and publication to adjust drug allocation or establish temporary procurement green channels. The use of innovative drugs should not be affected by the number of drug catalogs or hospital budgets. Negotiated drugs in the NRDL and innovative drugs in commercial insurance catalogs are exempt from the “one product, two specifications” restriction.

Reimbursement Support
The document supports case-by-case reimbursement for rational and reasonable use of innovative drugs in the NRDL when Diagnosis-Related Group (DRG) payments are unsuitable.-Fineline Info & Tech