Insurance reforms aid access to medicines

China's drug insurance regulatory reforms in the past few years have greatly eased the financial burden of patients while boosting access to advanced and innovative medications, according to a blue paper released on Nov 3.

The country has rolled out a number of major medical insurance policies since 2018, including regular updates of its drug reimbursement list, price negotiations with drugmakers and national bulk-buy programs.

"The implementation of comprehensive drug insurance reform policies has enabled patients to access high-quality medications at lower prices," according to the blue paper released by the Science and Technology Development Center of the Chinese Pharmaceutical Association.

Blue papers are reports issued by industries or research institutes. The paper published by the center examines drug use in 804 hospitals across China, including nearly 600 top-level hospitals.

In the past three years, 433 drugs have been added to the national drug reimbursement list, covering a wide range of severe and common illnesses such as cancer, hepatitis and diabetes. Meanwhile, 183 drugs have been delisted for dubious clinical outcomes or the potential risk of being abused.

Liu Guiyang, chief physician at the center, said the use of drugs being listed has increased significantly, signifying that the updated list has answered the practical needs of patients.

In addition, the availability of drugs treating cardiovascular diseases, diabetes, cancer and rare diseases has improved, the paper said.

Compared to the first quarter of 2015, the amount of diabetes drugs prescribed by hospitals increased by over 85 percent in the first quarter of this year, signaling that more patients suffering diabetes — which affects about 130 million people in China — are able to receive treatment.

At the same time, the amount of funds dedicated to reimbursing diabetes medications in the national medical insurance funds went up by only 48 percent. "This suggests that average prices of diabetes drugs have dropped," Liu said.

The amount of medications used to treat cancer and rare diseases has also jumped greatly since 2015, said the paper.

"Some novel cancer drugs are now added to the reimbursement list in replacement of traditional chemotherapies," he said, adding that the list now covers a much wider range of rare diseases.

Another highlight of China's drug insurance reform is it cuts drug prices through the centralized procurement program or price negotiations with drug manufacturers.

China has so far launched six rounds of bulk-buying, where drugmakers undergo a bidding process to win the right to supply drugs to public hospitals in large quantities.

During the first five rounds, average price cuts exceeded 50 percent, said the paper. As a result, more than 250 billion yuan ($39 billion) had been saved as of September, it added.

The price negotiation system mainly targets drugmakers who sell expensive and innovative drugs and are willing to slash their prices to be included in the national reimbursement list.

The paper said the system has saved nearly 170 billion yuan in the past three years, benefiting more than 100 million patients.

Liu added, "After innovative drugs receive market approval, it now takes much less time for them to be included in the national reimbursement list."

Jia Jidong, head of the Beijing Friendship Hospital's hepatitis center, said newly released drug insurance policies have markedly reduced prices of hepatitis B and C drugs, and helped expand treatment for people in need.

"Price negotiations and bulk-buy programs have together cut prices of hepatitis B medications by nearly 90 percent," he said, adding that three hepatitis C drugs became reimbursable starting in January of last year, leading to an average price cut of over 85 percent.