China has unveiled its first state-backed catalog of costly innovative drugs for private insurers to cover, making the industry pick up more of the nation’s soaring health-care costs.

Issued Dec. 7 by the National Healthcare Security Administration, the catalog will take effect Jan. 1, 2026. It supplements the state-funded National Reimbursement Drug List (NRDL) and is part of China’s effort to build a multi-tier health security system by 2030.

After reviews that began in late October, only 19 of 141 candidate drugs made the final list, which the administration describes as “highly innovative, clinically valuable, and offering significant patient benefits.” 

Fourteen cancer drugs dominate the catalog, including five CAR-T treatments with market prices at around 1 million yuan ($140,000) each. CAR-T therapies reengineer a patient’s own white blood cells to attack otherwise hard-to-treat tumors. 

Two Alzheimer’s drugs and several rare-disease therapies are also included.

The catalog was released alongside an eighth annual update to the NRDL, which added 114 medicines this year. The revision drew outsized attention because it coincided with the debut of the new innovative-drugs catalog.

Innovative medicines are new drugs with novel mechanisms and proven clinical benefits, but their high development costs often put them out of reach for many patients. 

“For now, many innovative drugs still aren’t eligible for state reimbursement because our NRDL has strict entry standards,” said Chen Dongmei, an associate professor from Fudan University’s Department of Risk Management and Insurance. “This new catalog lets private health insurance step in earlier to fill the coverage gap.”

China’s current payment mix for innovative drugs is “skewed,” with 44% covered by state funding, 49% paid by patients themselves, and just 7.7% covered by private insurance, according to a February 2025 industry report.

Joining the new catalog could also ease pressure on drug manufacturers’ margins, experts said. For years, companies have been required to cut prices by an average of 50% to 63% to join the state-funded NRDL — a “quantity-for-price” trade-off under China’s public insurance system, which covers more than 1.3 billion people.

For the new catalog, negotiations with the administration resulted in prices about 10% to 50% below market levels, according to industry insiders. 

Detailed list prices, however, will not be disclosed by the administration, unlike the NRDL. The move is meant to protect Chinese drugmakers’ bargaining power in overseas pricing negotiations, Xie Shitong, an associate researcher at Tianjin University’s School of Pharmaceutical Science and Technology, told Sixth Tone.

Xie said the key “policy dividend” for drugmakers is that listed drugs can be prescribed directly in hospitals, bypassing the extra reviews that have long kept many innovative therapies out of hospital procurement platforms.

For insurers, the catalog gives them “a clear target to upgrade products around patients’ real needs,” said Chen, from Fudan University.

But she noted the policy is still “experimental,” with limited market data on innovative drugs leaving insurers guessing on risk and payouts. “In practice, product design, risk-sharing mechanisms, and supportive policies will all need to keep evolving,” added Chen.

Editor: Marianne Gunnarsson.

(Header image: Teera Konakan/Getty Creative/VCG)