On Dec 28th, 2020, the National Healthcare Security Administration (NHSA) and Ministry of Human Resources and Social Security (MOHRSS) together issued the National Drug List for Basic Medical Insurance, Work-Related Injury Insurance and Maternity Insurance (2020 Edition), hereinafter referred to as the 2020 NRDL. It includes a total of 2800 medicines, including 1264 traditional Chinese medicines and Western medicines, 1315 Chinese patent medicines, and 221 medicines in negotiation period for purchasing order renewal. The 2020 NRDL will officially come into force starting from March 1st, 2021.
In the 2020 NRDL, 119 medicines are added to the list while 29 medicines are excluded from the original list. At the same time, those newly added medicines will be included in the payment scope of the basic medical insurance funds, whereas the 29 medicines deleted will be simultaneously excluded from the payment scope.
The newly added 119 medicines in the NRDL come from 704 nominated medicines. Different from previous years that any drug already on the market can be considered as the candidates of the list, the adjustment in NRDL this year only takes those eligible medicines outside the list into account. In other words, this year focuses on optimization rather than a general selection. The nominated medicines this year satisfy one of the following situations:
- Medicines for the treatment of respiratory diseases related to COVID-19
- Medicines in the Essential Drug List (2018)
- Medicines in the List of Overseas New Drugs Urgently Needed, List of Generic Drugs Encouraging to Develop, and List of Medicines for Children Encouraging to Develop
- Medicines included in the range of volume-based centralized procurement, and are successfully procured
- Medicines approved for market after Jan 1st, 2015; and medicines that have significantly changed their indications and functional indications after Jan 1st, 2015
- Medicines that have been included in 5 or more Provincial Reimbursement Drug List (PRDL)
Another feature of this adjustment in NRDL is that the number of medicines that are included in NRDL after lowering prices through drug price negotiations is the largest in the past years. NHSA has negotiated regarding the drug prices of 162 medicines and successfully lowered prices of 119 medicines by an average of 50.64% with a success rate of 73.46%. In addition, this is the first time NHSA has done the drug price negotiations regarding the medicines originally in the NRDL, and the annual sales of those 14 exclusively produced medicines that are selected exceed ¥1 billion. Through successful drug price negotiations, all of the 14 exclusively produced medicines are retained in the NRDL, with an average price reduction of 43.46%.
After the adjustment of NRDL, all domestically-made PD-1 inhibitors have been covered by basic medical insurance. Besides Sintilimab (Innovent Biologics) that has been included in NRDL after successful negotiations in 2019, these PD-1 inhibitors are Tislelizumab (Beigene), Toripalimab (Junshi Biosciences), and Camrelizumab (Hengrui Medicine).
Medicines in the latest edition of Diagnosis and Treatment Protocol for COVID-19 have all been included in the NRDL.