Nineteen novel drugs have been selected for inclusion in the first iteration of China's Commercial Health Insurance Innovative Drug Catalogue, portending potential access benefits as the program gains momentum.
The list, which was unveiled by China's National Healthcare Security Administration (NHSA) at a Dec. 7 press conference in Guangzhou, was whittled down from 24 drugs that entered final pricing negotiations and 121 that initially passed a formal review, according to local reports.
The catalog is set to take effect from Jan. 1, 2026, and prioritizes innovative drugs with “high levels of innovation, significant clinical value, substantial patient benefits, and coverage exceeding the scope of basic medical insurance,” the NHSA explained in a disclosure.
Among the drugs that made the list (PDF, Chinese) are several CAR-T therapies, plus targeted cancer treatments including BeiGene’s HER2 bispecific Ziihera, Pfizer’s multiple myeloma med Empliciti, Bristol Myers Squibb’s Yervoy and Johnson & Johnson’s Talvey. Alzheimer’s disease treatments from Eli Lilly and partners Eisai and Biogen made the grade, as well.
Unlike the well-established National Reimbursement Drug List, which ensures coverage under the state-run national medical insurance scheme, drugs that made the inaugural commercial insurance roster won’t enjoy any guaranteed coverage. Instead, drugs on the new formulary are recommended for commercial health coverage.
The formulary is expected to be gradually incorporated into commercial insurance programs backed by local governments. These programs, already available to residents at a relatively low out-of-pocket premium in some large Chinese cities, are considered supplemental to the national insurance scheme, with some already offering different levels of coverage for some pricey medicines, such as CAR-Ts.
However, this pathway is not considered an enforceable policy but rather a recommendation. Each commercial insurance company is still free to decide which drugs to include.
“With more new drugs added to the catalog, the level of clinical drug use will steadily improve, effectively boosting the pharmaceutical industry's confidence in increasing research and innovation, and providing greater protection for the health of the people,” the NHSA said in its release.
Shanghai-based CAR-T maker CARsgen Therapeutics, which earned a place on the list with its multiple myeloma cell therapy zevor-cel, says its inclusion can “help further alleviate the financial burden on patients and enhance the accessibility of advanced cell therapies,” co-founder Huamao Wang, Ph.D., said in a release, adding that the company is committed to “contributing to the 'Healthy China' initiative.”
The Healthy China initiative is a key national priority for the Chinese government amid rising rates of cancer and cardiovascular disease, prompting a focus on policy pushes in the health vein.