2020 NRDL Negotiation Results Unveiled: Prices of 119 Drugs Lowered by More than Half

On December 28, the National Healthcare Security Administration (NHSA) and the Ministry of Human Resources and Social Security released the National Reimbursement Drug List for Basic Medical Insurance, Work-related Injury Insurance and Maternity Insurance (2020), which will officially take effect on March 1, 2021. The renewed drug list contains a total of 2,800 medicines, including 1,426 Western medicines and 1,374 Chinese patent medicines. There has been no adjustment to the traditional Chinese medicines prepared in ready-to-use forms, and the number remains to be 892 on the list. 

The 2020 negotiations involved 162 drugs, 119 of which have been added to the list, representing a negotiation success rate of 73.46%. The average prices of the successfully negotiated drugs have been cut by 50.64%. After the adjustment, the medication burden for patients will be further eased. According to the NHSA, drug price reductions through negotiations and medical insurance reimbursement together are expected to reduce the medication burden by about 28 billion yuan for patients accumulatively in 2021. 

One of the characteristics of the negotiations was a record number of negotiated drugs and a wider range of treatments covered. The final 96 exclusive drugs successfully negotiated and 23 non-exclusive drugs directly added to the list involve a total of 31 clinical categories, accounting for 86% of all clinical categories. According to the NHSA's projection, the fund expenditures to be increased in 2021 would be basically equivalent to the space freed up by the negotiated and excluded drugs. At the same time, the agreement on drug prices reached in the negotiations will be valid for two years. After two years, the NHSA will adjust the payment standards again based on the actual sales to ensure smooth operation of the medical insurance fund. 

Another major characteristic of the negotiations was that negotiations on price reductions for drugs already on the list were arranged for the first time. According to the procedures, the review experts selected 14 exclusive drugs with high prices or costs and taking up relatively much of the medical insurance fund for price reduction negotiations, with the annual sales of each of these drugs being more than one billion yuan. After negotiations, all these drugs have been retained on the list, with an average price drop by 43.46%.

In addition, the adjusted NRDL supports the COVID-19 epidemic prevention and control. This adjustment has added to the list Ribavirin Injection, Abidor Granules, and all drugs listed in the latest edition of National Diagnosis and Treatment Protocol for COVID-19 as a practical action to help prevent and control the epidemic. 

Also, to better meet patients' needs of newly marketed drugs, those that came on the market before August 17 have also been included in the scope of adjustment and 16 of them have been added to the updated list, demonstrating the orientation of supporting new drugs.