{"entity":{"id":"nhsa","kind":"institution","name":"National Healthcare Security Administration","aka":["NHSA","国家医疗保障局"],"tldr":"The NHSA runs China's public health insurance and negotiates once a year which new cancer drugs are reimbursed, and at what price, through the National Reimbursement Drug List.","summary":"Created in 2018 to merge the urban employee, urban resident and rural insurance schemes, the NHSA administers basic medical insurance for more than 1.3 billion people and the National Reimbursement Drug List (NRDL). Since 2017 (15 targeted anticancer drugs, average 48.9% cut in cost per defined daily dose) and the dedicated 2018 oncology round (17 drugs), it has run annual price negotiations in which manufacturers accept steep discounts, typically more than half, for national reimbursement; renewals are renegotiated and a dual-channel policy (2021) lets designated pharmacies dispense listed drugs when hospitals do not stock them. It also runs volume-based procurement of generics and the DRG payment reform.","asOf":"2026-09-10","links":[{"label":"NHSA","url":"https://www.nhsa.gov.cn/"},{"label":"Zhang Y, et al. The impacts of government reimbursement negotiation on targeted anticancer medication price, volume and spending in China. BMJ Glob Health 2021","url":"https://doi.org/10.1136/bmjgh-2021-006196"},{"label":"Cai L, et al. Impact of the national drug price negotiation policy on the utilization, cost, and accessibility of anticancer medicines in China. J Glob Health 2022","url":"https://doi.org/10.7189/jogh.12.11016"}],"tags":["china"],"related":[],"cancers":[],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":["nmpa-cde","nice","ncc-china"],"pathways":[],"terms":["hta","financial-toxicity"],"trials":[],"people":[],"bottlenecks":["b-drug-pricing","b-global-access"],"keyPapers":["paper-zhang-bmj-glob-health","paper-cai-j-glob-health"],"journals":[],"dependsOn":[],"notes":[],"city":"Beijing","country":"CN","lat":39.904,"lng":116.407,"institutionType":"government","website":"https://www.nhsa.gov.cn/","programs":["National Reimbursement Drug List annual negotiation","Dual-channel pharmacy access for negotiated drugs","Volume-based procurement","DRG/DIP payment reform"]},"route":"/institutions/nhsa/","neighbours":{"institution":[{"id":"ncc-china","kind":"institution","name":"National Cancer Center of China","route":"/institutions/ncc-china/"},{"id":"nice","kind":"institution","name":"National Institute for Health and Care Excellence","route":"/institutions/nice/"},{"id":"nmpa-cde","kind":"institution","name":"National Medical Products Administration / Center for Drug Evaluation","route":"/institutions/nmpa-cde/"}],"term":[{"id":"china-vbp-nrdl","kind":"term","name":"China National Reimbursement Drug List negotiation and volume-based procurement","route":"/terms/china-vbp-nrdl/"},{"id":"financial-toxicity","kind":"term","name":"Financial toxicity","route":"/terms/financial-toxicity/"},{"id":"hta","kind":"term","name":"Health technology assessment (HTA), reimbursement and QALYs","route":"/terms/hta/"}],"bottleneck":[{"id":"b-global-access","kind":"bottleneck","name":"Most of the world has almost no cancer care","route":"/bottlenecks/b-global-access/"},{"id":"b-drug-pricing","kind":"bottleneck","name":"Prices and value","route":"/bottlenecks/b-drug-pricing/"}],"paper":[{"id":"paper-cai-j-glob-health","kind":"paper","name":"Impact of the national drug price negotiation policy on the utilization, cost, and accessibility of anticancer medicines in China: A controlled interrupted time series study","route":"/key-papers/paper-cai-j-glob-health/"},{"id":"paper-zhang-bmj-glob-health","kind":"paper","name":"The impacts of government reimbursement negotiation on targeted anticancer medication price, volume and spending in China","route":"/key-papers/paper-zhang-bmj-glob-health/"}],"person":[{"id":"chen-zhu","kind":"person","name":"Zhu Chen","route":"/people/chen-zhu/"}],"roadmap":[{"id":"global-access-roadmap","kind":"roadmap","name":"Global access and affordability roadmap: essential medicines and generics → biosimilars and frugal trials → reliance, pooling and homegrown innovation","route":"/roadmaps/global-access-roadmap/"}]}}