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NRDL: No Once-and-for-all Solution

Mar 09-2021   



The latest National Drug Reimbursement List (NRDL), released in December 2020, newly added 119 medicines and achieved significant price decreases. Despite so, Prof. Liu Guo’en, head of the NRDL’s pharmacoeconomic expert team, said in a media interview that it’s difficult to lower people’s payment burden once and for all.

 

For new drugs that wished to enter the NRDL, negotiations were conducted between their producers and the National Health Security Administration (NHSA). The latter relies on two teams to calculate the costs and benefits of the drugs concerned: one consisting of pharmacoeconomic experts and the other of experts from the National Social Security Fund (NSSF).

 

The pharmacoeconomic expert team is tasked with calculating the lowest possible prices of new drugs based on the gains for patients as well as the drugs’ negative side effects, comparable international prices, and competitiveness. The team of NSSF experts measures the financial impact of new drugs on the Fund. With these two sets of figures in hand, the NHSA then negotiates with drug producers.

 

According to Prof. Liu, it takes time to improve such an assessment process, increase the payment ratio of the NSSF, and lower the payment burden of patients. Some expensive drugs, like PD-1 inhibitors, are now included in the list but patients still have to pay a larger part of the expenses. This has led some people to decry the failings of the medical reform. However, Prof. Liu stressed that the capacity of the NSSF has to do with the national fiscal level and economic development, making it impossible to have a once-for-all solution.

 

Put in another perspective, if such medicines remained excluded from the list, patients would need to pay 100% by themselves. To further alleviate the burden for patients, economic development and fiscal and income growth hold the key.

 

Contention also arose out of the call of certain senior executives of domestic pharmaceutical companies for favorable treatment. Prof. Liu believed that having differentiated evaluation standards would decrease product and corporate competitiveness in the long term.

 

Prof. Liu is an NSD professor, PKU Distinguished Professor and Dean of the School of Global Health and Development at PKU. His research areas include health and development economics, national health care system reform, and pharmacoeconomics.

NRDL: No Once-and-for-all Solution

Mar 09-2021   



The latest National Drug Reimbursement List (NRDL), released in December 2020, newly added 119 medicines and achieved significant price decreases. Despite so, Prof. Liu Guo’en, head of the NRDL’s pharmacoeconomic expert team, said in a media interview that it’s difficult to lower people’s payment burden once and for all.

 

For new drugs that wished to enter the NRDL, negotiations were conducted between their producers and the National Health Security Administration (NHSA). The latter relies on two teams to calculate the costs and benefits of the drugs concerned: one consisting of pharmacoeconomic experts and the other of experts from the National Social Security Fund (NSSF).

 

The pharmacoeconomic expert team is tasked with calculating the lowest possible prices of new drugs based on the gains for patients as well as the drugs’ negative side effects, comparable international prices, and competitiveness. The team of NSSF experts measures the financial impact of new drugs on the Fund. With these two sets of figures in hand, the NHSA then negotiates with drug producers.

 

According to Prof. Liu, it takes time to improve such an assessment process, increase the payment ratio of the NSSF, and lower the payment burden of patients. Some expensive drugs, like PD-1 inhibitors, are now included in the list but patients still have to pay a larger part of the expenses. This has led some people to decry the failings of the medical reform. However, Prof. Liu stressed that the capacity of the NSSF has to do with the national fiscal level and economic development, making it impossible to have a once-for-all solution.

 

Put in another perspective, if such medicines remained excluded from the list, patients would need to pay 100% by themselves. To further alleviate the burden for patients, economic development and fiscal and income growth hold the key.

 

Contention also arose out of the call of certain senior executives of domestic pharmaceutical companies for favorable treatment. Prof. Liu believed that having differentiated evaluation standards would decrease product and corporate competitiveness in the long term.

 

Prof. Liu is an NSD professor, PKU Distinguished Professor and Dean of the School of Global Health and Development at PKU. His research areas include health and development economics, national health care system reform, and pharmacoeconomics.