The highly anticipated results of the 2025 National Reimbursement Drug List (NRDL) negotiations were officially unveiled today at the 2025 High-Quality Development Conference for Innovative Drugs in Guangzhou's Baiyun District. Under the newly introduced "NRDL + Commercial Insurance" dual-track model, over 100 companies engaged in five days of intensive negotiations, achieving an 88% overall success rate. A total of 114 drugs were added to the NRDL, including 50 first-class innovative drugs, while 19 innovative drugs were included in the inaugural Commercial Insurance Innovative Drug List.
Among the highlights, all five CAR-T therapies—previously a focal point for market watchers—successfully entered the commercial insurance list. Multinational giants like Pfizer and Johnson & Johnson also secured spots with blockbuster drugs. On the basic insurance front, Hengrui Pharmaceuticals (600276.SH) saw 10 of its drugs, including trastuzumab biosimilar Ruikang, successfully negotiated, while Innovent Biologics (01801) had seven innovative products (including expanded indications) added. Notably, treatments for Alzheimer's disease, rare diseases (e.g., velaglucerase alfa and luvomeitinib), and unmet clinical needs were incorporated into either the basic NRDL or the commercial insurance list.
Industry experts and executives emphasized that this year’s negotiations reflect the government’s strong support for genuine innovation. The expansion of the NRDL and the introduction of the commercial insurance list create new opportunities, particularly for high-value drugs, by providing a more robust payment ecosystem. However, concerns remain about the implementation of the commercial insurance mechanism, especially regarding cost-effectiveness balance and payment sustainability.
**Key Takeaways from the 2025 NRDL Adjustments:** - **Record Innovation Inclusion**: 50 first-class innovative drugs accounted for nearly half of the newly added drugs, signaling a shift toward "value-based purchasing." - **Commercial Insurance Breakthroughs**: The five CAR-T therapies—previously hindered by cost-effectiveness debates in basic insurance—found a pathway via commercial insurance, marking a milestone for cell and gene therapies. - **Multinational and Domestic Wins**: Companies like Hengrui, Innovent, and multinationals (e.g., Eisai’s lecanemab for Alzheimer’s) secured significant victories. - **Rare Disease Focus**: Drugs for conditions like Gaucher disease and thalassemia were prioritized, addressing critical gaps in coverage.
**Industry Reactions:** - **Hengrui Pharmaceuticals** highlighted the NRDL’s role in guiding market priorities, pledging to align sales and academic resources with reimbursed products. - **CAR-T Developers** (e.g., CARsgen Therapeutics) hailed the commercial insurance inclusion as a pivotal step for high-cost therapies, though challenges in hospital adoption persist. - **Commercial Insurance Uncertainties**: While applauded for enabling premium pricing, stakeholders stressed the need for clearer implementation rules and reimbursement pathways.
**Future Outlook:** The 2025 NRDL adjustments, the eighth since the National Healthcare Security Administration’s inception, saw stabilized price cuts (average ~63%) and a focus on "strategic purchasing." With provincial rollouts set for December 2025 and effectiveness from January 2026, the industry now eyes the commercial insurance list’s real-world impact—its ability to scale and sustain will determine its long-term viability.
**Challenges Ahead:** - **Hospital Access**: Smaller innovators face hurdles in penetrating hospital formularies post-listing. - **Data Standards**: Calls for unified real-world evidence frameworks to streamline evaluations. - **Policy Stability**: Longer NRDL cycles for high-value drugs are urged to support R&D planning.
In summary, the 2025 NRDL negotiations underscore China’s commitment to fostering innovation while balancing affordability. The commercial insurance experiment, if successfully implemented, could redefine market access for cutting-edge therapies.