China Added 114 Drugs to Its Reimbursement List and Launched a Commercial List in 2026

China’s National Reimbursement Drug List (NRDL) defines the medicines reimbursed by basic medical insurance and is adjusted every year through a process of application, review and price negotiation led by the National Healthcare Security Administration (NHSA). On 7 December 2025, the NHSA and the Ministry of Human Resources and Social Security jointly released the updated NRDL, which took effect on 1 January 2026.

The 2025 round added 114 drugs to the basic list, including 50 drugs described as first-class (Class 1) innovative medicines. One law-firm summary puts the total number of entries on the updated list at 3,253. As in previous years, listing depends on companies accepting negotiated prices in exchange for national reimbursement.

Alongside the NRDL, the NHSA published the first Commercial Health Insurance Innovative Drug List, which also took effect on 1 January 2026. The list contains 19 drugs, including CAR-T cell therapies, treatments for rare diseases such as neuroblastoma and Alzheimer’s disease medicines. According to one secondary source, 121 high-value innovative drugs initially passed formal review for this list, and 19 were included in the end.

The commercial list does not provide basic medical insurance reimbursement. Analysts describe it as an NHSA-endorsed reference list that signals to commercial health insurers which high-value innovative therapies may be appropriate for coverage. It creates a second, publicly coordinated route for very high-cost medicines that are unlikely to meet the price expectations of the basic list.

The first edition’s small size, 19 drugs out of a much larger pool of candidates, indicates that inclusion is selective. How widely commercial insurers adopt the listed drugs, and on what terms, will determine how much additional access the list creates in practice, and early analyses have begun to examine its first year of operation.

The 2026 adjustment started earlier than usual. Secondary sources report that a draft work plan appeared in May 2026 and that the planned timetable placed publication of the updated NRDL and commercial list around the end of November 2026. The 2026 plan added a pre-submission channel for products awaiting formal approval and a comparator pre-communication step, under which companies can discuss the choice of comparator with the NHSA in advance.

The NHSA published preliminary formal review results on 29 June 2026. According to secondary reporting, 601 generic names passed formal review for the basic list, 368 of them not yet listed and 233 already listed, compared with 535 in 2025, and 58 passed final formal review for the commercial list. Of 57 candidates that used comparator pre-communication, 54 passed formal review. Companies were reported to have been required to submit negotiation materials by 10 August 2026. One source stated that, as of 2 November 2026, the NHSA had not published the 2026 lists, and no official results had been confirmed at the time of checking.

For companies with innovative medicines in China, the annual NRDL cycle remains the main route to broad patient access, and the timing of approval relative to the application window strongly affects time to reimbursement. The new pre-submission channel may allow products approved shortly before or during the window to enter negotiations sooner, and comparator pre-communication offers a chance to settle a key evidence question before the formal review.

The commercial list gives manufacturers of very high-cost therapies an alternative to accepting basic-list price levels, but uptake depends on commercial insurers’ coverage decisions. Market access teams should prepare health economic evidence suited to NHSA negotiation, decide early whether a product is better suited to the basic or commercial list, and monitor the NHSA’s announcements for the 2026 results and the 2027 work plan.

The scale of the 2026 round also matters for planning. With 368 drugs not yet on the list passing preliminary formal review, compared with 310 a year earlier according to secondary reporting, competition for listing and for favourable negotiated prices is likely to remain intense. Companies with products in crowded therapeutic classes should expect the NHSA to compare their price and evidence closely with those of listed alternatives. Medical writers supporting NRDL dossiers should ensure that the clinical evidence summary, comparator rationale and economic evaluation are consistent with each other and with the evidence presented to the regulator at approval, since inconsistencies can weaken a company’s position during expert review and negotiation.