Effects of NRDL price negotiations on the pricing, market penetration, and spending of targeted lung cancer medications in China

doi:10.5246/jcps.2025.06.041

Abstract

Abstract:

Between 2016 and 2024, the Chinese government incorporated several innovative drugs into the National Reimbursement Drug List (NRDL) through price negotiations. These negotiations led to significant price reductions, which in turn stimulated an increase in sales. This study aimed to assess the impact of this policy on the pricing, utilization, and overall expenditure of targeted lung cancer therapies included in the NRDL. Using an interrupted time series analysis of procurement data from 698 healthcare institutions, the study evaluated both immediate and long-term effects. In terms of immediate effects, price negotiations resulted in a significant decline in the defined daily dose cost (DDDc) for all targeted therapies (P < 0.05). Regarding long-term trends, a significant shift was observed only in the pricing trajectory of Gefitinib, Icotinib, and Ensartinib (P < 0.05). In terms of immediate effects on drug utilization, all targeted medicines experienced a substantial increase in volume (P < 0.05), except for Gefitinib and Icotinib. Over the long term, the usage of all targeted therapies exhibited a significant upward trend (P < 0.05). With respect to expenditure, the immediate impact of NRDL inclusion resulted in a significant increase in spending on Afatinib, Crizotinib, Osimertinib, Alectinib, and Ensartinib (P < 0.05). Over time, total spending on targeted medicines showed a significant increase (P < 0.05), except for Erlotinib. Overall, NRDL price negotiations successfully reduced the economic burden on lung cancer patients, improving both accessibility and affordability of targeted therapies in China.

Key words: Lung cancer, Targeted medicine, National Reimbursement Drug List, Price negotiation

Supporting:

Cheng Wang, Hongbin Yi, Sheng Han, Luwen Shi. Effects of NRDL price negotiations on the pricing, market penetration, and spending of targeted lung cancer medications in China[J]. Journal of Chinese Pharmaceutical Sciences, 2025, 34(6): 543-555.

Figures/Tables 7

Table 1. Basic information of the target drugs.

Table 2. ITSA results for the DDDc of target drugs.

Table 3. ITSA results for the volume of target drugs (thousands of DDDs).

Table 4. ITSA results for the spending of target drugs (millions of CNY).

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