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Pharmaceutial Pricing and Reimbursement in China

Published by: Decision Resources

Published: Jun. 29, 2009 - 31 Pages


Table of Contents


Executive Summary

Strategic Considerations

Stakeholder Implications

Introduction

Regulatory Structure

Ministry of Health

State Food and Drug Administration

Ministry of Human Resources and Social Security

National Development and Reform Commission

State Administration of Traditional Chinese Medicine

Organization and Funding of the Healthcare System

Historical Perspective

Central Planning Era (1949-1978)

Market-Based Era (1978-2002)

Current Organization of Healthcare

Health Insurance

Organization of Healthcare Provision

Pharmaceutical Market Trends

Pharmaceutical Pricing

Historical Pricing Procedures

Standard Pricing Procedures

Premium Pricing

Centralized Drug Tenders

International Price Comparison

Reimbursement and Cost Containment

Drug Reimbursement

Price Cuts

Generic Prescribing

Intellectual Property Protection

Outlook and Implications for the Pharmaceutical Industry

Radical Healthcare Reform Program

Changes to the Health Insurance System

Investment in Healthcare Facilities and Professionals

Improved Quality and Range of Healthcare Services for Patients

New System of Hospital Funding

Overhaul of the Pharmaceutical Supply System

Challenges and Opportunities for Drug Manufacturers



Tables

1. Organization of Healthcare Provision in Urban and Rural Areas

2. Average Sources of Income and Expenditure for General Hospitals in the Public Health System, 2007

3. Average Outpatient and Inpatient Drug Expenditures Per Patient by Type of General Hospital in the Public Health System in Select Years, 1995-2007

4. Maximum Markups Permitted on Ex-Manufacturer Prices of Fully Reimbursed Drugs Included in the National Reimbursement Drug List

5. Ex-Manufacturer Prices of Select Drugs in China and Other Major Markets as a Percentage of U.S. Prices, 2008


6. Pharmaceutical Price Cuts Imposed by the Chinese Government, October 1997-May 2007

Figures

1. Sources of Healthcare Funding in China, 1995-2006

2. Ex-Manufacturer Prices of Select Drugs in China as a Percentage of U.S. Prices,2008

Abstract

Introduction

With a growth rate of more than 20% per year, the Chinese pharmaceutical market is set to become the third largest in the world in 2011. A radical healthcare reform package recently unveiled by the government will more than double public healthcare expenditures from 2009 to 2011. For biopharmaceutical companies competing in China, future success will depend on a clear understanding of the implications of these reforms.

Questions Answered in This Report
  • More than 1 billion of China’s 1.3 billion residents now have some form of government-sponsored health
    • insurance. Which are the most important public health insurance programs? What level of benefi ts do these programs offer? What changes are planned for the near future?
  • Prices for international branded drugs in China are generally comparable to prices in some European markets.
    • How do Chinese prices compare with prices in the United States? Which kinds of drugs have prices close to, or higher than, U.S. prices?
  • Hospitals are the dominant distribution channel for prescription drugs in China. Why do hospitals play such an important role in the healthcare system and the pharmaceutical market? How does the government plan to exercise stricter control over hospital prescribing in the future?
  • In the future, a drug’s reimbursement prospects are likely to depend heavily on inclusion in a new national essential medicines list. How extensive is this list likely to be? How will the healthcare system procure and use drugs on this list?
Scope
  • Regulatory structure: key policy decision makers in the Chinese healthcare system.
  • Organization and funding of the healthcare system: historical perspective, health insurance, organization
    • of healthcare provision.
  • Pharmaceutical pricing: historical pricing procedures, standard pricing procedures, premium pricing,
    • centralized drug tenders, international price comparison.
  • Reimbursement and cost containment: drug reimbursement, price cuts.
  • Outlook and implications for the pharmaceutical industry: changes to the health insurance system, investment in healthcare facilities and professionals, improved quality and range of healthcare services for patients, new system of hospital funding, overhaul of the pharmaceutical supply system, challenges and opportunities for drug manufacturers.


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