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Improving access to medicines: lessons from 10 years of drug reforms in China, 2009-2020

Mao, Wenhui, Jiang, Hongli, Mossialos, Elias ORCID: 0000-0001-8664-9297 and Chen, Wen (2022) Improving access to medicines: lessons from 10 years of drug reforms in China, 2009-2020. BMJ Global Health, 7 (11). ISSN 2059-7908

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Identification Number: 10.1136/bmjgh-2022-009916


China initiated its healthcare reform in 2009 to provide accessible and affordable healthcare to all. We summarised China's drug reforms between 2009 and 2020 using the WHO framework. China has initiated comprehensive drug policies to address different issues, including: (1) issuing or amending major regulations with changes in institutional settings; (2) implementing the marketing authorisation holder system and bioequivalence assessment to improve the quality of drugs; (3) leveraging accelerated market approval and insurance listing to encourage needs-driven innovation and improve the access to new drugs; (4) introducing compulsory licensing to address major public health threats when needed; (5) scaling up the National Essential Medicine Policy and introducing pharmacoeconomic evaluation in National Reimbursable Drug List to promote rational use of medicine and evidence-based selection; (6) applying differentiated pricing strategies and scaling up zero mark-up policies to form a new financing mechanism; (7) adapting bulk procurement and placing strict regulations on the supply chain management to ensure supply and reduce the cost; (8) empowering pharmacists to improve the rational use of medicine; and (9) using procurement and supply chain digital platforms to inform decision and improve efficiency. China's drug reform has adopted a phased and systemic approach that mobilises multiple policy levers including governance, regulation and financing. Despite the progress, emerging challenges in implementation, coordination and capacity need to be addressed. Cross-cutting lessons from China's drug reforms include aligning the drug reform with the overall health reforms, adapting a systemic approach that mobilised policy levers and stakeholders and informing policy decision by conducting pilot studies.

Item Type: Article
Official URL:
Additional Information: © 2022 The Authors
Divisions: Health Policy
LSE Health
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RM Therapeutics. Pharmacology
Date Deposited: 30 Nov 2022 16:12
Last Modified: 20 Jul 2024 05:48

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