by Bruce Liu and Ivy Jiang for Simon Kucher

“The National Healthcare Security Administration (NHSA) has recently announced developments in the provincial medtech access and reimbursement policies. How will China’s medtech access landscape evolve as a result?

China has come a long way with pharmaceutical access policies since the introduction of the National Reimbursement Drug List (NRDL) system for innovative drugs in 2017, and volume-based procurement (VoBP) for matured generics in 2018. Despite tweaks and twists each year, the overarching framework has largely stayed intact and increasingly institutionalized.

The case is different for medtech.

New developments in China’s medtech access landscape

Historically the access environment, procurement process, coding eligibility, and reimbursement standards for medtech devices and consumables have always been region-specific. In many cases, there were substantial variations and heterogeneities in decision-making at the city and hospital levels. As such, the environment posed challenges to the industry, as well as to the government stakeholders.

As the main stakeholder, NHSA has been looking into possible reforms, initially with the top-down approach of establishing National Reimbursement Medical Device List (NRMDL), aiming to replicate NRDL. However, this approach has encountered challenges given the complexity of medtech device and consumable landscape, and the large variations in healthcare budgets and needs across provinces.

In May 2023, NHSA indicated a change of direction from top-down management to a bottom-up approach, issuing policies requesting NRMDL to be established in all provinces by 2025. Additionally, each province must introduce access and negotiation mechanisms for high-value devices and consumables, and reimbursement standards tailored to local budget and healthcare needs…”

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