# National Healthcare Security Administration

Source: https://onco.cc/institutions/nhsa/  
OnCo record `nhsa` (Institution). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The NHSA runs China's public health insurance and negotiates once a year which new cancer drugs are reimbursed, and at what price, through the National Reimbursement Drug List.

## Summary

Created in 2018 to merge the urban employee, urban resident and rural insurance schemes, the NHSA administers basic medical insurance for more than 1.3 billion people and the National Reimbursement Drug List (NRDL). Since 2017 (15 targeted anticancer drugs, average 48.9% cut in cost per defined daily dose) and the dedicated 2018 oncology round (17 drugs), it has run annual price negotiations in which manufacturers accept steep discounts, typically more than half, for national reimbursement; renewals are renegotiated and a dual-channel policy (2021) lets designated pharmacies dispense listed drugs when hospitals do not stock them. It also runs volume-based procurement of generics and the DRG payment reform.

## Fields

- Kind: Institution
- Last checked: 2026-09-10
- Also known as: NHSA; 国家医疗保障局
- Tags: china
- City: Beijing, CN
- Type: government
- Website: https://www.nhsa.gov.cn/

## Sources

- NHSA: https://www.nhsa.gov.cn/
- Zhang Y, et al. The impacts of government reimbursement negotiation on targeted anticancer medication price, volume and spending in China. BMJ Glob Health 2021: https://doi.org/10.1136/bmjgh-2021-006196
- Cai L, et al. Impact of the national drug price negotiation policy on the utilization, cost, and accessibility of anticancer medicines in China. J Glob Health 2022: https://doi.org/10.7189/jogh.12.11016

## Connected records

- institutions: [National Cancer Center of China](https://onco.cc/institutions/ncc-china/), [National Institute for Health and Care Excellence](https://onco.cc/institutions/nice/), [National Medical Products Administration / Center for Drug Evaluation](https://onco.cc/institutions/nmpa-cde/)
- terms: [China National Reimbursement Drug List negotiation and volume-based procurement](https://onco.cc/terms/china-vbp-nrdl/), [Financial toxicity](https://onco.cc/terms/financial-toxicity/), [Health technology assessment (HTA), reimbursement and QALYs](https://onco.cc/terms/hta/)
- bottlenecks: [Most of the world has almost no cancer care](https://onco.cc/bottlenecks/b-global-access/), [Prices and value](https://onco.cc/bottlenecks/b-drug-pricing/)
- key papers: [Impact of the national drug price negotiation policy on the utilization, cost, and accessibility of anticancer medicines in China: A controlled interrupted time series study](https://onco.cc/key-papers/paper-cai-j-glob-health/), [The impacts of government reimbursement negotiation on targeted anticancer medication price, volume and spending in China](https://onco.cc/key-papers/paper-zhang-bmj-glob-health/)
- people: [Zhu Chen](https://onco.cc/people/chen-zhu/)
- roadmaps: [Global access and affordability roadmap: essential medicines and generics → biosimilars and frugal trials → reliance, pooling and homegrown innovation](https://onco.cc/roadmaps/global-access-roadmap/)

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