BEIJING, April 18 (Xinhua) -- A six-week course of treatment for brain cancer at a hospital in China can cost about 54,000 yuan (about 7,870 U.S. dollars), a price that could be unaffordable for many families, given the country's per capita disposable income of 43,377 yuan in 2025.
However, the burden can be significantly eased, as more than half of the cost can now be reimbursed by China's national basic medical insurance, which covers most of the population.
China's current national reimbursement drug list has about 270 cancer drugs for the treatment of over 20 types of tumors, after an update took effect in January this year that added 36 antitumor drugs.
These include chemotherapy, targeted therapy, immunotherapy, and antibody-drug conjugates (ADCs). The reimbursement list also covers some essential supportive medicines, such as potent antiemetics and long-acting agents to boost white blood cell counts.
"The current list includes most of the common cancer drugs, and has especially added more core medicines for gastric cancer, gynecological tumors, and some rare cancers," said Zhou Hui, vice president of Hunan Cancer Hospital based in central China's Changsha.
"Moreover, there have been more highly effective and low-toxicity drugs," he said.
China's National Healthcare Security Administration updates the national reimbursement drug list annually through price negotiations. This has enabled more new cancer drugs to be added to the list within about a year after their approval for the Chinese market.
Sacituzumab Tirumotecan, for example, is a novel targeted cancer drug developed by a Chinese pharmaceutical manufacturer and was approved for the treatment of triple-negative breast cancer in November 2024.
It has been added to the reimbursement list this year, cutting the out-of-pocket cost per vial by more than 8,000 yuan.
Beyond basic medical insurance, China is also looking to private health insurance, which has yet to be widely adopted by the public, as a complementary solution to ease the burden for patients with rare cancers that need more advanced -- but also costly -- therapies.
In a recently issued set of guidelines on improving the drug pricing mechanism, the government underscored the need to develop a "multi-tiered medical security system," and to fully leverage the roles of commercial health insurance and charitable assistance.
The call echoes with the release of China's first commercial insurance innovative drug list in December 2025. The list, taking effect this year, includes 19 innovative drugs that are beyond the affordability limits of basic medical insurance but are recommended for commercial insurance.
Several novel cancer drugs are included, among which is axicabtagene ciloleucel for the treatment of relapsed or refractory large B-cell lymphoma. As the first CAR-T therapy -- an immunotherapy that genetically alters the patient's T cells to help attack cancer cells -- approved in China, it was once priced at over 1 million yuan per infusion.
The private insurance drug list, according to Hao Haiping, president of the China Pharmaceutical University, provides patients with a new payment option and also supports innovative drug developers.
He suggested that while basic medical insurance should remain focused on providing essential coverage, private insurance should increase its share of total health spending, with supportive policies to expand its reach.
Access to innovative medicines also needs to be improved. For hospitals, prescribing and supplying novel cancer drugs on the commercial insurance list still requires careful consideration, and many remain cautious due to limited understanding of these drugs' clinical efficacy and risks.
Wan Bin, the pharmaceutical affairs management director at the Jiangsu Provincial People's Hospital, noted that real-world clinical usage data is a key consideration.
"Many drugs on the list are highly innovative and generally lack sufficient real-world clinical data, so there have been concerns about potential risks in clinical application," Wan said, mentioning that the hospital had not yet included the novel drugs in its routine supply catalog, but can provide patients with access through temporary procurement.
"We have opened up hospital-enterprise collaboration and plan to carry out real-world clinical follow-up studies to further clarify efficacy and safety of these drugs," she added.
According to Lin Likai, a senior researcher at the Hospital Management Institute of Wuhan University, implementing the commercial insurance drug list requires coordination among multiple stakeholders.
"Private health insurance in China is still underdeveloped," Lin said. "The priority is to build a sound ecosystem and remove bottlenecks across its various links." ■
