Western drugmakers seek entry into China's private insurance catalog

Western drugmakers such as Eli Lilly, Novo Nordisk, and Pfizer are seeking to expand sales in China by applying for inclusion in Beijing's new commercial health insurance catalog. The catalog lists innovative and expensive medicines, including treatments for diabetes, Alzheimer's, and cancer. A total of 121 drugs have cleared the initial screening, with final decisions expected by October or November. This move aims to balance affordability with innovation in China's drug pricing system.

Western pharmaceutical giants, including Eli Lilly & Co., Novo Nordisk A/S, and Pfizer Inc., are vying for a spot in Beijing's new commercial health insurance catalog. This catalog aims to expand access to innovative and expensive medicines in China's rapidly growing pharmaceutical market. The inclusion of these drugs in the catalog could significantly boost sales for multinational companies and balance affordability with innovation in China's drug pricing system.

A total of 121 drugs, including oral diabetes treatments from Novo Nordisk, Alzheimer's therapies from Eli Lilly, and cancer treatments from various manufacturers, have cleared the initial screening. The final outcome is anticipated by October or November. These drugs, which are too expensive for state insurance but recommended for reimbursement by private health insurers, represent a significant opportunity for drugmakers to expand their reach in China.

The new catalog is part of a broader strategy by Beijing to increase coverage of innovative medicines through both state and commercial health insurance schemes. Drug companies traditionally had to offer steep discounts in exchange for a place on the national drug reimbursement list. The commercial catalog offers a new pathway, allowing these drugs to be reimbursed at a smaller discount, thereby opening up a larger market for multinational companies.

This move is part of a broader trend in China to reform the drug pricing system and better reward medical innovation. Commercial health insurance, which currently makes up a fraction of China's drug spending, could grow into a more significant pillar of the country's total health expenditure, driving both revenue and accessibility of innovative drugs [1].

However, this expansion comes amid ongoing legal challenges. A federal appeals court recently revived a class action lawsuit accusing Sanofi, Eli Lilly, Novo Nordisk, and AstraZeneca of conspiring to restrict discounts under the Section 340B Drug Discount Program, which provides discounted drugs to safety-net hospitals and clinics serving low-income patients [2]. This lawsuit highlights the complex landscape of drug pricing and reimbursement in the United States and the potential for regulatory challenges to impact market dynamics.

In conclusion, the inclusion of innovative and expensive medicines in China's commercial health insurance catalog represents a significant opportunity for Western drugmakers. This move, part of a broader effort to balance affordability with innovation, could drive revenue and accessibility of these drugs in China. However, it also highlights the ongoing regulatory challenges and complexities in the global drug pricing landscape.

References:
[1] https://www.bloomberg.com/news/articles/2025-08-12/eli-lilly-pfizer-seek-spot-in-china-private-insurance-catalog
[2] https://www.benzinga.com/news/legal/25/08/47037198/sanofi-eli-lilly-novo-nordisk-astrazeneca-face-renewed-claims-of-conspiring-to-restrict-340b-discounts