NHSA Reveals Drug Company Forged Doctor Letters in China Drug Procurement
China’s National Healthcare Security Administration (NHSA) has disclosed that an imported original-research drug company submitted forged joint letters purportedly signed by 78 doctors from 31 hospitals in an attempt to influence the 12th round of national centralized drug procurement. Over 80% of the signatures were found to be inauthentic, according to a risk notice published by the NHSA on July 7. The incident has raised serious concerns about integrity in China’s bulk drug purchasing system, with both Novartis and Takeda issuing public denials that they were the company involved.
The Forgery
The forged document, described as a “joint expert recommendation letter,” was submitted during the product selection stage of the 12th batch of national centralized drug procurement. NHSA investigators contacted each of the purported signatories and found that more than 80% of signatures were not genuine. The investigation revealed that company sales staff had forged signatures, copied and pasted signatures from other documents, and even fabricated fictional persons. A small number of genuine signatures were obtained through deception, with sales staff claiming the documents were for “after-sales follow-ups” or “survey questionnaires.”
Despite the forgery, the NHSA confirmed that the drug in question had passed expert review through normal procedures and has been formally included in the 12th batch procurement. The agency is now organizing national medical institutions to report their intended purchase quantities.
Industry Denials
Following the NHSA’s disclosure, market rumors quickly identified the drug as sacubitril/valsartan (brand name Entresto), Novartis’s blockbuster heart failure treatment with over 6 billion RMB in annual China sales. Novartis China issued a swift denial, stating: “We confirm that the company referred to in the article is not Novartis. Novartis has always strictly complied with national laws and regulations, and firmly supports the nation’s initiatives to promote high-quality development of the pharmaceutical industry.”
Takeda China also denied involvement, telling The Paper: “The company referred to in this incident is not Takeda. The company has always strictly complied with national laws and regulations and participated compliantly in procurement-related communications.”
The actual company responsible for the forgery has not been publicly identified by the NHSA.
NHSA’s Warning
The NHSA used strong language in its risk notice, stating: “We firmly oppose companies using improper means to interfere with drug procurement work, and solemnly remind all pharmaceutical companies not to use illegal or non-compliant methods to interfere with procurement, or bear the consequences.” The agency emphasized that it had held over 40 consultation sessions with domestic and foreign companies regarding the 12th batch procurement in the first half of 2026, demonstrating its commitment to open dialogue.
Implications for China’s Drug Procurement System
China’s centralized drug procurement system, launched in 2018 with the “4+7” pilot program, has become a cornerstone of the country’s healthcare cost-containment strategy. The system uses volume-based procurement, guaranteeing purchase volumes in exchange for significant price reductions. By 2025, China had conducted 11 rounds of national-level procurement, saving billions in healthcare costs.
However, the system has faced controversies. In February 2025, experts raised concerns about the quality of some procured drugs, and in February 2026, authorities cracked down on online misinformation about procurement. The NHSA published lists of “seriously dishonest” pharmaceutical companies under its credit evaluation system in May 2026.
This latest incident represents one of the most brazen attempts to manipulate the procurement process since its inception. The systematic nature of the forgery—with an 80%+ inauthentic signature rate and sophisticated deception tactics—suggests organized effort rather than individual misconduct.
What’s Next
The NHSA’s decision to publicize the incident serves as a strong deterrent to other companies. The agency’s existing credit evaluation system could impose severe penalties, including market exclusion, on the offending company. Industry analysts expect heightened scrutiny of all documents submitted by drug companies in future procurement rounds, with increased compliance costs particularly for foreign pharmaceutical companies operating in China.
The identity of the company behind the forgery remains an open question, as does the question of whether this was an isolated incident or part of a broader pattern of procurement manipulation. The NHSA has signaled that it will continue to investigate and take action against any improper interference with the procurement process.