China Updates Essential Drug List, Adds Innovative Drugs

China has released the 2026 edition of its National Essential Drug List (NEDL), marking the first update in eight years and, for the first time, including innovative drugs in the selection and adjustment scope. The landmark policy shift, announced on July 9 by the National Health Commission (NHC) alongside the National Administration of Traditional Chinese Medicine and the National Disease Control and Prevention Administration, expands the list to 794 drug varieties and will take effect on September 1, 2026, according to Xinhua News Agency.

Context: An Eight-Year Gap

The 2026 update is the fourth revision since China’s new healthcare reform began in 2009, following previous editions in 2009, 2012, and 2018. While the list was originally expected to be updated every three years, the eight-year gap meant that many innovative drugs approved during this period were not accessible through the essential drug system, particularly limiting patient access at grassroots medical institutions. The new edition addresses this by incorporating 16 innovative drugs in total, including four domestically produced Class I new drugs — three chemical/biological products and one traditional Chinese medicine (TCM) preparation.

Key Changes in the New List

The updated NEDL contains 476 chemical drugs and biological products (across 791 dosage forms and 1,355 specifications) and 318 TCM varieties (across 544 dosage forms and 888 specifications). It adds 68 new chemical/biological drugs and 48 new TCM drugs, with a strong focus on chronic disease management. New additions include five diabetes drugs, four hypertension medications, seven chronic obstructive pulmonary disease (COPD) drugs, and eight gastrointestinal treatments, as reported by The Paper.

Notable drug inclusions highlighted in the research include Novo Nordisk’s GLP-1 receptor agonist semaglutide (brand name NovoNorm®) for type 2 diabetes, the long-acting insulin degludec (NovoDawn®), and rapid-acting insulin aspart (NovoRapid®). Among domestic innovators, Remegen’s telitacicept — a globally first-in-class BLyS/APRIL dual-target fusion protein for autoimmune diseases — was included, alongside Yiling Pharmaceutical’s Jieyu Chufan Capsule, a new TCM for mild-to-moderate depression.

Focus on Children’s Medications

For the first time, the list establishes children’s drugs as an independent category, following the new “National Essential Drug List Management Measures” issued in February 2026 by 11 government departments. The update adds 31 child-appropriate varieties, including five pediatric-specific drugs, bringing the total pediatric-specified varieties to 317 with 905 child-appropriate specifications. This directly addresses a long-standing gap in China’s healthcare system, where children’s medications have often required adult dosages to be split or estimated.

Expert Perspectives

Gong Xiangguang, Director of the Pharmaceutical Policy Department at the NHC, stated that the update “attempts to include innovative drugs in the selection and adjustment scope, exploring a feasible path for more innovative drugs to enter the essential drug list in the future.” He noted that China’s drug R&D has developed rapidly in recent years, with a large number of innovative drugs approved for market covering tumor, neurological, and immune system diseases, as reported by 21st Century Business Herald.

Jin Chunlin, Director of the Shanghai Health Development Research Center, emphasized that the most significant aspect of this revision is “emphasizing keeping pace with the times, promptly including innovative drugs in the catalog, reflecting the overall direction of China’s medication development.” However, senior healthcare reform expert Xu Yucai cautioned that “compared to expanding the catalog size, perfecting the diagnosis and treatment standards corresponding to medical insurance, supervision, and medication policies, and promoting their implementation, is the top priority.”

Implications for Patients and Industry

The inclusion of innovative drugs means patients at grassroots medical institutions will gain access to cutting-edge therapies previously available only at large urban hospitals. The new list accounts for approximately 71% of total drug usage in public medical institutions nationwide, underscoring its central role in China’s healthcare system.

For the pharmaceutical industry, the policy signals that developing innovative drugs can lead to rapid inclusion in the essential drug list, potentially accelerating R&D investment. Domestic innovative drug developers such as Remegen and Yiling Pharmaceutical gain a significant market access advantage, as essential drug status typically drives procurement volumes across public hospitals.

Challenges Ahead

Despite the expansion, experts identified several implementation challenges. Medication linkage remains a key issue — patients treated at tertiary hospitals often cannot continue the same medication regimen when returning to grassroots clinics due to different drug formularies. Many primary care facilities also lack the pharmacy services capability to properly manage expanded drug formularies. Additionally, the medical insurance catalog and essential drug list are not fully synchronized; inclusion in the NEDL no longer guarantees insurance coverage.

What’s Next

The new “National Essential Drug List Management Measures” stipulate that the NEDL will be updated on a cycle of no more than three years, replacing the previous irregular update pattern. The NHC has stated it will combine the innovative development of the pharmaceutical industry, promote the standardized application of innovative drugs, and let the achievements of pharmaceutical innovation benefit the people better and faster. As the September 1 implementation date approaches, attention will turn to how effectively grassroots institutions can operationalize the expanded list and whether the medical insurance catalog will be updated to ensure full synchronization.