Summary of Key Points
After an 8-year wait, the national essential medicine list has finally been updated! The 2026 version will come into effect on September 1st and includes a total of 794 medications (476 chemical/biological drugs and 318 traditional Chinese medicines), with 116 new additions (mostly for chronic diseases, commonly used drugs at the grassroots level, and innovative drugs) and 2 deletions. This adjustment focuses on addressing the issues of "connectivity in drug supply at the grassroots level" and "inability of innovative drugs to reach the grassroots." It is also closely linked to medical insurance coverage, with almost all essential medicines being fully reimbursable. In the future, the frequency of list updates will be reduced to ensure that new drugs can benefit the public more quickly.
What's New and What's Been Removed in the New List?
The 116 newly added medications are all considered "essential":
- Chronic disease drugs: 4 additional types for hypertension, 5 for diabetes (covering different mechanisms of action to provide patients with more options), 7 for chronic obstructive pulmonary disease (COPD), and 8 for common digestive diseases;
- Mental health drugs: 5 new additions, including medications for treating attention deficit hyperactivity disorder (ADHD) in children, making it easier for people with mental health issues to obtain the necessary treatment;
- Innovative drugs: For the first time, 4 domestically developed Class I innovative drugs have been included (such as newly researched anticancer or chronic disease medications).
Only 2 chemical drugs have been removed, likely due to the availability of better alternatives or safety concerns. Additionally, the list has been refined in terms of dosage forms and specifications (with 109 new dosage forms and 175 new specifications), making it more accurate for doctors to prescribe and easier for grassroots hospitals to stock.
After the adjustment, the list covers almost all common diseases: chemical drugs can treat 1,180 conditions, and traditional Chinese medicines cover 63 different therapeutic effects. 71% of the medications used in public medical institutions nationwide are essential medicines (78% in grassroots hospitals, 74% in secondary hospitals, and 65% in tertiary hospitals).
Why a Focus on Grassroots and Innovative Drugs?
- Grassroots medication supply is crucial: Medications prescribed by larger hospitals may not be available at the grassroots level, forcing patients to travel back and forth for treatment. Most of the newly added drugs are already in use at the grassroots level, such as those for hypertension and diabetes, which helps to ensure a continuous supply of necessary medications both in large hospitals and community clinics.
- Innovative drugs are finally being recognized: Since 2018, more than 270 innovative drugs have been approved in China. However, due to the 8-year interval between list updates, many new drugs could not reach the grassroots level, leaving patients to pay out of pocket or wait in long queues at large hospitals. This time, innovative drugs have been included for the first time, and the process of bringing them to market will be streamlined to make good medications more accessible.
Does Being on the Essential Medicine List Mean Faster Medical Insurance Reimbursement?
In simple terms, if a medication is on the essential list, it is generally eligible for medical insurance reimbursement. The government has mandated that medical insurance prioritize covering essential medicines. All the old essential medicines, except for one traditional Chinese medicine, are now covered by insurance, and the 116 newly added drugs are also included. In the future, the types of reimbursement (e.g., higher reimbursement rates for certain categories) will be adjusted to reduce patients' out-of-pocket costs.
For example, if a medication is on the essential list, you can buy it at a community hospital with insurance coverage and may even pay less than at a private pharmacy, as the prices of essential medicines are regulated by the government.
Hospitals Are Held Accountable for Using Essential Medicines
The government has set strict requirements for hospitals:
- Grassroots hospitals (community health service centers, township health clinics): Must stock more than 90% of essential medicines.
- Secondary hospitals (county-level hospitals): More than 80%.
- Tertiary hospitals: More than 60%.
To ensure compliance, these requirements are monitored through evaluations. Hospitals are scored based on their purchase volume, usage amount, and the proportion of essential medicines prescribed. The results are linked to government funding: those that perform well receive more funding, while those that do not may receive less or face penalties. As a result, hospitals are incentivized to use essential medicines, ensuring that patients can access the necessary medications wherever they seek treatment.
Why Such a Long Interval Between Updates?
According to regulations from 2015, the essential medicine list should be updated every three years, but this time it was eight years. The reason for the delay is the change in the disease landscape: heart disease has become the leading cause of death (accounting for 25%), and the prevalence of Alzheimer's disease has risen from 19th to 6th place. With over 310 million people aged 60 and above, there is a significant increase in demand for medications for chronic and age-related diseases. Additionally, the rapid introduction of new drugs has outpaced the update process of the existing list.
After this adjustment, officials have stated that the time between updates for innovative drugs will be shortened, so patients no longer have to wait eight years for new treatments.
In summary, the new essential medicine list aims to ensure that medications are "available, affordable, and of high quality" for the public: common drugs can be easily obtained at the grassroots level, innovative drugs can be quickly introduced, and medical insurance provides adequate coverage. Future updates will be more timely, effectively addressing the challenges associated with accessing and paying for healthcare.