The reform of the essential medicines system in China: a comprehensive approach to universal coverage

In OECD countries, medicines spending accounts for approximately 17% of total health spending or 1.5% of gross domestic product (GDP) [1]. New technologies and pharmaceuticals have been important contributors to rising health care costs. At the same time, patients may not have access to cost–effective medicines because of lack of health insurance coverage, limited insurance benefits, high medicines prices, physician prescribing choices, or differences between available essential medicines and consumer demand [2]. With the exception of a few countries [3], however, the approach to reform tends to be piecemeal rather than comprehensive.