Issues in drug pricing, reimbursement, and access in China with references to other Asia-Pacific region.

OBJECTIVES Pharmaceutical policies have become paramount in China and other countries of the Asia-Pacific region because of rapidly rising expenditures on drugs. The problems are especially acute in China because expenditures on drugs are typically so large. This article intends to review effects of the policy of drug expenditure containment with primary reference to China, and it proposes some measures to deal with rising pharmaceutical expenditures. METHODS This article overviews the issues of pharmaceutical pricing, reimbursement, and access in China, and there are a number of policies or measures to control pharmaceutical expenditures. Nevertheless, the effect of those policies of containing drug expenditure is ambiguous so far, and some policies have negative impacts to the manufacturers, providers, and patients. Some underlying reasons are identified. First, the policy's focus on health-care costs is, to some extent, neglected. Second, the governance of the health sector, including pharmaceutical sector, needs to be improved by both the government and the market. RESULTS This article proposes some suggestions to change policies in drug pricing, reimbursement, and access, and make policies more responsive to the main problem of rising health-care expenditures rather than that of pharmaceutical expenditures alone. CONCLUSIONS The policy suggestions include those of setting the reasonable price for pharmaceuticals, instituting reasonable incentives for all health decision-makers to encourage efficient use of pharmaceuticals and other health resources, and making pharmaceutical markets more efficient, either in the demand or the supply side.