Prefer generic drugs that have passed consistency evaluation and those selected in centralized procurement

No cost at all. When a doctor prescribes medication or you go to buy medicine, simply ask: “Is there a generic version included in the centralized procurement program?”

The national centralized drug procurement initiative resulted in a 53% average price reduction for the second batch, with some drugs dropping by as much as 93%. By April 2026, 11 rounds had been conducted, covering 490 drugs. A total of 1,695 drugs have either passed or are considered to have met consistency evaluation standards, accounting for roughly two-thirds of all commonly used chemical drugs in China (official data from 2020–2026).

国家医疗保障局 (2020). 第二批国家组织药品集中采购和使用工作答记者问. https://www.nhsa.gov.cn/art/2020/1/17/art_38_2264.html；国家医疗保障局 (2026). 国务院政策例行吹风会：健全全周期全渠道药品价格形成机制. http://www.nhsa.gov.cn/art/2026/4/15/art_14_20221.html；国务院办公厅 (2016). 关于开展仿制药质量和疗效一致性评价的意见（国办发〔2016〕8 号）. https://www.gov.cn/zhengce/zhengceku/2016-03/05/content_5049364.htm；国家食品药品监督管理总局 (2016). 关于发布普通口服固体制剂参比制剂选择和确定等 3 个技术指导原则的通告（2016 年第 61 号）附件 1、附件 3，海南省药品监督管理局转载. https://amr.hainan.gov.cn/himpa/ztzl/fzy/201607/t20160720_1591587.html；国家医疗保障局 (2024). 集采药品质量严格监管，企业检查和品种抽检两个「全覆盖」. https://www.nhsa.gov.cn/art/2024/12/30/art_52_15287.html；国家医疗保障局 (2025). 医保部门、药监部门有关同志就集采药品相关问题接受人民日报健康客户端记者采访. https://www.nhsa.gov.cn/art/2025/2/9/art_14_15647.html

There is some debate: some claim that consistency evaluation only checks ingredients, not actual therapeutic effects. This is only partially true. The evaluation process involves giving healthy volunteers the drug and measuring its concentration levels in their blood over time; if those levels fall within 80%–125% of those produced by the original brand-name drug, it is deemed acceptable. For drugs where dosage variations can be dangerous, stricter criteria apply. Excipients—substances other than the active ingredient used for filling or coating—may differ from those in the original drug, as regulations only require identical active ingredients, dosage form, administration method, and therapeutic purpose. Consequently, consistency evaluation does not involve testing the drug on patients to gauge effectiveness; that is assessed through separate research. The National Healthcare Security Administration has conducted real-world studies involving 63 centrally procured drugs, nearly 100 top-tier hospitals, and over 300,000 patients; results consistently showed no difference compared to original brand-name drugs. For example, with metformin, the rate of achieving target HbA1c levels was 83.4% for generic users versus 78.9% for brand-name users; conversely, for fasting blood glucose control, generic users achieved a 83.8% success rate compared to 87.6% for brand-name users. In January 2025, some doctors claimed that centrally procured drugs failed to lower blood pressure, induce anesthesia, or treat diarrhea; investigations by healthcare authorities at seven Shanghai hospitals found these claims largely stemmed from hearsay and personal experience; one of the cited diarrhea medications had not yet been used in hospitals at the time. It was also acknowledged that nine problematic drugs were disqualified from the first nine procurement rounds involving over 1,600 products—six of these were imported drugs, including three original brand-name products, while three were domestic products. Two practical steps can be taken: first, original brand-name drugs remain widely available, as centralized procurement accounts for only 60%–80% of hospital purchases; patients can still obtain them at higher cost. Second, for chronic disease patients switching to generic drugs, it is vital to monitor blood pressure, blood sugar, and HbA1c levels regularly (as outlined in Section 16, point 3) rather than relying on subjective feelings; if results worsen, consult a doctor and report any adverse reactions—never discontinue medication on your own.