China to Cover More Cancer and Rare Disease Drugs
Welcome back to Learn English with Podcasts! Sarah, let me ask you a simple question. If a life-saving drug costs 3000 yuan a month, and insurance suddenly makes it cost only 300, would you say that is good news?欢迎回到 Learn English with Podcasts！Sarah，我来问你一个简单的问题。如果一种救命药每月要花3000元，而医保突然让它只要300元，你会说这是好消息吗？
That is not just good news, that is life-changing news. For many families, that difference decides whether they can keep taking the medicine or not.那不仅仅是好消息，那是能改变生活的好消息。对很多家庭来说，这个差额决定了他们能否继续吃药。
Exactly. And that is what happened in China this week. On September 4, at a big press conference in Beijing about the 15th Five-Year Plan, the National Healthcare Security Administration made a clear promise.没错。而这正是本周在中国发生的事。9月4日，在北京一场关于“十五五”规划的新闻发布会上，国家医保局作出了一个明确的承诺。
The 15th Five-Year Plan — that is China's plan for the next 5 years, right? What did they promise?“十五五”规划——就是中国未来5年的计划，对吧？他们承诺了什么？
Yes. Vice Director Li Tao said the government will adjust the basic medical insurance drug list every year. And they will put more innovative drugs into the insurance — especially for cancer, chronic diseases, rare diseases, and children's diseases.是的。副局长李滔说，政府将每年调整基本医保药品目录。并且将把更多创新药纳入医保——尤其是针对肿瘤、慢性病、罕见病和儿童疾病的药。
Innovative drugs — you mean new drugs that are very effective but usually very expensive?创新药——你是说那些非常有效但通常非常贵的新药吗？
Exactly. The newest science, like targeted cancer therapies or rare disease treatments. In the past, many of these drugs were not covered, so families had to pay the full price themselves.完全正确。最新的科技，比如靶向抗癌疗法或罕见病治疗药。过去，很多这类药不在报销范围，家庭必须自己付全款。
So what is the situation now? How many drugs does China's basic insurance already cover?那现在情况如何？中国的医保已经覆盖了多少种药？
The current list, which started on January 1, 2026, includes 3253 Western and Chinese patent medicines, plus 892 traditional Chinese medicine pieces. And over the last 8 years, the government has added 199 innovative drugs through negotiations.现行的目录从2026年1月1日开始执行，包括3253种西药和中成药，外加892种中药饮片。而在过去8年里，政府通过谈判已经新增了199种创新药。
199 new drugs in 8 years — that is a lot. What was new just this year?8年新增199种新药——这非常多。今年新增了哪些？
This year, 114 new drugs were added, and 50 of them were Class 1 new drugs — that means completely new drugs developed in China. For example, a breast cancer drug called sacituzumab, a pancreatic cancer drug, a diabetes drug called tirzepatide, and a cholesterol drug that you only need twice a year.今年新增了114种药，其中50种是1类新药——就是在中国全新研发的药。比如一种叫芦康沙妥珠单抗的乳腺癌药、一种胰腺癌药、一种叫替尔泊肽的糖尿病药，还有一种一年只需打两针的降胆固醇药。
Wait, twice a year for cholesterol? That sounds much easier than taking pills every day.等等，一年两针就能降胆固醇？这听起来比每天吃药容易多了。
It is. And there is also a thalassemia drug called deferiprone. In places like Guangxi, patients used to pay almost 3000 yuan a month for it. After negotiation and insurance, they now pay only about one tenth.确实。还有一种治疗地中海贫血的药叫去铁酮。像在广西，患者过去每月要付近3000元。经过谈判和医保报销后，现在只需付大约十分之一。
So from 3000 to 300 — that brings us back to your first question. That one tenth is exactly the difference between giving up and continuing treatment.所以从3000到300——这就回到了你一开始的问题。这十分之一，正是放弃治疗和坚持治疗的区别。
Yes. And on September 4, Li Tao said they want more stories like that. They will also make the reimbursement list for medical services and medical consumables the same across the whole country. So the difference between regions will be smaller.是的。而在9月4日，李滔说他们想要更多这样的故事。他们还将推动医疗服务项目和医用耗材报销目录在全国统一。这样地区之间的差异就会更小。
You mean right now, a treatment might be covered in Shanghai but not in a smaller city?你是说现在，一项治疗在上海可能报销，但在小城市就不行？
Exactly. By making a national unified list, people can get fairer coverage no matter where they live. That is the second part of the promise.没错。通过制定全国统一的目录，无论住在哪里，人们都能得到更公平的保障。这是承诺的第二部分。
This all sounds great, but how does the government make expensive drugs affordable? Do they just pay whatever the company asks?这些听起来都很棒，但政府如何让昂贵的药变便宜的？难道公司要多少就给多少吗？
No, that is the smart part. Every year, the government does a negotiation. They bring together about 1.3 billion insured people as one big buyer. And they say to the drug company: if you lower your price, we will put your drug in the insurance and millions of people can use it.不是，这是最巧妙的部分。每年，政府都会进行谈判。他们把约13亿参保人集合成一个巨大的买方。然后对药企说：如果你降价，我们就把你的药放进医保，让数百万人都能用上。
Ah, so it is like group shopping. Lower price, but many more customers. Did it work?啊，所以就像团购。价格更低，但客户多得多。这奏效了吗？
It worked very well. As of February 2026, the fund has paid 504.8 billion yuan for negotiated drugs since 2018, which drove total sales to 740 billion yuan and helped 1.17 billion visits. And the industry also grew — profits up 11.3% a year, research spending up 23% a year.非常奏效。截至2026年2月，自2018年以来基金已为谈判药品支付5048亿元，带动总销售7400亿元，惠及11.7亿人次。而且行业也在增长——利润年均增长11.3%，研发投入年均增长23%。
So both patients and companies win. But what about the most expensive drugs that are still too costly even after negotiation? Like CAR-T therapy for cancer?所以患者和企业双赢。但那些即使谈判后依然太贵的药怎么办？比如治疗癌症的CAR-T疗法？
That is why China created a second list — the Commercial Health Insurance Innovative Drug List. The first version started on January 1, 2026 with 19 drugs. These are high-value drugs for cancer, Alzheimer's, and rare diseases in children.这就是为什么中国创建了第二份清单——商业健康保险创新药目录。第一版于2026年1月1日启动，有19种药。这些是针对癌症、阿尔茨海默病和儿童罕见病的高价值药。
So these 19 are not in basic insurance yet, but commercial insurance can recommend covering them?所以这19种还没进基本医保，但商业保险可以推荐报销它们？
Yes. And for hospitals, using drugs from this list has three special rules. They do not count toward the hospital's self-pay rate, they are not counted as replaceable drugs in centralized procurement, and the payment is not part of the normal disease-based payment. So hospitals are not afraid to use them.是的。而且对医院来说，使用这份目录里的药有三个特殊政策。它们不计入医院的自费率指标，不纳入集采可替代品种监测，也不计入常规的按病种付费。所以医院不怕使用它们。
That solves the old problem — sometimes a drug is approved but hospitals do not want to use it because of cost controls.这就解决了老问题——有时候一种药获批了，但医院因为控费而不愿使用。
Exactly. As of May 2026, those 19 drugs were already available in 1486 medical institutions, double the number at the start of the year. And more than 100 commercial insurance products now include them.没错。截至2026年5月，这19种药已在1486家医疗机构配备，是年初的两倍多。而且已有100多个商业保险产品覆盖了它们。
And what is next? When will we know which new drugs are added?那接下来呢？我们什么时候能知道哪些新药会被加入？
Right now, actually. In June, the government received 818 applications for 674 generic drugs. And the next negotiation is starting on September 5 in Beijing. For the first time, they will negotiate the basic list and the commercial list together, at the same time. The results will be announced in November.就是现在。6月，政府收到了674个通用名共818份申报。而下一轮谈判将于9月5日在北京开始。第一次，他们将同时对基本目录和商保目录进行谈判。结果将在11月公布。
So in just two months, we will know which cancer, rare disease, and children's drugs become much cheaper for families.所以短短两个月后，我们就会知道哪些癌症、罕见病和儿童用药会为家庭便宜很多。
Yes. And Li Tao also said they want to push unified national standards so the promise is real everywhere — from Beijing to a small county hospital in Guangxi.是的。李滔还说他们想推动全国统一的标准，让承诺在各地都落到实处——从北京到广西的小县医院。
You know, my favorite part of this story is a small detail. For basic drugs, the government also added four domestic Class 1 innovative drugs to the National Essential Drug List on September 1 — including a depression drug and a cholesterol drug. That list tells every public hospital: you should have these.你知道吗，我最喜欢这个故事里的一个小细节。9月1日，政府还把四种国产1类创新药加入了国家基本药物目录——包括一种治疗抑郁的药和一种降胆固醇药。这份目录告诉每一家公立医院：你们应该配备这些药。
Right. So it is not just about paying. It is about making sure the drug is actually in the hospital when you need it.没错。所以不仅仅是支付问题。还要确保当你需要时，药真的就在医院里。
It reminds me of what my aunt says: you hope you never need the most expensive drug in the pharmacy, but you sleep better knowing it is there and you can afford it if you do need it.这让我想起我阿姨说的话：你希望永远不需要药房里最贵的那种药，但知道它就在那里、需要时你能负担得起，你会睡得更安稳。
That is a perfect way to put it. Insurance does not make us sick less often, but it makes getting better less scary.说得太好了。医保不会让我们少生病，但它让治好病变得不那么可怕。
Thanks for listening to Learn English with Podcasts today. Have you ever seen insurance help your family with a big medical cost? Tell us your story.感谢今天收听 Learn English with Podcasts。你有没有见过医保帮助你的家人支付一大笔医疗费用？告诉我们你的故事。
And we will see you next time. Maybe by November, some of those 818 applications will have become good news for someone you know.我们下期再见。也许到11月，这818份申请中的一些就会成为你认识的某人的好消息。