# Characteristics of indications, clinical trial evidence, clinical benefits and the costs of price-negotiated multi-indication drugs for solid tumours in China

## TL;DR

This study examines how China's drug price negotiation policy affects the costs and clinical benefits of cancer drugs for solid tumors.

## Contribution

The study provides empirical evidence on the impact of China's National Drug Price Negotiation policy on drug costs and clinical benefits.

## Key findings

- The median monthly drug cost dropped significantly after the National Drug Price Negotiation policy.
- No significant correlation was found between drug costs and clinical trial evidence or benefits.
- ASCO Value Framework scores showed a negative correlation with drug costs.

## Abstract

Cancer is a leading cause of death globally, with China accounting for a significant portion of new cases and deaths. The Government of China has introduced the National Drug Price Negotiation (NDPN) policy to mitigate the high costs of anticancer drugs, especially multi-indication drugs, aimed at improving patient access to effective treatments.

In this retrospective study, we examined 24 multi-indication anticancer drugs for solid tumours included in the National Reimbursement Drug List (NRDL) between 2016 and 2023. We collected characteristics of indication, clinical trial evidence, and clinical benefits of these drugs, calculated monthly drug costs, and assessed the associations the two by regression and correlation analyses.

We observed a significant reduction in the median monthly drug cost from USD 3863.08 before NDPN to USD 732.91 after their inclusion in the NRDL. However, the correlation analyses showed no significant relationships between drug costs and characteristics of indications, clinical trial evidence, and clinical benefits, while American Society of Clinical Oncology Value Framework scores demonstrated a negative correlation with costs, indicating that pricing may not accurately reflect clinical benefits.

While we found that the NDPN policy has significantly reduced drug costs, we did not observe a significant correlation between costs and specific characteristics. This highlights a need for a more transparent pricing mechanism linked to clinical efficacy to improve the accessibility and affordability of cancer therapies that effectively balance the interests of pharmaceutical companies, patients, and health insurance funds.