导航中国医疗器械市场：挑战、改革与机遇

Challenges, reforms, and opportunities ZHEN NIE, Head of Med Devices, Global Consulting, IQVIA MedTechNANCY (SHUHUAI) JIN, Engagement Manager, Management Consulting, IQVIA China Table of contents Introduction to China’s MedTech market1Mounting financial pressures on China’s public medical insurance1Volume-based procurement: Expanding reach and impact2Are cost-control measures reaching a “turning point”?2Embracing innovation to stay competitive in a changingmarket3Private healthcare: A growing opportunity amid reform3Turning regulatory uncertainty into long-term growth strategies4The road ahead: How MedTech firms can thrive in China’s market5References7About the authors8 Introduction to China’s MedTech market China has firmly established itself as the world’s second-largest medicaldevice market, with high growth expectations globally. However, given thecomplexities of the local environment and the numerous challenges MedTechcompanies face, where do future opportunities lie? As the largest payer of health services in China, theNational Healthcare Security Administration (NHSA)has implemented a series of reforms. These includeVolume-Based Procurement (VBP), which lowersthe listing price of medical consumables and drugs;Diagnosis Related Group (DRG) payment reforms,which aims to curb the excessive growth of medicalexpenses; and price adjustment for medical serviceitems, which helps optimize the Basic MedicalInsurance (BMI) fund expenditure structure. This IQVIA MedTech whitepaper explores the currentstate of China’s MedTech market, examining thefinancial pressures, regulatory reforms, emergingopportunities, and providing insights into how MedTechcompanies can navigate this complex landscape. Mounting financialpressures on China’s publicmedical insurance The COVID-19 pandemic further strained China’spublic medical insurance fund. Acting as anaccelerator, it hastened policy implementations,introducing significant uncertainty into the localregulatoryenvironment. In recent years, China’s total health expenditure hasbeen rising due to the growing medical needs of itspopulation. However, total health expenditure remainsaround 7% of GDP, still below the median level of OECDcountries. At the same time, the slowdown in economicgrowth has led to reduced income growth for the BasicMedical Insurance (BMI) fund. While the reform is expected to continue, it isanticipated to proceed in a more stable and gradualmanner. From a horizontal perspective, VBP continuesto expand its geographical scope and product varieties.From a vertical perspective, further reductions in theabsolute price of medical consumables under VBP arebecoming less likely. The pricing of coronary stents ofapproximately 100 US dollars and PIVCs at about 60 UScents has already placed cost pressures onto local andmultinational manufacturers. Volume-based procurement:Expanding reach and impact With VBP becoming a norm, the scope of medicalconsumables includes high-value consumables, low-value consumables, equipment, as well as In VitroDiagnostic (IVD) reagents. Many of these items arecovered by a large-scale inter-provincial VBP alliance.Additionally, and unsurprisingly, the price regulationsand the establishment of service item guidelines haveled to IVD reagents now being included in the reformscope. Currently, the policy uncertainty is decreasing,and MedTech companies in China have adjusted theirexpectations to align with the new landscape. To date, the Chinese government’s various medicalreform initiatives have significantly expanded. Forinstance, VBP now includes over 70 varieties of medicalconsumables, and the DRG payment was on track toreach nearly 100% of regions covered by the end of2024 when last reviewed. Are cost-control measuresreaching a “turning point”? As a significant step in BMI expenditure control, VBPhas gained widespread attention during its nationwideimplementation. By 2025, with the rollout of the10thround of the VBP for pharma products, concernsemerged regarding potential declines in the quality ofdrugs and medical consumables due to price reductions. In January 2025, representatives from ShanghaiRuijin Hospital submitted a proposal titled “On howto use effective drugs in the context of VBP”. Theyhighlighted inconsistencies in the clinical efficacy ofsome VBP acquired drugs. Although the NationalHealthcare Security Administration (NHSA) and theNational Medical Products Administration (NMPA)provided comprehensive responses in February, theconcerns underscored public apprehension aboutthe “side effects” of the reform. Patients worry that price reductions could compromise product quality,companies face cost pressures and shrinking profitmargins (raising concerns about R&D investment), andphysicians express doubts about treatment outcomes. While this debate will not deter NHSA fromcontinuing its VBP activities, it signals that the rapidpace of reform in recent years may be reaching a“turningpoint”. Shanghai, Nanjing, Suzhou,