In China, Rare Dissent Over a Program to Save on Drug Costs

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Top doctors raised concerns about domestically made drugs, saying Beijing’s effort to lower costs is sacrificing quality.

A person in blue hospital scrubs and cap walking alone down a hospital hallway.
A hospital in Shanghai in 2023. This year, foreign-branded drugs were largely absent from the government list of medicines covered under China’s national health insurance and offered at public hospitals.Credit...Qilai Shen for The New York Times

Alexandra StevensonZixu Wang

Jan. 25, 2025, 12:00 a.m. ET

A rare display of public anger is unfolding in China over the quality of domestically produced drugs.

A prominent Shanghai surgeon pointed to anesthetics that do not put patients to sleep. A respected Beijing cardiologist questioned blood pressure medication that failed to regulate. A former editor at a leading online health platform went as far as to accuse domestic drugmakers of fraud.

The concerns spilled out into public discussions this week when some top doctors and hospital leaders called on the government to change how it buys drugs for its public hospitals.

The outburst of scrutiny, unusual in a country where the authorities keep a tight grip on public criticism of the government, was a rebuke of Beijing’s campaign to lower medical costs. Officials are working to shore up China’s national health care system, which is under financial pressure in part because of a rapidly aging population.

The policy, which was put in place in 2018, encourages fierce competition between drug manufacturers and has been successful at sharply driving down drug prices. But this year, foreign-branded drugs were largely absent from the government list of medicines that are covered under China’s national health insurance and offered at public hospitals.

The change has effectively pushed out many foreign pharmaceutical companies that do not want to compete against Chinese companies willing to sell their drugs at rock-bottom prices.


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