Key Points
- Negotiation progress (Nov 2, 2025): On-site talks signaled a breakthrough — a representative from 合源生物 said “我们谈成了,” and five CAR‑T medicines (led by Naji’ao Lunsai Injection / Nàjī Ào Lún Sài 注射液, approved in 2023) have passed review for the this year’s 商保 innovative‑drug list.
- Patient access impact: Inclusion on commercial insurance can enable earlier access, reduce out‑of‑pocket costs, and create interim reimbursement pathways while national negotiations continue.
- Pricing and payment levers: Negotiators are considering direct price discounts, outcome‑based payments, installment/annuity models, and pilot coverage programs to balance clinical value and affordability.
- What to watch next: Look for official confirmation from the 国家医疗保障局 listing accepted products and negotiated prices, plus rollout choices (regional pilots vs national), reimbursement mechanics, and data requirements for outcome‑based models.
CAR‑T therapies are at the center of a potentially industry‑shifting negotiation in China.
On the afternoon of November 2, 2025, negotiators met on site for the 2025 National Medical Insurance Directory and parallel commercial‑insurance (shāngbǎo 商保) innovative‑drug price talks.
A negotiating representative for Heyuan Shengwu (Heyuan Shengwu 合源生物) left the meeting visibly pleased and told Cailian Press (Cailian She 财联社) reporters, “We’ve reached an agreement” (“我们谈成了”).
The final outcome is still subject to formal announcement by the National Healthcare Security Administration (Guójiā Yībǎo Jú 国家医疗保障局).
What this development means for CAR‑T drugs
Naji’ao Lunsai Injection (pinyin: Nàjī Ào Lún Sài 注射液) was approved for marketing in 2023.
According to the reporting, five CAR‑T medicines, represented by that product, have passed review for inclusion on this year’s commercial‑insurance innovative‑drug list.
Why that matters:
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Commercial‑insurance coverage can create earlier access.
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Inclusion on the commercial catalog may reduce out‑of‑pocket costs for patients.
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It can establish reimbursement pathways while national medical insurance negotiations continue.
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Why price negotiations matter for individualized cell therapy
CAR‑T stands for chimeric antigen receptor T‑cell therapies.
They engineer a patient’s own immune cells to attack cancer cells.
These therapies can deliver dramatic clinical responses in some blood cancers.
But their manufacturing complexity and single‑course treatment model have historically driven list prices to extremely high levels.
That price dynamic has kept CAR‑T medicines out of national medical insurance negotiations for the past four years.
Price concessions or alternative payment models are usually required to make these treatments insurable at scale.
What negotiators and payers are trying to solve
Regulators and insurers are balancing two hard facts.
One: CAR‑T offers clear clinical value for certain patients.
Two: the list prices strain payer budgets and can block patient access.
Negotiations aim to reconcile clinical value with affordability.
That can happen via:
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Direct price discounts that bring list prices down.
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Outcome‑based payments where payments link to clinical results.
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Installment or annuity models that spread cost over time.
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Pilot coverage programs that limit initial exposure while collecting real‑world data.
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Next steps — what to watch closely
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Official confirmation: Watch for publication from the National Healthcare Security Administration (Guójiā Yībǎo Jú 国家医疗保障局) listing accepted products and negotiated prices.
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Rollout strategy: Monitor whether commercial insurers adopt national rollout or start with regional pilots.
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Reimbursement mechanics: Check for rules on outcome‑based payments, installment plans, and reimbursement ceilings.
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Clinical and hospital rules: Pay attention to eligibility criteria set by hospitals and insurers that will affect real‑world access.
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Data collection: Look for requirements to track outcomes, which will determine whether outcome‑based models become standard.
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What investors, founders, and health‑tech teams should take away
This negotiating moment is a possible inflection point for bringing high‑cost cell therapies into broader coverage frameworks.
For investors, the shift could change valuation dynamics for companies with CAR‑T assets approved or near approval.
For founders and operators, the environment underscores the need to design commercial strategies that work with insurer constraints — including pricing, data, and patient selection.
For health‑tech teams, there is an opportunity to build outcome tracking, patient support, and billing systems that make outcome‑based and installment payments operationally feasible.
Plain language summary
Negotiations on November 2 signaled progress toward getting CAR‑T therapies into commercial‑insurance coverage in China.
If the talks lead to negotiated prices or new reimbursement rules, more patients could access these individualized cancer therapies sooner through private plans, even before national medical insurance inclusion.
References
- “天价抗癌疗法”CAR-T或将在今年商保价格协商中实现突破 – 东方财富网
- 财联社 – 财联社
- National Healthcare Security Administration – 国家医疗保障局
CAR‑T therapies
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