China's Growing Importance in Global Cancer Medicines

Following the global shift toward innovation-driven cancer care, China has rapidly transformed its cancer medicine research, development, regulation, and financing systems over the past decade. This review aims to provide a comprehensive understanding of these transformations from the perspective of China's unique market-government coordination. This review applies an integrative framework that combines historical development, regulatory reforms, market access mechanisms, and affordability strategies. It traces the evolution of China's cancer medicine research and development-from sporadic imitation in the mid-20th century to a globally competitive innovation ecosystem-accelerated by the 2015 drug regulatory reform and subsequent international harmonization. It further examines the interaction among regulatory oversight, pricing mechanisms, and health insurance coverage and evaluates policy tools such as self-evaluation scoring, National Reimbursement Drug List negotiations, and volume-based procurement. China's reform-driven policies have enhanced both innovation and accessibility. Pricing and procurement mechanisms have expanded patient access while containing costs, and multilayered financing arrangements-combining basic medical insurance, targeted medical aid, and city-based private insurance-have improved affordability and sustainability for high-cost cancer medicines. Despite substantial progress, China continues to face challenges in balancing innovation incentives with equitable access, optimizing therapeutic value assessment, and ensuring long-term fiscal sustainability. The Chinese experience offers policy-relevant insights for countries seeking to enhance cancer medicine accessibility and innovation capacity through integrated regulatory and financing reforms.