On February 11, the National Health Commission, National Development and Reform Commission, Ministry of Industry and Information Technology, Ministry of Finance, Ministry of Commerce, State Administration for Market Regulation, National Healthcare Security Administration, and four other departments jointly issued the "National Essential Medicines List Management Measures" (hereinafter referred to as the "Measures"), effective immediately upon promulgation. The previous "National Essential Medicines List Management Measures" issued by the former National Health and Family Planning Commission on February 13, 2015, is hereby abolished.

The newly revised management measures stipulate that the selection of essential medicines should "highlight clinical value," emphasize the institutional rigidity of "adjustment cycles not exceeding three years in principle," and clarify the coordination and alignment between the essential medicines list, medical insurance catalog, centralized procurement policies, and tiered diagnosis and treatment systems.

Core Shift: From "Basic Coverage" to "Clinical First Choice"
The most significant change in the new Measures is the adjustment of its core philosophy. Unlike the 2015 version, which focused on "basic coverage and strengthening primary care," the new version emphasizes the principle of "clinical first choice," specifying that essential medicine selection will comprehensively consider multiple factors including changes in disease spectrum, clinical application practices, pharmaceutical standards updates, new drug approvals, essential medical and health service needs, basic medical insurance coverage levels, and drug supply assurance.

This transformation means that the essential medicines list is no longer merely synonymous with "low-cost drugs" but is upgrading toward "value-based medicine"—while ensuring accessibility, it places greater emphasis on clinical value and cost-effectiveness.

List Management: Dynamic Adjustment with Entry and Exit Mechanisms
The new Measures establish more standardized selection and adjustment procedures:
Expert Consultation Mechanism: A national essential medicines expert database will be established, with list formulation requiring multiple stages including consultation, review, public comment, and approval;
Dynamic Management: The adjustment cycle for the list should not exceed three years in principle, with timely adjustments when necessary, addressing the previous situation of delayed updates spanning over a decade;

Clear Exit Mechanism: Drugs experiencing serious adverse reactions, those no longer recommended by clinical practice guidelines, or those replaced by alternatives with superior risk-benefit or cost-effectiveness ratios will be promptly removed from the list. 

Meanwhile, the new Measures designate four categories of drugs excluded from inclusion: drugs containing ingredients from nationally endangered wild animals and plants, drugs primarily used for tonic and health care purposes, drugs suspended from production and sales due to serious adverse reactions, and other drugs not aligned with the positioning of essential medicines.

Policy Coordination: Linkage with Tiered Diagnosis and Treatment, Centralized Procurement, and Medical Insurance Payment
The new Measures strengthen systematic coordination with related reforms:
Expanded Legal Basis: The "Basic Medical and Health Care and Health Promotion Law" and "Drug Administration Law" are added as legal foundations; 

Policy Document Alignment: Close coordination with policies such as the "General Office of the State Council's Opinions on Improving the National Essential Medicines System" and the "General Office of the State Council's Opinions on Further Ensuring Stable Supply and Prices of Shortage Drugs"; 

Usage Linkage: Essential medicine supply and utilization are deeply integrated with tiered diagnosis and treatment, centralized drug procurement, and medical insurance reimbursement, forming a closed policy loop of "access-procurement-utilization-payment."

The current 2018 edition of the essential medicines list includes 685 drugs, now over seven years old, with a significant gap from actual clinical needs. The introduction of the new Measures, by strengthening dynamic adjustment mechanisms, highlighting clinical value orientation, and deepening policy coordination, has laid the institutional foundation for the new round of essential medicines list adjustments scheduled to begin in 2026. It is expected to facilitate the timely inclusion of more clinically urgently needed drugs, enhancing public access to essential medicines.