Should annual cost of the drug inform reimbursement decisions? A perspective from China’s healthcare security system

Incorporating the evaluation of ACD into the appraisal process is crucial for informing reimbursement decisions, especially in health insurance systems without robust safety net mechanisms for patients. This study innovatively estimated the value of ACD threshold, addressing the research gap and providing a methodological reference for quantitative research. Despite adopting maximized reimbursement benefits of BMI, the estimated ACD threshold appears unable to support innovative medications priced comparably to those in global markets. In the future, China should establish a risk-sharing mechanism and improve the level of medical reimbursement benefits to mitigate financial barriers for patients' access to high-value medications.