Adapting Value-Based Pricing to Chinese Patent Medicines: International Lessons and a Hedonic Pricing Perspective

Abstract Value-based pricing (VBP) has become an important policy approach for aligning pharmaceutical prices with clinical benefit, cost-effectiveness, and health system priorities. However, most existing VBP mechanisms have been developed within modern biomedical and health technology assessment frameworks, where clinical outcomes, comparators, and evidence hierarchies are relatively well defined. Whether these mechanisms can be directly applied to traditional herbal medicines remains uncertain, particularly for Chinese patent medicines (CPMs), which are characterized by complex formulations, multidimensional value attributes, heterogeneous clinical use, and uneven evidence quality. This review adopts a policy-oriented narrative approach with a structured search strategy to synthesize academic literature, policy documents, technical guidelines, and assessment reports related to international pharmaceutical VBP practices. Three representative mechanisms are examined: cost-effectiveness threshold-based pricing, multi-payer value negotiation, and added-benefit-based price negotiation. These mechanisms commonly rely on high-quality comparative evidence, clear comparators, standardized outcome measures, and mature health technology assessment and reimbursement decision-making processes. For CPMs, direct transplantation of these approaches may be constrained by evidence mismatch, difficulties in measuring holistic and long-term benefits, heterogeneous real-world use, and insufficient mechanisms for expressing multidimensional value in price formation. To address these challenges, this review proposes a hedonic-pricing-informed pathway for CPM value-based pricing. This pathway links multidimensional value attribute identification, evidence mapping and data construction, hedonic pricing modelling, interpretation of price signals, value-to-price translation and policy options, and dynamic updating. By examining how observable drug characteristics are associated with market prices, hedonic pricing may help identify which value attributes are already reflected in prices, which remain under-recognized, and whether current price signals are consistent with the expected value structure of CPMs. This approach is not intended to replace conventional health technology assessment or pharmacoeconomic evaluation, but to provide a complementary empirical perspective for value-to-price translation under conditions of evidence uncertainty. The proposed pathway may support more transparent, feasible, and policy-relevant pricing, reimbursement, and resource allocation decisions for traditional herbal medicines.