China Will Pay One Price for 158 Conditions, Whatever the Hospital
- China’s National Healthcare Security Administration said on 17 August 2026 that the forthcoming version 3.0 of its disease-based payment groupings will carry a national list of 158 primary-level disease categories, comprising 31 DRG categories and 127 DIP categories. The mechanism is described as same disease, same payment.
- Within a single pooling region, those categories will be paid at an identical standard regardless of hospital tier. They cover common, frequently occurring and some chronic conditions judged suitable for treatment at grade II institutions and below, where those facilities already have the capacity.
- The list is overwhelmingly medical rather than surgical. Of the 31 DRG categories, 27 are internal medicine and 4 are procedures. Of the 127 DIP categories, 97 are medical. The named conditions include hypertension, diabetes, respiratory infection, neck and back disorders and coronary heart disease.
- Version 2.0 was issued in July 2024. NHSA told a briefing in March that version 3.0 was built on roughly 1 billion case settlement records from 2022 to mid-2025 and some 30,000 valid comments, with publication expected around July 2026 and formal execution planned for January 2027.
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This reads as administrative harmonisation. It is a patient-flow policy delivered through payment design, and the conditions chosen determine which medicines it touches.
- Removing the tier premium reverses the economics of who treats these patients. A tertiary hospital paid the same as a township facility for a hypertension admission still carries tertiary cost structures. Across 158 categories that turns routine chronic admissions from profitable to marginal at the top of the system.
- The selection is where drug cost dominates case cost. With 27 of 31 DRG entries in internal medicine, these are admissions whose expense sits in medicines rather than theatre time. That is not incidental. It is the segment where a packaged payment squeezes the pharmacy line hardest.
- The channel moves with the patient. Grade II and below institutions carry narrower formularies and less room to absorb costly agents inside a fixed payment. Any cardiometabolic portfolio selling through tertiary hospital channels in China should model volume migration from 2027, not price.