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Over the past decade, China has emerged as one of the world’s primary developers of oncology targeted and immunotherapy drugs — Chinese-developed PD-1/PD-L1 inhibitors, third-generation EGFR TKIs, BTK inhibitors, and ADCs (antibody-drug conjugates) have gained international recognition, with some drugs (such as BeiGene’s zanubrutinib) achieving #1 class position in the US market. For international patients, this means: China not only has full international originator drug access, but also offers a large pipeline of domestically developed innovative drugs — typically priced at 1/5 to 1/10 of US costs. This article walks through China’s PD-1/PD-L1 immunotherapy, lung cancer TKIs, KRAS G12C, ADCs, BTK, and other core targeted/immune drugs in detail, including availability, pricing, and the practical international patient access pathway.

China Has Become a Major Global Source of Oncology Drug Innovation

Key facts [1]:

  • In 2024, approximately 1/3 of oncology drug pipeline molecules acquired or licensed by major multinational pharmaceutical companies came from China
  • In the past 3–4 years, global M&A in the ADC space has exceeded $10 billion USD
  • Chinese self-developed drugs have received approvals in multiple international markets including the US, Europe, Japan, Korea, Southeast Asia, and the Middle East
  • Chinese PD-1, BTK, ADC, and third-generation EGFR-TKI have reached or exceeded international peer levels in multiple categories

Practical implication for international patients: in China you can access both global originator drugs (Keytruda, Tagrisso, Enhertu, etc.) and many China-exclusive or China-leading innovative drugs — at pricing typically 1/5 to 1/10 of US costs.

PD-1/PD-L1 Immune Checkpoint Inhibitors

China has one of the world’s largest selections of PD-1/PD-L1 drugs. As of 2024, China has approved 10+ PD-1/PD-L1 inhibitors [2]:

Imported (US/European originators):

  • Pembrolizumab (Keytruda, Merck)
  • Nivolumab (Opdivo, BMS)
  • Atezolizumab (Tecentriq, Roche)
  • Durvalumab (Imfinzi, AstraZeneca)

Chinese domestic (8+):

  • Sintilimab (Tyvyt, Innovent)
  • Toripalimab (Tuoyi, Junshi) — first Chinese-developed PD-1 to receive FDA approval (for nasopharyngeal cancer)
  • Camrelizumab (AiRuiKa, Hengrui)
  • Tislelizumab (Tevimbra, BeiGene)
  • Penpulimab (Akeso/Sino Biopharmaceutical)
  • Zimberelimab (Yuheng)
  • Serplulimab (Henlius)
  • Pucotenlimab (LePu)

Pricing comparison [2][3]:

Drug United States China
Keytruda (pembrolizumab) ~$13,000 / 4 weeks ~$8,000 / 4 weeks
Sintilimab (domestic) Not marketed in US NRDL price $166 / 100mg; annual cost ~$5,750
Tislelizumab (domestic) Marketed in US NRDL price $193 / 100mg; annual cost ~$6,690

Chinese PD-(L)1 average annual treatment cost is approximately 80% less than US.

Practical implications for international patients:

  • If you’re already on Keytruda/Opdivo in your home country → you can continue the same imported drug in China (still at lower cost than US)
  • If you’re considering switching to a domestic PD-1 (lower cost) → domestic PD-1 has clinical data largely comparable to imported, with broad indication coverage
  • Most indications (lung, liver, gastric, esophageal, lymphoma, cervical, etc.) have NMPA approval for domestic PD-1

Lung Cancer TKIs: EGFR / ALK / ROS1

EGFR TKI (for EGFR-mutated non-small cell lung cancer):

Generation Imported Chinese Domestic
First Gefitinib, Erlotinib Multiple generic versions
Second Afatinib, Dacomitinib —
Third Osimertinib (Tagrisso, AstraZeneca) Aumolertinib (Hansoh) + Furmonertinib (Allist)
Fourth (in development) Multiple in development —

International position of Chinese domestic third-generation EGFR-TKIs [4]:

  • Aumolertinib (Hansoh): NMPA approved 2020 for second-line T790M+, 2021 for first-line (19del/L858R). China’s first self-developed third-generation EGFR-TKI, second worldwide
  • Furmonertinib (Allist): NMPA approved 2021 for second-line T790M+, later extended to first-line. First-line mPFS 20.8 months (comparable to osimertinib)

ALK TKI:

  • Imported: Crizotinib, Alectinib, Brigatinib, Lorlatinib
  • Chinese domestic: Iruplinalkib (Qilu Pharmaceutical) — NMPA approved 1st line ALK+ NSCLC in January 2024; Phase III INSPIRE study mPFS 27.7 months vs crizotinib 14.6 months [5]

ROS1 TKI: crizotinib, entrectinib, and repotrectinib all accessible in China.

Pricing comparison:

  • US osimertinib initial pricing $251.78/day; Chinese osimertinib reduced by 71% after NRDL inclusion
  • Chinese domestic third-generation EGFR-TKIs (aumolertinib, furmonertinib) typically priced 30–50% less than osimertinib

Practical implications for international patients:

  • EGFR 19del/L858R mutation patients: China offers full third-generation TKI options at substantially lower cost than the US
  • ALK+ patients: iruplinalkib’s first-line mPFS of 27.7 months is at international standard
  • Some lung cancer patients can maintain long-term low-cost medication (vs the high-cost burden in the US)

KRAS G12C Inhibitors (Emerging Area)

KRAS G12C is one of the most important breakthroughs in targeted oncology of the past 5 years.

Globally approved:

  • Sotorasib (Lumakras, Amgen) — FDA approved 2021
  • Adagrasib (Krazati, BMS) — FDA approved 2022

Chinese domestic KRAS G12C drugs [6]:

  • Glecirasib (Jacobio):
    • May 2024: NMPA accepted NDA with priority review
    • China Phase II NSCLC data: ORR 47.9%, mPFS 8.2 months, mOS 13.6 months
    • Breakthrough Therapy Designation for pancreatic cancer KRAS G12C — uncommon for this disease
    • China rights licensed to Allist in 2024
  • Fulzerasib / GFH925 (GenFleet): another Chinese domestic KRAS G12C

Practical implication for international patients: if you or a family member is a KRAS G12C-mutated solid tumor patient (especially NSCLC or pancreatic cancer), China offers one of the world’s richest portfolios of KRAS G12C drug options. Note: NMPA approval status for sotorasib and adagrasib should be confirmed with a Chinese IMD before traveling.

ADCs (Antibody-Drug Conjugates) — China’s Global Leadership

ADCs are the most significant breakthrough in oncology treatment of the past 5 years — combining antibodies (which recognize cancer cells) with chemotherapy drugs (which kill cells) for precision attack. China is among the most active countries in ADC development globally [7].

Core ADC drug availability in China:

T-DXd (Enhertu / trastuzumab deruxtecan, Daiichi Sankyo / AstraZeneca):

  • Initial China approval 2023 for HER2+ breast cancer
  • Subsequently expanded: HER2-low breast cancer, HER2+ gastric/GEJ cancer, HER2-mutated NSCLC
  • November 2024: included in NRDL through negotiation, effective January 1, 2025, with 50%+ price reduction — substantially improving accessibility

Disitamab Vedotin (RC48 / Aidixi®, RemeGen):

  • China’s first domestically developed approved ADC
  • Approved for HER2+ gastric cancer (conditional), urothelial cancer, HER2-low breast cancer, and other indications across 4 categories
  • August 2021: licensed overseas rights to Seagen, with $200M USD upfront payment + total deal value up to $2.6B USD — one of China’s largest single out-licensing deals at the time

Trodelvy (sacituzumab govitecan): used for triple-negative breast cancer (TNBC) and others

China’s global ADC position:

  • In 2024, approximately 1/3 of major pharmaceutical company acquisitions/licensing pipelines came from China
  • Past 3–4 years global ADC M&A exceeded $10 billion USD
  • Merck-Kelun (Sichuan Kelun-Biotech) 2022 ADC collaboration total value approximately $9.4 billion USD
  • Multiple Chinese biotech companies (RemeGen, Sichuan Kelun, Akeso, Innovent, LaNova Medicines, etc.) have ADC pipelines licensed to or acquired by major international pharmaceutical companies

Practical implications for international patients:

  • HER2+ breast cancer, HER2-low breast cancer, HER2+ gastric cancer, HER2-mutated NSCLC patients: China’s T-DXd pricing has been substantially reduced through NRDL negotiation
  • HER2+ gastric cancer, urothelial cancer patients: China’s Disitamab Vedotin (not available in many markets) is a distinctive value proposition for international patients traveling to China

BTK Inhibitors: BeiGene’s Zanubrutinib Leads Globally

Zanubrutinib (Brukinsa, BeiGene) [8]:

  • Self-developed by BeiGene in China
  • Approved in 70+ markets globally
  • 2024 Q1 global sales $351M USD (+153% YoY)
  • The only BTKi approved for follicular lymphoma
  • Widest class indication coverage globally (5 indications)
  • #1 in US CLL (chronic lymphocytic leukemia) new patient market share within the BTK class — a landmark achievement for Chinese innovative drugs in Western markets

Comparison with ibrutinib (Imbruvica): zanubrutinib’s ALPINE head-to-head trial data showed superior PFS in CLL vs ibrutinib, with lower cardiovascular adverse effects.

Practical implication for international patients: for CLL, follicular lymphoma, mantle cell lymphoma, Waldenström macroglobulinemia, and other BTK-indication patients, zanubrutinib is the international-grade BTK treatment that China can offer.

Other Major Targeted Therapies

PARP inhibitors (for BRCA-mutated, HRD+ ovarian, breast, and prostate cancers):

  • Imported: Olaparib, Niraparib (introduced by Zai Lab, included in NRDL)
  • Chinese domestic: Fluzoparib (Airuiyi, Hengrui), Pamiparib (BeiGene)

CDK4/6 inhibitors (HR+/HER2- breast cancer):

  • Imported: palbociclib, abemaciclib, ribociclib
  • Chinese domestic: Dalpiciclib (Hengrui) — NMPA approved 2021, China’s first self-developed CDK4/6i

VEGF inhibitors: bevacizumab (Avastin imported + multiple Chinese biosimilars), apatinib (Hengrui), anlotinib (Sino Biopharmaceutical), and others

China’s Targeted/Immunotherapy Pricing Advantage

Comprehensive pricing comparison [2][3][7][8]:

Category China Annual Treatment Cost US Annual Treatment Cost
Domestic PD-1 ~$5,000–$10,000 $150,000+ (Keytruda etc.)
Third-generation EGFR TKI Domestic ~$10,000–$25,000 Osimertinib ~$200,000+
ALK TKI Domestic ~$15,000–$30,000 $200,000+
KRAS G12C Domestic pricing not yet disclosed $300,000+
T-DXd NRDL price reduced 50%+ $200,000+
Zanubrutinib Chinese list price lower $180,000+ (Imbruvica comparable)

Core value: annual cost of Chinese targeted/immunotherapy is typically 1/5 to 1/10 of US — for long-term medication patients with chronic cancers (such as chronic leukemia, long-term EGFR-TKI maintenance), 5-year cumulative savings can reach hundreds of thousands of dollars.

Practical International Patient Pathway for Targeted/Immunotherapy Access in China

Most common scenarios:

  1. Long-term home country treatment cost (PD-1, EGFR-TKI, BTK, etc.) is unaffordable → travel to China to access the same drug at lower cost, or domestic drugs with the same mechanism
  2. China-exclusive drugs not approved in your home country (such as Disitamab Vedotin) → only available in China
  3. Home country recommendation differs from China NMPA-approved options (especially in emerging areas like ADC, KRAS G12C)

Practical pathway:

Step 1 · Remote second opinion evaluation (see Article 9)

  • Send your home country diagnosis + genetic testing results (EGFR, ALK, ROS1, KRAS, HER2, BRCA, etc.) to a Chinese IMD
  • Chinese specialists evaluate whether a more suitable Chinese-accessible plan exists

Step 2 · Arrival in China + on-site confirmation + medication initiation

  • On-site evaluation + necessary supplemental testing
  • Obtain medication from Chinese pharmacy or hospital pharmacy
  • Begin treatment

Step 3 · Two models for long-term medication:

  • Complete treatment in China: regular follow-up in China
  • China prescription + home country medication consumption: you can purchase the drug in China and take it home for use (note: customs rules and home country regulations require confirmation in advance). This is the most common “value-optimized model” for international patients — return to China every 3–6 months for medication refills and re-evaluation

Common Questions

Are the imported originator drugs (Keytruda, etc.) purchased in China the same quality as those in the US? Yes. Keytruda, Opdivo, Tagrisso, and other imported drugs in China are directly supplied from the original manufacturers (Merck, BMS, AstraZeneca) — the same product sold in the US. Pricing is lower because of NRDL negotiations and supply chain considerations.

Is the efficacy of domestic PD-1 / EGFR-TKI really comparable to imports? Core data is largely comparable — most domestic drugs’ Phase III clinical trials have been published in top international journals (NEJM, Lancet, JCO, etc.). But head-to-head trials don’t exist for every indication — discuss with a Chinese MDT specialist for your specific disease and stage.

Can I take Chinese-purchased drugs back to my home country? Depends on your country’s customs regulations. General principles:

  • Prescription drugs require Chinese physician prescription + your country’s legality for the drug
  • Most countries allow up to 3 months of personal use quantity for entry
  • Imported originator drugs (like Keytruda) typically have no issue — same drug exists in your home country
  • China-exclusive domestic drugs (like Disitamab Vedotin) may require “compassionate use” or “special authorization” in your home country — consult your home country regulatory authority

Is remote prescription + international shipping feasible? Not feasible. China’s internet medical care regulations don’t allow cross-border prescriptions (see Article 9), and international shipping of prescription drugs typically violates customs regulations. International patients must travel to China for consultation and pick up medications in person.

How does international insurance reimbursement cover targeted/immunotherapy?

  • Imported originator drugs: typically reimbursable by international insurance (MSH International, Cigna Global, etc.)
  • China-exclusive domestic drugs: reimbursement is complex; confirm with your insurer before traveling

Bottom Line

Core value of Chinese targeted/immunotherapy:

  • One of the world’s most complete drug option portfolios — imports + domestic dual track
  • Pricing typically 1/5 to 1/10 of US
  • China-exclusive domestic innovative drugs (Disitamab Vedotin, zanubrutinib, aumolertinib, furmonertinib, and others) recognized in international markets
  • ADC global leadership — multiple Chinese biotechs’ ADC pipelines licensed to international pharma majors

Best-suited international patients for targeted/immunotherapy in China:

  • Long-term medication cost unaffordable in home country
  • Disease matches China-exclusive drug (such as Disitamab Vedotin for HER2+ gastric cancer)
  • Seeking the most cost-effective cancer maintenance treatment plan
  • Already on imported originator drug in home country → continue same drug at lower cost in China

If you’re considering targeted/immunotherapy in China, MedCareInChina can match the optimal China-accessible plan based on your genetic testing results and condition — clearly identifying specific available drugs, estimated cost, and long-term management pathway.

→ Send your case to hello@medcareinchina.com

See Service & Refund Policy and Medical Disclaimer for service boundaries.

Sources

  1. China as a major global source of oncology drug R&D — In 2024, approximately 1/3 of major pharmaceutical companies’ acquisition/licensing pipelines came from China; global ADC M&A in the past 3-4 years exceeded $10 billion. Source: synthesized from Reuters and Fierce Pharma industry reports.
  2. China PD-1/PD-L1 pricing and accessibility — As of 2022, China approved 10 PD-1 drugs. Sintilimab NRDL price 1,080 RMB/100mg; tislelizumab NRDL price 1,253.53 RMB/100mg. Sources: JoGH https://jogh.org/2025/jogh-15-04069 ; Chinese PD-1 global attention https://www.ilcn.org/chinas-domestic-pd-1-pd-l1-inhibitors-demanding-global-attention/
  3. Osimertinib Chinese pricing — Initial pricing ~$251.78/day, 71% reduction after NRDL inclusion. Source: PMC https://pmc.ncbi.nlm.nih.gov/articles/PMC6519771/
  4. Chinese domestic third-generation EGFR-TKI — Aumolertinib (Hansoh) 2020 China’s first self-developed third-generation; furmonertinib (Allist) 2021 approval, first-line mPFS 20.8 months. Source: Frontiers in Pharmacology https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2024.1357913/full
  5. Iruplinalkib (Qilu Pharmaceutical ALK-TKI) — June 2023 second-line approval, January 2024 first-line approval. Phase III INSPIRE study mPFS 27.7 months vs 14.6 months. Sources: NMPA https://english.nmpa.gov.cn/2023-06/28/c_940312.htm ; JTO https://www.jto.org/article/S1556-0864(24)00072-8/fulltext
  6. Chinese domestic KRAS G12C inhibitors — Glecirasib (Jacobio) May 2024 NMPA accepted NDA + priority review; Phase II NSCLC ORR 47.9%, mPFS 8.2 months, mOS 13.6 months; pancreatic cancer Breakthrough Therapy Designation. Sources: ASCO Post https://ascopost.com/issues/july-25-2024/phase-ii-study-shows-activity-for-novel-targeted-agent-in-kras-g12c-mutated-nsclc/ ; OncLive https://www.onclive.com/view/glecirasib-receives-breakthrough-therapy-designation-in-china-for-kras-g12c-mutated-pancreatic-cancer
  7. China ADC global leadership — T-DXd November 2024 NRDL inclusion with 50%+ price reduction; Disitamab Vedotin (RemeGen) Seagen license: $200M upfront + total deal up to $2.6B (one of China’s largest single out-licensing deals). Sources: AstraZeneca https://www.astrazeneca.com/media-centre/press-releases/2024/enhertu-approved-in-china-as-first-her2-directe-therapy-for-patients-with-her2-mutant-metastatic-non-small-cell-lung-cancer.html ; BusinessWire https://www.businesswire.com/news/home/20210809005208/en/Seagen-and-RemeGen-Announce-Exclusive-Worldwide-License-and-Co-Development-Agreement-for-Disitamab-Vedotin ; Fierce Pharma https://www.fiercepharma.com/pharma/taking-aim-at-roche-and-astra-daiichi-seagen-bets-up-to-2-6b-china-s-first-home-made-adc
  8. BeiGene zanubrutinib (Brukinsa) global leadership — 2024 Q1 global sales $351M, approved in 70+ markets, #1 in US CLL new patient class share. Source: BeiGene SEC filing https://www.sec.gov/Archives/edgar/data/0001651308/000165130824000049/exhibit991-q12024earningsr.htm
  9. Dalpiciclib (Hengrui CDK4/6i) — December 2021 NMPA approval, China’s first self-developed CDK4/6i. Source: Hengrui https://www.hengrui.com/en/media/detail-149.html
  10. Chinese PARP inhibitor accessibility — Niraparib (Zai Lab, NRDL renewal), fluzoparib (Hengrui, NMPA approved), pamiparib (BeiGene). Source: Zai Lab https://zailab.gcs-web.com/news-releases/news-release-details/zai-lab-announces-updates-chinas-national-reimbursement-drug