Chapitre d'ouvrage: China is the second largest pharmaceutical market in the world. This sector grew by 21.4% between 2002 and 2012. In OECD countries, spending on medical drugs accounted for approximately 17% of total health spending or 1.5% of gross domestic product (GDP) in 2009. That same year, spending on pharmaceutical products in China represented 43% of the total healthcare expenditure. Aware of the issue, the Chinese government has reacted. A limitation on the hospital mark-up on drugs has been implemented and a list of key drugs that are considered essential has been set up. Drugs on this list have to be accessible to everyone, with a regulated price to be kept as low as possible. To keep prices low, procurement is made through centralized bidding at provincial level, pharmaceutical companies delivering directly to medical facilities. Yet, in the field, the reality remains at times complex, with different ways to circumvent these constraints.