Beijing’s health-care reforms are giving global pharmaceutical companies better access to the world’s second-largest drug market.

Top drug manufacturers are getting access to the world’s second most valuable market for pharmaceutical products, after the U.S. However, China also is trying to clamp down on runaway drug prices. 

Fifty-one innovative drugs, 80% of them from global pharmaceutical companies, were approved last year, up from just five in 2016. However, manufacturers will have to negotiate prices to get on a list of treatments covered by China’s state insurance program.

Global drug companies have so far mostly been selling off-patent drugs in China, which can be very lucrative as U.S. generic-drug prices are on average 45% cheaper than those in China.

The Chinese government in September expanded its bulk-purchase program for generics to almost the whole country. A pilot program across 11 major cities, including Shanghai and Beijing, resulted in almost 50% drop in generic prices.