China's centralized drug procurement experienced four stages of hospital decentralized procurement, prefectural procurement by invitation to bid, provincial procurement by invitation to bid and alliance volume-based procurement. After more than 30 years of exploration and improvement, the procurement system has developed into a volume-based mode with the general idea of "national organization, alliance procurement and platform operation" and the basic principles of "volume-based procurement, exchanging volume for price, integration of bidding and procurement, use guarantee, quality guarantee, supply guarantee and payment guarantee", which will become the most mainstream drug procurement mode in China by 2025. After the establishment of National Healthcare Security Administration, it has organized 6 batches of drug procurement and 2 batches of consumables. A working pattern of coordinated promotion of national, provincial and trans-provincial alliance procurement has been formed. In the future, centralized drug procurement should strengthen "system integration and efficient coordination", play a critical role in promoting the high-quality development of public hospitals, coordinate the interests of pharmaceutical enterprises and insured patients, solve main problems by stages, eradicate improper sales from system and mechanism, purify the industry ecology, stimulate normative competition, and promote the transformation and healthy development of the pharmaceutical industry. In the future, volume-based procurement will show the trend of normalization, wide coverage, multi-level, large alliance, excellent rules, more intensive development, full supporting, stable connection, strong platform and trustworthy use.