Objective: The paper attempts to explore scientific and reasonable strategies for the formulation of national negotiated drug prior self-financed ratio. Methods: The study summarizes the practical experience of national negotiated drug prior self-financed ratio in typical areas in China, and explores feasible strategies for the formulation of national negotiated drug prior self-financed ratio based on principal-agent and stakeholder theories. Results: The study summarizes five common methods of formulating the prior self-financed ratio based on the practice in typical regions, and concludes that the fifth way of forming a differentiated range for multiple negotiated drug prior self-financed ratio is more in line with the needs of medical insurance management in the new era. At the same time, the factors affecting the prior self-financed ratio of national negotiated drugs are proposed from the perspectives of medical insurance, patients, medical institutions and pharmaceutical enterprises, and a strategy based on the "benchmark ratio and adjustment range" is devised for the formulation of prior self-financed ratio of negotiated drugs, which can relieve the burden of patients' medicines while ensuring the safety of the health insurance fund and promote the rational drug use. Conclusion: Each region should establish a scientific, reasonable and transparent mechanism for the formulation of national negotiated drug prior self-financed ratio, explore the dynamic adjustment mechanism, and gradually improve the management of self payment ratio of regular Category B drugs on this basis.