Objective: The paper attempts to analyze the current status of price governance tools, local practice differences, implementation dilemmas, and underlying causes for non-selected brand-name drugs under centralized volume-based procurement, and to provide a reference basis for improving the coordinated mechanism of online listing prices, medical insurance payments, procurement and utilization, risk warning, and evidence feedback. Methods: Policy document analysis, comparative case study, framework analysis, and thematic analysis were applied. National and local policies were systematically reviewed. Field investigation materials from Shanghai, Heilongjiang, Hebei, Fujian, and Jiangsu, together with expert consultation findings, were used to conduct a structured comparison and synthesis of governance tools and implementation issues. Results: A policy tool system has taken shape for the price governance of non-selected brand-name drugs, with listing price management as the foundation, reimbursement standards as the core lever, hospital procurement and use management as the key implementation mechanism, and price risk warning as a supplementary tool. The five regions have developed differentiated governance approaches in reimbursement coordination, competitive listing, transparent procurement platform management, red/yellow risk labeling, price comparison rules, and filing-based procurement. Thematic analysis identified several key problems, including overreliance on a single price benchmark, unclear boundaries for clinical substitution, insufficient linkage between reimbursement and listing procurement policies, and difficulties in balancing special clinical needs with the prevention of generalized use of high-cost drugs. These problems are mainly attributable to unclear price gradient rules, overlapping pressures from reimbursement and hospital performance assessment, insufficient evidence on clinical substitution, and inadequate interdepartmental coordination and data feedback mechanisms. Conclusion: Price governance for non-selected brand-name drugs should be stratified, coordinated, and evidence-informed. Policy priorities include improving reasonable price gradient rules, clarifying the boundaries of clinically appropriate use, strengthening coordination between reimbursement and procurement policies, optimizing dynamic price risk warning mechanisms, and establishing feedback systems based on quality, supply stability, and real-world evidence.