 This study found that the National Essential Medicines Policy, NEMP, implemented in primary care in Hangzhou, China has resulted in unintended consequences such as frequent unavailability of certain essential drugs, which leads to patient flow from primary care to hospital outpatient clinics for drug refills, difficulties in providing continuing care in primary care, and compromised patient trust in primary care physicians. Additionally, this study found that many primary care physicians and specialists believe that the NEMP does not help direct patient flow to community-based care. These results suggest that further measures need to be taken to ensure that the NEMP is effective and efficient in meeting the healthcare needs of patients. This article was authored by Dan Wu, Taipang Lam, Kwok FAI Lam and others.