OBJECTIVE： To provide suggestions for promoting universal access to expensive life-saving medicines for China. METHODS： Literature review and key informant interview were used to conduct restrospective analysis of the medical insurance system， essential medicines system， medical services delivery system and drugs’ procurement and supply strategies to promote access to anti-HIV medicines universal access to expensive life-saving medicines in Thailand and its implications to China. RESULTS & CONCLUSIONS： Thailand responded to the call of international societies in including non-substitutable patented expensive life-saving medicines with confirmed efficacy as a special category of essential medicines， developed special directory and regular update mechanism for expensive medicines in national essential medicines， established sustainable financing and supply systems and health technology assessment to serve policy setting， fully used the rights of developing countries endorsed by the international conventions and national laws， obtained affordable prices through national negotiations and coordination among governmental agencies and with non-governmental organizations. Thai’s experience provide valuable reference for China to achieve universal access to expensive life-saving medicines in a developing country.