"4+7" city drug volume-based purchasing and using pilot program in China and its impact

Tang, Mi; He, Jiangjiang; Chen, Minxing; Cong, Lixuan; Xu, Yawei; Yang, Yan; Hou, Zongliu; Song, Peipei; Jin, Chunlin

doi:10.5582/ddt.2019.01093

Cited by 48 publications

(51 citation statements)

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“…However, the results of segmented linear regression indicated no statically signi cant difference in the change of volume or expenditure for non-winning products, whether in level change or in trend change. In terms of the original intention of policy design, the NCDP policy hopes that the bid winning drugs under substantial price cut will replace the non-winning drugs as much as possible, so as to archive the goal of reducing drug costs and relieve the overall drug burden of patients [24,25]. From this point of view, the original intention of this policy may have not been fully achieved.…”

Section: Discussionmentioning

confidence: 99%

The impacts of Chinese drug volume-based procurement policy on the volume and expenditure of antibiotic drugs

Yang

Chen

et al. 2021

Preprint

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Background: In 2019, Chinese government implemented the first round of National Centralized Drug Procurement (NCDP) pilot (so-called "4+7" policy) in mainland China, in which an oral antibiotic agent (cefuroxime axetil) was included. Given the current condition of the irrational use of antibiotics in China, this study aims to evaluate the potential effect of the "4+7" policy on antibiotic use. Methods: This study used drug purchasing order data from the Centralized Drug Procurement Survey in Shenzhen 2019, covering 24 months from January 2018 to December 2019. Oral antibiotic drugs related to "4+7" policy were selected as study samples, including cefuroxime axetil and its alternative drugs. Segmented linear regression analysis with interrupted time series was adopted to examine the effect of "4+7" policy on the volume and expenditure of antibiotic drugs. Results: Compared with April to December 2018, the total volume and expenditures of cefuroxime axetil and its alternative antibiotic drugs from April to December 2019 increased 41.8% and 18.1%, respectively. The results of segmented linear regression showed that the volume of cefuroxime axetil products significantly increased 161.16 thousand DDDs after "4+7" policy (95% CI: 59.43 to 262.90, p-value = 0.004). For the alternative drugs of cefuroxime axetil, the volume and expenditures significantly increased 273.65 thousand DDDs (95% CI: 90.17 to 457.12, p-value = 0.006) and 3471.66 thousand RMB (95% CI: 1529.70 to 5413.62, p-value = 0.001), respectively. Conclusion: This study provides evidence that the implementation of "4+7" volume-based procurement policy was associated with significant increases in the volume and expenditure of cefuroxime axetil and its alternative drugs. The increase in antibiotic use after the policy needs special attention and vigilance.

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Section: Discussionmentioning

confidence: 99%

The impacts of Chinese drug volume-based procurement policy on the volume and expenditure of antibiotic drugs

Yang

Chen

et al. 2021

Preprint

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“…On the other hand, out-of-city and out-of-province patients could have problems finding the exact prescription medications they need, as those medicines might be not available at their local hospitals and drugstores. In January 2019, the General Office of the State Council of the People's Republic of China implemented the National Centralized Drug Purchasing (NCDP) and Using pilot program and selected 11 cities (including Shenzhen) in mainland China to carry out the “4+7” City-Drug-Volume-Based-Purchasing pilot project [ 15 ]. As the “frontier” of Chinese prescription medicine reform, prescription medicines that were made by the doctors of Shenzhen’s hospitals may be more affordable.…”

Section: Discussionmentioning

confidence: 99%

The Internet Hospital Plus Drug Delivery Platform for Health Management During the COVID-19 Pandemic: Observational Study

et al. 2020

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Background Widespread access to the internet has boosted the emergence of online hospitals. A new outpatient service called “internet hospital plus drug delivery” (IHDD) has been developed in China, but little is known about this platform. Objective The aim of this study is to investigate the characteristics, acceptance, and initial impact of IHDD during the outbreak of COVID-19 in a tertiary hospital in South China Methods The total number of and detailed information on online prescriptions during the first 2 months after work resumption were obtained. Patients’ gender, age, residence, associated prescription department, time of prescription, payment, and drug delivery region were included in the analysis. Results A total of 1380 prescriptions were picked up or delivered between March 2 and April 20, 2020. The largest group of patients were 36-59 years old (n=680, 49.3%), followed by the 18-35 years age category (n=573, 41.5%). In total, 39.4% (n=544) of the patients chose to get their medicine by self-pickup, while 60.6% (n=836) preferred to receive their medicine via drug delivery service. The top five online prescription departments were infectious diseases (n=572, 41.4%), nephrology (n=264, 19.1%), endocrinology (n=145, 10.5%), angiocardiopathy (n=107, 7.8%), and neurology (n=42, 3%). Of the 836 delivered prescriptions, 440 (52.6%) were sent to Guangdong Province (including 363 [43.4%] to Shenzhen), and 396 (47.4%) were sent to other provinces in China. Conclusions The IHDD platform is efficient and convenient for various types of patients during the COVID-19 crisis. Although offline visits are essential for patients with severe conditions, IHDD can help to relieve pressure on hospitals by reducing an influx of patients with mild symptoms. Further efforts need to be made to improve the quality and acceptance of IHDD, as well as to regulate and standardize the management of this novel service.

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“…Profit model and motivation for commissioned companies are unclear risk of implementation of the "4+7 Policy" is a supply shortage due to the "single source" and "volumeprice linkage" model (9). According to international experience, one of the chief advantages of using GPOs is to help prevent and mitigate drug shortages (10).…”

Section: Not Publishedmentioning

confidence: 99%

Prospects for development of group purchasing organizations (GPOs) in China within the context of national centralized drug procurement

Chen

Cong

et al. 2020

DD&T

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group purchasing organizations (GPOs), centralized drug purchasing, China Healthcare group purchasing organizations (GPOs) are considered to play an integral role in the healthcare supply chain by keeping prices low and helping all members of the healthcare system achieve their objectives. China has been exploring GPOs in the field of drug procurement since 2015, and there are currently three GPO models in Shanghai, Shenzhen, and Guangzhou. Although the three models operate differently and they have each been examined, they have all achieved certain results and demonstrated the ability to control drug expenditures. In 2018, the National Healthcare Security Administration implemented a national centralized drug procurement policy, also known as the 4 + 7 procurement policy ("4+7 Policy"). This policy context has also led to changes in the strategy for development of GPOs in China. GPOs need to explore strategies that do not overlap with the scope of 4 + 7 procurement, and they need to develop dynamic and personalized procurement plans that are more in line with first-line clinical practices to have a synergistic effect in combination with the "4+7 Policy." In the future, GPOs will grow rapidly in China. The number of GPOs need to be increased to prevent monopolies, and GPOs need to expand their diversified value-added services to perform more tasks in terms of supply chain management and data analysis.

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"4+7" city drug volume-based purchasing and using pilot program in China and its impact

Cited by 48 publications

References 0 publications

The impacts of Chinese drug volume-based procurement policy on the volume and expenditure of antibiotic drugs

The impacts of Chinese drug volume-based procurement policy on the volume and expenditure of antibiotic drugs

The Internet Hospital Plus Drug Delivery Platform for Health Management During the COVID-19 Pandemic: Observational Study

Prospects for development of group purchasing organizations (GPOs) in China within the context of national centralized drug procurement

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