The Effects of the National Centralized Drug Purchasing Pilot Program on Nucleos(t)ide Analogs in Shenzhen City: An Interrupted Time Series Analysis

Wen, Xiaotong; Yin, Shicheng; Cui, Lanyue; Mao, Lining; Lin, Zhaoyu; Yaermaimaiti, Zilalai; Geng, Xin; Li, Yingxia; Yang, Ying; Cui, Dan; Mao, Zongfu

doi:10.3389/fpubh.2021.718013

Cited by 13 publications

(24 citation statements)

References 56 publications

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“…Most studies found that the volume of policy-related drugs increased, while the purchase spending declined after the implementation of NCDP (4, 16,17). The policy effects on antihypertensive drugs, antibiotic drugs, and nucleoside analogs were consistent with the overall policy effects (18)(19)(20).…”

Section: Introductionmentioning

confidence: 83%

The impact of national centralized drug procurement on health expenditures for lung cancer inpatients: A difference-in-differences analysis in a large tertiary hospital in China

Zhang

Ren

Zheng

et al. 2022

Front. Public Health

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The availability and affordability of medicines remain major health challenges around the world. In March 2019, the Chinese government introduced a pilot National Centralized Drug Procurement (NCDP) program in order to reduce drug prices and improve the affordability of effective and safe medicines. This study aimed to assess the impact of NCDP policy on health expenditures of cancer patients. Using inpatient discharge records from a large hospital in the pilot city, we performed a difference-in-differences design to estimate the change in health expenditures before and after the policy. We found that the implementation of NCDP was associated with a significant decrease in total expenditures (14.13%) and drug expenditures (20.75%) per inpatient admission. There were also significant reductions in non-drug-related expenditures, including a 7.65% decrease in health service expenditures, a 38.28% decrease in diagnosis expenditures, and a 25.31% decrease in consumable material expenditures per inpatient admission. However, the NCDP implementation was associated with a 107.97% increase in the traditional Chinese medicine expenditures. Overall, the study provided evidence that the NCDP policy has achieved its goals of high-quality and affordable healthcare. The drug expenditures of lung cancer patients revealed a continuous decline, and the policy may have spillover effects on other healthcare expenditures. Further studies are needed to evaluate the long-term effects of NCDP on policy-related expenditures and health outcomes.

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Section: Introductionmentioning

confidence: 83%

The impact of national centralized drug procurement on health expenditures for lung cancer inpatients: A difference-in-differences analysis in a large tertiary hospital in China

Zhang

Ren

Zheng

et al. 2022

Front. Public Health

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“… 11 , 17 The growth trend of nationwide data in NAs purchases is supported by a previous report from Shenzhen province. 18 However, that study reported only short-term changes and did not analyze the proportional change of first-line NAs.…”

Section: Discussionmentioning

confidence: 99%

Impact of National Centralized Drug Procurement Policy on Antiviral Utilization and Expenditure for Hepatitis B in China

Zhao¹,

Li²,

Wang³

et al. 2022

J Clin Transl Hepatol

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Background and Aims:The National Centralized Drug Procurement (NCDP) policy was launched in mainland China in April 2019, with entecavir (ETV) and tenofovir disoproxil fumarate (TDF) being included in the procurement list. We conducted the current study to investigate the impact of the NCDP policy on the utilization and expenditures of antiviral therapy for chronic hepatitis B (CHB) in China. Methods: Procurement records, including monthly purchase volume, expenditure, and price of nucleos(t)ide analogs (NAs), were derived from the National Healthcare Security Administration from April 2018 to March 2021. The changes in volumes and expenditures of the first-line NAs and bid-winning products were calculated. The effects of price, volume, and structure related to drug expenditure were calculated by the Addis and Magrini (AM) Index System Analysis. Results: The purchase volume of NAs significantly increased from 134.3 to 318.3 million DDDs, whereas the expenditure sharply decreased from 1,623.41 to 490.43 million renminbi (RMB) or 241.94 to 73.09 million US dollars (USD). The proportions of firstline NAs rose from 72.51% (ETV: 69.00%, TDF: 3.51%) to 94.97% (ETV: 77.42%, TDF: 17.55%). AM analysis showed that the NCDP policy decreased the expenditure of all NAs (S=0.91) but increased that of the first-line NAs in the bidwinning list (S=1.13). Assuming the population size of CHB patients remains stable and a compliance rate of ≥75%, the proportion of CHB patients receiving first-line antiviral therapy would increase from 6.36-8.48% to 11.56-15.41%. Conclusions:The implementation of the NCDP policy significantly increased the utilization of first-line NAs for CHB patients at a lower expenditure. The findings provided evidence for optimizing antiviral therapy strategy and allocating medical resources in China.

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“…Wen et al found that in Shenzhen, the NVBP pilot program was associated with reduced DDDs and improved accessibility of nucleos(t)ide analogs. ( Wen et al, 2021 ). Our study further investigated the impact of the NVBP on antiviral drugs in all pilot cities with a longer period of study time.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, several studies have also assessed the effect of NVBP on some specialized drugs, including antibiotics, antihypertensive drugs, and nucleic acid drugs. These studies found that the NVBP might have a positive effect on different types of drugs ( Yang et al, 2021a ; Yang et al, 2021b ; Wen et al, 2021 ). However, the study on the nucleos(t)ide analogs only included the data in one of the pilot cities of the NVBP for a relatively short period of time ( Wen et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

“…These studies found that the NVBP might have a positive effect on different types of drugs ( Yang et al, 2021a ; Yang et al, 2021b ; Wen et al, 2021 ). However, the study on the nucleos(t)ide analogs only included the data in one of the pilot cities of the NVBP for a relatively short period of time ( Wen et al, 2021 ). Hence, the impact of NVBP on drug prices, total expenditures, and utilization of antiviral therapy in all seven pilot cities over a longer period of time remains unclear.…”

Section: Introductionmentioning

confidence: 99%

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Impact of National Volume-Based Procurement on the Procurement Volumes and Spending for Antiviral Medications of Hepatitis B Virus

et al. 2022

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Introduction: Although persistent inhibition of HBV replication by antiviral therapy has shown to slow disease progression, cost-related access barriers to these essential medicines are becoming salient. The national volume-based procurement (NVBP) was piloted in China and led to substantial reduction in the list price of prescription drugs. To examine the impact of NVBP on selected antiviral medication costs per defined daily dose (DDD), procurement volumes, and spending.Methods: We employed an interrupted time series design to examine changes in cost per defined daily dose (DDD), procurement volumes, and spending for NVBP bid-winning antiviral medications (tenofovir disoproxil fumarate and entecavir) in 11 pilot cities from 2017 to 2020. Procurement transaction data were obtained from 9,454 hospitals in the Chinese Hospital Pharmaceutical Audit (CHPA) database. In the secondary analysis, the control group comprised two non-NVBP drugs (adefovir and lamivudine) procured in 11 cities not exposed to the NVBP.Results: Cost per DDD of the two hepatitis B virus (HBV) antiviral medications reduced by CNY1.598 (p = 0.002) immediately following the implementation of NVBP, dropping from an average cost of CNY16.483 per DDD at baseline to CNY6.420 at the end of the observation period. NVBP implementation resulted in a substantial reduction in daily costs of antivirals and an increase in monthly procurement volumes by 6.674 million DDDs (p = 0.017), while monthly spending was reduced by CNY138.26 million (p = 0.002). In the secondary ITS analysis with a control group, the average cost per DDD of the NVBP bid-winning antivirals declined by CNY4.537 (p < 0.001), monthly procurement volumes increased by 7.209 million DDDs (p = 0.002), and monthly spending dropped by CNY138.83 million (p < 0.001).Conclusion: Volume-based procurement piloted in China may be effective for reducing price and total expenditures and improving drug utilization, which is especially important for HBV patients who need constant access to antiviral therapies.

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The Effects of the National Centralized Drug Purchasing Pilot Program on Nucleos(t)ide Analogs in Shenzhen City: An Interrupted Time Series Analysis

Cited by 13 publications

References 56 publications

The impact of national centralized drug procurement on health expenditures for lung cancer inpatients: A difference-in-differences analysis in a large tertiary hospital in China

The impact of national centralized drug procurement on health expenditures for lung cancer inpatients: A difference-in-differences analysis in a large tertiary hospital in China

Impact of National Centralized Drug Procurement Policy on Antiviral Utilization and Expenditure for Hepatitis B in China

Impact of National Volume-Based Procurement on the Procurement Volumes and Spending for Antiviral Medications of Hepatitis B Virus

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