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

Abstract

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.

Local causes of essential medicines shortages from the perspective of supply chain professionals in Saudi Arabia

“…Centralized procurement or pooled procurement can be defined as a collaboration initiative of buyers that consolidates their purchases ( Baldi and Vannoni 2017 ). Previous studies have improved spending efficiency and access to essential medicines in some countries ( Baldi and Vannoni, 2017 , Wang et al, 2021 , Zhang et al, 2022 ). As part of Vision 2030, Saudi Arabia has implemented significant pharmaceutical and procurement policy reforms.…”

Improving access to medicines: lessons from 10 years of drug reforms in China, 2009–2020

“…Some early evidence has observed improved availability and affordability of drugs. [121][122][123][124][125] However, it might take additional time to observe the policy impact comprehensively. Additionally, there are critical shortfalls in both the quantity and capacity of pharmacists in the short term in China.…”

“…The latest reform has to establish a sustainable financing mechanism to compensate reasonable cost for prescriptions while they remain de-linked from the unit price or sales revenue of drugs. Some early evidence has observed improved availability and affordability of drugs 121–125. However, it might take additional time to observe the policy impact comprehensively.…”

Assessment of patients’ preferences for new anticancer drugs in China: a best–worst discrete choice experiment on three common cancer types

“…In recent years, molecular targeted therapies and other innovative anticancer drugs offer hopes for patients with cancer. The accessibility of new anticancer drugs has improved significantly since the Chinese government expanded regulatory capacity and initiated a series of programmes to accelerate the development, review, approval and reimbursement of new drugs 6 7. Despite advances in therapeutic strategies and drug availability, cancer treatment involves uncertainties and risks, as well as high out-of-pocket costs 8 9.…”