The impacts of the “4+7” pilot policy on the volume, expenditures, and daily cost of Serotonin-Specific Reuptake Inhibitors (SSRIs) antidepressants: A quasi-experimental study

Abstract

Objectives: The purpose of this study was to quantitatively evaluate the impacts of the”4 + 7” pilot policy on purchase volume, purchase expenditures, and daily cost and to find the changes in the use of SSRIs.Methods: Data was collected covering 31 months, before, during, and after the “4 + 7” pilot policy was implemented in Shenzhen. Interrupted time-series (ITS) analysis was used to examine whether there had been a significant effect with the onset of the “4 + 7” pilot policy in March 2019.Findings: The daily cost of policy-related drugs had a substantial drop of 2.93 yuan under the “4 + 7” pilot policy. The result has shown a 76.70% increase in volume and a 3.39% decrease in the expenditure on policy-related drugs. This study found that the “4 + 7” pilot policy increased the proportion of purchasing winning drugs, with an increment of 85.60 percent. After the implementation of the “4 + 7” pilot policy, policy-related drugs decreased by 443.55thousand Chinese yuan. The study indicated that volume of winning products significantly increased as shown in the regression with a level coefficient (β2) of -224.17 (p < 0.001) and trend coefficient (β3) of 15.74 (p < 0.001). The result revealed that both volume and expenditures on branded products showed a significant decrease in the regression in the post-intervention period (level coefficient of volume: β2 = -57.65, p < 0.01, trend coefficient of volume: β3 = -3.44, p < 0.01; level coefficient of expenditure: β2 = -712.98, p < 0.01, trend coefficient of expenditure: β3 = -40.10, p < 0.01).Conclusion: The volume-based procurement has successfully led to price reductions and improved the affordability of medicines, especially for those with chronic diseases. The volume-based procurement has demonstrated initial success in reshaping the composition of the Chinese pharmaceutical market in favor of generics with high quality and low prices.

The impact of the national centralized drug procurement on the use of original and generic targeted anti- tumor drugs in Hohhot, China: an interrupted time-series analysis

“…At the same time, the expenditure of the generic targeted anti-tumor drugs decreased(-81.64%, -43.45%, and − 93.10%), and the DDDc decreased(-85.54%, -85.86%, and − 84.93%), which met the requirements of the NCDP to reduce medicines cost and alleviate the drug burden of patients, which was similar to the results of previous studies [22,23]. Furthermore, a signi cant decrease in both the quantity and dosage of original targeted drugs employed was observed subsequent to the policy intervention, aligning with the ndings reported by Yang et al [7,[10][11][12].…”

“…Previous studies have indicated that the volume of policy-related antiviral drugs, antidepressants, antihypertensives and antibiotics has a signi cant increase, while volume of related original drugs medications decreased sharply ,after implementing the NCDP in China. [7,[10][11][12]. At the same time, the NCDP policy has successfully reduced the drug expenditure of policy-relevant varieties [13].…”

The cost of total hip arthroplasty: compare the hospitalization costs of national centralized procurement and national volume-based procurement

“…Wang et al ( 31 ) showed that the implementation of the “4 + 7” policy increased the use of cardiovascular generic drugs and significantly improved access to affordable drug costs for patients. Wen et al ( 32 ) showed that batch procurement successfully reduced the price of selective serotonin reuptake inhibitors and improved access to affordable drugs, especially for patients with chronic diseases. Since its implementation, NVBP has successfully reshaped the Chinese drug market structure, making it more conducive to high-quality and low-cost generic drugs.…”

Healthcare professionals’ knowledge, attitude and practice towards National Centralized Drug Procurement policy in central China: A cross-sectional study

“…The fast rise of pharmaceutical expenditure and the resulting increase in total health expenses have brought a heavy burden to the finances and the daily medical care of the people around the world, accessibility and affordability of medicines have become major issues for healthcare systems globally (Seidman and Atun, 2017;Long et al, 2022;Wen et al, 2022;Zhang et al, 2022). And China is no exception (Ma et al, 2020).…”