Abstract
In 2019, the Chinese government implemented the first round of the National Centralized Drug Procurement (NCDP) pilot (so-called “4 + 7” policy) in mainland China, in which 25 drugs were included. We conducted this study to examine the impacts of NCDP policy on drug utilization and expenditures, and to clarify the main factors contributing to drug expenditure changes. This study used drug purchasing order data from the Centralized Drug Procurement Survey in Shenzhen 2019. Drugs related to the “4 + 7” policy were selected as study samples, including 23 “4 + 7” policy-related varieties and 15 basic alternative drugs. Driving factors for drug expenditures changes were analyzed using A.M. index system analysis (Addis A. & Magrini N.’ method). After the implementation of the NCDP policy, the volume of “4 + 7” policy-related varieties increased by 73.8%, among which winning products jumped by 1638.2% and non-winning products dropped by 70.8%; the expenditures of “4 + 7” policy-related varieties decreased by 36.9%. Structure effects (0.47) and price effects (0.78) negatively contributed to the increase in drug expenditures of “4 + 7” policy-related varieties, while volume effects (1.73) had positive influence. NCDP policy successfully decreased drug expenditures of “4 + 7” policy-related varieties with structure effects playing a leading role. However, total drug expenditures were not effectively controlled due to the increasing use of alternative drugs.
Highlights
Many countries worldwide are facing the challenge of ever-increasing pharmaceutical expenditures [1,2,3,4], and the global pharmaceutical market reached USD 955 billion in 2019 [5].In China, the total pharmaceutical expenditures increased by 17 times from 1990 to 2009, with an annual growth of 15.2% [6]
In order to curb the growth of total pharmaceutical expenditures, the Chinese government has carried out centralized drug procurement since 2000 [9]
This study examined the impacts of National Centralized Drug Procurement (NCDP) policy on drug utilization and drug expenditures
Summary
In China, the total pharmaceutical expenditures increased by 17 times from 1990 to 2009, with an annual growth of 15.2% [6]. In order to curb the growth of total pharmaceutical expenditures, the Chinese government has carried out centralized drug procurement since 2000 [9]. Centralized drug procurement successfully saves drug costs [10,11]. With the help of a pooled procurement service, nine Caribbean island countries reduced unit drug costs by more than 50% [12]. The pooled procurement system implemented in Delhi, India, was estimated to save nearly 30% of the annual drug bill of the government, and this system was praised by the World
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