Spending In China Research Articles

PT5 Impacts of National Drug Price Negotiation on Type 2 Diabetes Drugs Price, Volume, and Spending in China

PT5 Impacts of National Drug Price Negotiation on Type 2 Diabetes Drugs Price, Volume, and Spending in China

HPR121 Impacts of National Drug Price Negotiation on Chronic Myeloid Leukemia Drugs Price, Volume and Spending in China

HPR121 Impacts of National Drug Price Negotiation on Chronic Myeloid Leukemia Drugs Price, Volume and Spending in China

Exploring asymmetric influence of R&D expenditures on CO2 emissions in China: evidence from nonlinear ARDL model.

R&D spending upsurges technological advancement and innovation which results in lowering energy consumption and environmental degradation. The current study investigates the asymmetrical impact of R&D spending on CO2 emissions in China via employing annual data from 1980 to 2021 and the NARDL model for empirical analysis. The estimated results of the NARDL model confirmed that there are asymmetries in positive and negative coefficients of R&D spending in China. The results depict that the positive shock in R&D spending exerts a negative and statistically significant impact on CO2 emissions in both runs implying that an increase in R&D spending lowers CO2 emissions. However, the negative coefficient of R&D spending yields a positive and statistically significant impact on CO2 emissions revealing the fact that a negative shock in R&D spending results in the upsurge of CO2 emissions in China. According to these findings, the impact of positive and negative shocks in R&D spending on CO2 emissions is asymmetric. The findings also show that the impact of a negative shock in R&D spending is greater than the impact of a positive shock on CO2 emissions. In addition to the negative shock in R&D spending, increases in energy consumption, economic growth, and FDI inflows also contribute to an upsurge in CO2 emissions in China. The robustness of the estimated results is assessed using standard fully modified ordinary least square (FMOLS) and dynamic ordinary least square (DOLS) models. The FMOLS and DOLS results have been confirmed to be sound and consistent with the results of the NARDL model. The study suggests that the economic strategies should aim at investing in R&D spending to foster environment-friendly technological innovations and to lower environmental degradation in China.

Impacts of adjustment of National Reimbursement Drug List on orphan drugs volume and spending in China: an interrupted time series analysis

ObjectiveTo evaluate the impacts of the 2017 adjustment of National Reimbursement Drug List (NRDL) on orphan drugs hospital procurement volumes and spending in China.DesignWe used an interrupted time series design...

The short- and long-run effects of medical malpractice lawsuits on medical spending and hospital operations in China

China is experiencing a surge in medical malpractice lawsuits. Using administrative hospital panel data, this paper investigates both short- and long-run impacts of medical malpractice lawsuits on patient medical spending and hospital operations. We find that after the occurrence of an additional malpractice lawsuit in a hospital, total medical spending per patient visit increases by 2.8% in the current year and by as much as 8.8% in the long run. This increase is mainly driven by spending on prescription drugs and diagnostic tests. In response, hospitals invest more in medical devices and procure more drugs. We find little evidence of changes in patient outcomes. Our findings show that the surge of medical malpractice lawsuits leads to defensive medicine and fuels the secular growth of medical spending in China.

An empirical study of the impact of generic drug competition on drug market prices in China.

Generic substitution is encouraged to reduce pharmaceutical spending in China, and with incentive policies, the market size of the generic drug continues to rise. To find out how the generic competition affects drug price in this area, this study examines how the quantity of generic drug manufacturers can influence average drug price in the Chinese market. This study uses a rigorous selection of drugs from the 2021 China's National Reimbursement Drug List (NRDL), and uses drug-level fixed effects regressions to estimate the relationship between competition and price within each drug. We note that drug prices decline with increasing competition in the Chinese market, but not in a perfectly linear manner, with marginal price declines decreasing after the fourth entrant and "rebounding" at subsequent entrants, especially the sixth. The findings suggest the importance of maintaining effective competition between suppliers to control prices, and that the government needs to further control generic pricing, especially for late entry generics, to ensure effective competition in the Chinese market.

Empirical analysis of R&D spending, transport infrastructure development and CO2 emissions in China

Over the past few decades, the transportation sector has been the largest contributor to CO2 emissions in China. Research and Development spending leads to technological innovation in the country and could affect the CO2 emission in the country. Therefore, this study analyzes the nexus between CO2 emissions, transport infrastructure and R&D spending in China. A QARDL approach was used for the data analysis, which revealed Research and Development and Transport infrastructure has a positive impact on CO2 emissions. R&D was only significant in the first 25% quantile, while transportation was significant in almost all quantiles. These results suggest that R&D spending in China is mainly allocated to the sectors that emit the CO2 emission. It is recommended that government should allocate more R&D to carbon-reducing sectors. Furthermore, the government should consider green transportation investments and renewable energy projects in the transportation sector to reduce CO2 emissions in the country.

The morbidity costs of air pollution through the Lens of Health Spending in China

This study is one of the first to present causal evidence of the morbidity costs of fine particulates (PM2.5) for all age cohorts in a developing country, using individual-level health spending data from a basic medical insurance program in Wuhan, China. Our instrumental variable (IV) approach uses thermal inversion to address potential endogeneity in PM2.5 concentrations and shows that PM2.5 imposes a significant impact on healthcare expenditures. The two-stage least squares (2SLS) estimates suggest that a 10 μg/m3 (micrograms per cubic meter) reduction in monthly average PM2.5 leads to a 2.36% decrease in the value of health spending and a 0.79% decline in the number of transactions at pharmacies and healthcare facilities. Also, this effect, largely driven by spending at pharmacies, is more salient for males and children, as well as middle-aged and older adults. Moreover, our estimates may provide a lower bound on individuals’ willingness to pay, amounting to CNY 43.87 (or USD 7.09) per capita per year for a 10 μg/m3 reduction in PM2.5.

Impact of COVID -19 on Defence spending in China: military burden or peacekeeping facilitation?

Impact of COVID -19 on Defence spending in China: military burden or peacekeeping facilitation?

What drives health-care spending in China? A nationwide decomposition analysis

ABSTRACT In this study, we explore the geographic variation in health-care spending and its driving factors in China, using a nationwide and claim-level sample of inpatients ensured under the urban basic medical insurance schemes in 2010. We show geographic variation in health-care spending is substantial in China and is significantly larger than Medicare spending in the US. The substantial geographic variation is primarily driven by the quantity variation. We also discuss the potential correlates of the quantity of health care at the city level. The findings imply possible allocation inefficiency in China’s current urban health-care system.

Race to the Top or Bottom? Globalization and Education Spending in China

Race to the Top or Bottom? Globalization and Education Spending in China

Assessing the long-term effects of Basic Medical Insurance on catastrophic health spending in China.

Many developing countries have implemented social health insurance programmes to protect their citizens against the financial risks of seeking healthcare. While many studies have explored how individual insurance enrolments affect catastrophic health spending (CHS) in the short term, there is a lack of evidence on the long-term macro-level effects of social health insurance on CHS in low- and middle-income countries. This study examines the long-term effects of Basic Medical Insurance (BMI) on individual CHS in China, a middle-income country that has witnessed one of the highest worldwide increases in CHS rates despite its remarkable achievement of universal health insurance coverage. Specifically, we used existing longitudinal data from 1989 to 2015, therein assessing BMI policy effects by constructing two macro-level indicators, including the year of BMI presence at the prefectural level and number of years relative to BMI introduction. We employed a three-level difference-in-differences approach for the estimation. There were two main findings. First, BMI policy did not significantly reduce the probability of incurring CHS for BMI enrollees over time. Years after BMI was introduced, the policy even predicted a significant increase in the probability of incurring CHS for individuals who shifted their enrolments from traditional insurance to BMI. Second, BMI policy had spillover effects on the increase in the probability of incurring CHS for non-BMI individuals a few years after its inception. We believe there are three possible explanations for these findings: (1) shrinking BMI service coverage compared to pre-existing government-funded insurance schemes, (2) a profit-driven hospital reform that induces the overuse of expensive medicines and diagnostic tests and (3) the absence of strategic purchasing among local BMI agencies. We also discuss how relevant policy interventions may alleviate insurance-driven financial risks.

The Morbidity Costs of Air Pollution Through the Lens of Health Spending in China

The Morbidity Costs of Air Pollution Through the Lens of Health Spending in China

The effects of smoking, regular drinking, and unhealthy weight on health care utilization in China

BackgroundPreventive risk factors such as smoking, drinking, and unhealthy weight have contributed to the accelerated rise in noncommunicable chronic diseases, which are dominant drivers of health care utilization and spending in China. However, few studies have been conducted using a large longitudinal dataset to explore the impact of such preventive risk factors on health care utilization. Therefore, this study aimed to ascertain the effects of smoking, regular drinking, and unhealthy weight on health care utilization in China.MethodsThis research was a longitudinal study using data from five waves of the China Family Panel Studies (CFPS) conducted between 2010 and 2018, and the final sample consisted of 63,260 observations (12,652 participants) across all five waves of data collection. Health care utilization was measured from two perspectives: outpatient utilization and inpatient utilization. Smoking status was categorized as never smoker, former smoker, or current smoker. Unhealthy weight was classified based on the participants’ body mass index. A fixed effects logistic regression model was used for the analysis.ResultsThe results of fixed effects logistic regression showed that current and former smokers were approximately 1.9 times and 2.0 times more likely to use outpatient care than those who never smoked, respectively (odds ratio (OR) = 1.88, p < 0.05; OR = 2.03, p < 0.05). Obese people were approximately 1.3 times more likely to use outpatient care than healthy weight people (OR = 1.26, p < 0.05). Moreover, the results show that compared to those who never smoked, for current and former smokers, the odds of being hospitalized increased by 42.2 and 198.2%, respectively (OR = 1.42; p < 0.1, OR = 2.98; p < 0.05). Compared to healthy weight people, overweight and obese people were also more likely to be hospitalized (OR = 1.11; p < 0.1, OR = 1.18; p < 0.1, respectively).ConclusionAmong Chinese adults, current and former smokers were more likely to use outpatient and inpatient care than those who had never smoked. Moreover, compared to healthy weight people, obese people were more likely to use outpatient and inpatient care, and overweight people were more likely to use inpatient care. These results may have important implications that support the government in making health care resource allocation decisions.

Decoupling and decomposition analysis of CO2 emissions from government spending in China

Exploring the role of government spending (GS) in CO2 mitigation is essential for achieving low-carbon development goals; however, the mechanism by which GS affects CO2 emissions remains unclear. The decoupling relationship between GS on energy-savings and environmental protection (GSP) and CO2 emissions in China from 2007 to 2019 was investigated. In addition to evaluating the temporal attribute of the decoupling state, the concept of a dynamic path of the decoupling state was proposed for the first time. Moreover, from the perspective of direct and indirect effects and decoupling elastic factors, the drivers of decoupling elasticity between GSP and CO2 emissions were analysed by developing two non-residual decomposition methods for the Tapio decoupling elastic index. Results based on 30 Chinese provinces showed that these provinces experienced either one or more of the decoupling states: weak, strong, expansive negative, and strong negative decoupling; however, most provinces experienced weak decoupling. Beijing, Tianjin, and Jilin were in the intensive dynamic path of the decoupling state, whereas other provinces remained in the extensive dynamic path. The energy intensity, energy-related carbon intensity, and GS structures of education contributed to the decoupling of GSP from CO2 emissions, however, GS intensity on capital-labour input delayed.

The relationship between LNG price, LNG revenue, non-LNG revenue and government spending in China: An empirical analysis based on the ARDL and SVAR model

The present paper examines the dynamic relationship between liquefied natural gas (LNG) price, LNG revenue, non-LNG revenue and government spending (GOVS) in China using autoregressive distributed lag (ARDL) and structural vector auto-regressive (SVAR) model. The goal of carrying out ARDL and SVAR together is to consolidate and strengthen the consistency of the results obtained from both approaches. ARDL results show that a positive influence relationship between both short-run and long-run LNG prices, LNG revenue, non-LNG revenue and GOVS, but there was no significant relationship between LNG price and GOVS. The SVAR also substantiates the results of ARDL test and provides further insight which shows that long-run fiscal synchronization hypothesis is evidenced between the LNG revenue and GOVS, while spend-tax hypothesis exists in the long-run between GOVS and non-LNG revenue. It is also evidenced that there is a complementary relationship between LNG revenue and non-LNG revenue, but this complementary role is stronger than the substitution role. Since non-LNG revenue has a greater impact on GOVS in the short-run, and the impact of LNG prices and LNG revenue on GOVS in the long-run increases over time, thus, GOVS mitigates the direct impact of non-LNG revenue to some extent, and that an appropriate allocation of spending in the non-LNG industry will have a positive impact on the development of the market economy supporting the Keynesian and spend-tax hypothesis.

The Effectiveness of Environmental Spending in China and the Environmental Kuznets Curve

The aim of this study is to determine whether recent environmental spending in China has enabled it to reduce its emissions of greenhouse gases in the context of an Environmental Kuznets Curve-based model and promote sustainable economic development. Following the Paris Agreement in 2015, there has been a coordinated effort to reduce the consumption of fossil fuels and prevent the excessive warming of the climate. The study uses annual regional data across China and a dynamic panel data approach for estimating an EKC model which includes measures of the increased use of fossil fuels and the spending across China to reduce environmental damage. The results suggest that the policies have been effective in controlling emissions across a variety of pollutants and that the EKC tends to hold in China but varies according to the pollutant. This suggests that these policies should be continued and where possible, extended.

The Effect of Interpersonal Spending Pressure on Intention to Smoke among Low-Income People in China

Objectives: Test the effect of capital on household human relationship expenditure and thus examine the effect on the willingness to smoke. Methods: Threshold model and Critical theory of capital. Results: China is a large consumer of tobacco, and tobacco account for a significant proportion of interpersonal spending in China. It is found that the percentage of social spending of low-income families is much higher than that of high-income families. In recent years, the social expenditures of extremely low-income people have far exceeded their income. At the same time, the types of urban and rural areas, traditional customs, business management, social exchange, and education level significantly impact the family’s human relationship expenditure. Conclusion: This paper shows that, unlike in Western countries, cigarettes present a huge advantage in interpersonal interactions in China, hence the phenomenon that the richer one is, the more one consumes tobacco. Social poverty has become a significant obstacle to the sustainable growth of low-income people’s income. Under the effect of capital, the relationship between people is deeply reflected as the relationship between human and material, and then presents the characteristics of materialization. The reason why people accept this way of interaction lies in the domination of rational principles. To control the materialized social relations, we need the construction of timely theory and the formation of values free from capital control to alleviate the social poverty.

The impacts of government reimbursement negotiation on targeted anticancer medication price, volume and spending in China

IntroductionNew targeted therapies have changed cancer treatment in the past decades. However, high prices of targeted anticancer medications have increased economic burden for both patients and health insurance systems. In...

Potential clinical and economic impact of optimised maintenance therapy on discharged patients with COPD after hospitalisation for an exacerbation in China

ObjectivesChronic obstructive pulmonary disease (COPD) exacerbations requiring hospitalisation are a considerable burden, both clinically and economically. Although long-acting maintenance therapy is recommended in both the GOLD (Global Initiative for Chronic...