Impact of China’s zero mark-up drug policy on drug cost of NCDs’ outpatients: an interrupted time series analysis

Du, Jielin; Xie, Jiajia; Qian, Yan; Wu, Mingyue; Huang, Wenjing; Jin, Yixin; Peng, Xin; Deng, Dan

doi:10.1186/s12913-021-06414-3

Cited by 13 publications

(23 citation statements)

References 31 publications

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“…We discarded 25 records that could not fulfill the selection criteria. Fifteen studies (including retrospective cohort studies, time series studies, and quasiexperimental studies) were eventually included (1)(2)(3)(4)(5)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). Table 3 outlines the features of the selected studies.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…One study showed that the number of medicines prescribed per patient and the use of antibiotics, intramuscular injections, and intravenous injections reduced, while the use of hormones increased (12). The total drug expenditure decreased by 14.4%, while the drug expenditure of outpatients with chronic diseases in tertiary hospitals was reduced due to the implementation of the ZPED (14,16).…”

Section: Drug Costmentioning

confidence: 99%

“…The great reduction in expenditure on drugs caused more physicians to induce patients/healthcare service needs. The separation of hospital revenue from drug sales (SHRDS) policy is not an effective means of controlling healthcare expenditure (16). In addition, the increase in inpatient physician workdays decreased the mortality rate of inpatients.…”

Section: Othersmentioning

confidence: 99%

“…In China, urban employees with basic medical insurance cannot afford outpatient expenses. Outpatient expenses could be deducted from the amount in the personal account, such as a partial return of the paid amount (16). A previous study also demonstrated that the abolishment of the drug markup fee at public hospitals has more predictable benefits for patients if they are urban employees with basic medical insurance (24).…”

Section: Clinical Practice Of Zero-markup Policymentioning

confidence: 99%

“…In addition, due to the limited reimbursement rate for patients who are urban residents with basic medical insurance, such patients may be more inclined to purchase drugs independently outside of the hospital, meaning that the execution of the ZPED in tertiary hospitals is less effective on medical costs. In contrast, urban employees with basic medical insurance may have a relatively higher awareness of reasonable drug use or may be more willing to make the decision to purchase drugs at hospitals (16).…”

Section: Clinical Practice Of Zero-markup Policymentioning

confidence: 99%

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Systematic Review of the Effect of a Zero-Markup Policy for Essential Drugs on Healthcare Costs and Utilization in China, 2015–2021

Liu

Hsu²,

Liu

et al. 2021

Front. Med.

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Objective: This systematic review aimed to discuss the effects of a zero-markup policy for essential drugs (ZPED) on healthcare costs and utilization in China in the years 2015–2021.Methods: We searched the PubMed, Embase, Scopus, and CINAHL databases for all associated studies carried out from January 1, 2015, to May 31, 2021, without any limitations regarding the language the studies were written in. To prevent selection bias, gray documents were tackled by other means. The methodological approaches were assessed by applying the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Newcastle-Ottawa Scale (NOS) collaboration tool.Results: Forty studies were selected at first and then 15 studies that met the inclusion criterion. Most of the studies showed a considerable decrease in total medical spending and drug spending in both outpatient and inpatient services. After the implementation of ZPED, studies showed that the medical services increased and total hospital income sustained, despite a decrease in drug revenue. Minimal or no government subsidy is required from a financial perspective.Conclusions: Although, the government could implement ZEPD with lower medical cost and drug cost to patients, and sustained income for health facilities, we have limited understanding of whether the increase in medical services was induced by the provider or was a response to unmet needs in the population. Further, studies using rigorous and advanced methods to study health policy, patient behaviors, provider behaviors, and government decisions are warranted.

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Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Section: Drug Costmentioning

confidence: 99%

Section: Othersmentioning

confidence: 99%

Section: Clinical Practice Of Zero-markup Policymentioning

confidence: 99%

Section: Clinical Practice Of Zero-markup Policymentioning

confidence: 99%

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Systematic Review of the Effect of a Zero-Markup Policy for Essential Drugs on Healthcare Costs and Utilization in China, 2015–2021

Liu

Hsu²,

Liu

et al. 2021

Front. Med.

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Le système de santé chinois

Milcent

2021

Med Sci (Paris)

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Côté santé, la Chine connaît une situation paradoxale, avec des indicateurs dont la courbe de progression est spectaculaire : une espérance de vie passée de 43,7 ans en 1960 à 76,9 ans en 2019 ; des dépenses de santé à hauteur de 5,35 % du produit intérieur brut (PIB) en 2018… Mais un système décrit par de nombreux observateurs comme manquant d’efficacité et des relations excessivement tendues voire violentes [1, 2] entre, d’un côté, le personnel soignant et les médecins et, de l’autre côté, les patients et leur famille. Pour comprendre le système de santé chinois, je m’attacherai dans cette revue à le contextualiser puis je montrerai comment, face à l’incapacité à mettre en place un système fondé sur des modèles existants, ce système de santé est en train de se redessiner en développant un système alternatif de soins.

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