Improving access to medicines and beyond: the national volume-based procurement policy in China

Abstract

.Since 2019, the Chinese central government has taken significant steps to centralize national purchasing power and has implemented a pooled procurement system. In this paper, we provide an in-depth analysis of China's National Volume-Based Procurement (NVBP) policy, which represents a unique approach to pooled procurement within the pharmaceutical sector. The primary objectives of the NVBP are to reduce drug prices, enhance access to affordable medications, and improve the overall functioning of the pharmaceutical industry in China. Our analysis delves into the key features of the NVBP, including its centralized procurement system, volume-based procurement approach, and the guaranteed procurement volumes allocated to winning bidders. We also address the challenges and implications associated with the NVBP, such as its impact on the pharmaceutical industry, the sustainability of price reductions, and the importance of striking a balance between price reduction and industry sustainability. Through a comparative analysis, we shed light on the distinct characteristics of China's approach to pooled procurement and its potential ramifications for healthcare policies and practices. By examining the NVBP within the broader context of China's evolving healthcare landscape, we aim to contribute to a deeper understanding of the implications and effectiveness of this unique policy initiative.

Impacts of national volume-based drug procurement policy on the utilization and costs of antihypertensive drugs in a Chinese medicine hospital: an interrupted time series analysis of 5138 patients

“…However, some patients and doctors still had doubts about the safety and efficacy of the bid-winning drugs. It is necessary to explore more systematic approaches to boosting public confidence in bid-winning generic drugs and enhance physicians’ acceptability of them ( Zhu et al, 2023 ).…”

National Volume-Based Procurement (NVBP) exclusively for insulin: towards affordable access in China and beyond

“…In contrast, our study reported a higher price cut, suggesting that the concentration of national demand significantly strengthened our negotiating power. The centralised negotiation approach, combined with larger purchase quantities, allowed us to secure substantial price discounts 13 14…”

“…As the world’s second-largest pharmaceutical market, China’s previous rounds of pooled procurement for chemical drugs achieved more significant price cuts, improving bargaining power through pooling purchasing power across the nation 13. The NVBP received an unprecedentedly high political commitment 13 14. As described previously,13 14 under the direct supervision of the State Council, the Working Group—consisting of the National Healthcare Security Administration (NHSA), National Medical Products Administration (NMPA) and National Health Commission —is responsible for overseeing the regulation, evaluating and organising the procurement.…”

“…The NVBP received an unprecedentedly high political commitment 13 14. As described previously,13 14 under the direct supervision of the State Council, the Working Group—consisting of the National Healthcare Security Administration (NHSA), National Medical Products Administration (NMPA) and National Health Commission —is responsible for overseeing the regulation, evaluating and organising the procurement. The Joint Procurement Office (JPO)—consisting of local representatives from the participating jurisdictions—is responsible for overseeing the implementation of NVBP.…”

“…Therefore, the procurement mechanism should be designed specifically for insulin. The novel procurement initiatives for NVBP exclusively for insulin were implemented in November 2021 after successfully carrying out five rounds of NVBP procurement for chemical drugs 14. Here, we describe how a pooled procurement mechanism was implemented for insulin in China.…”