Interrupted time-series analysis of the impact of generic market entry of antineoplastic products in China

Guan, Xiaodong; Tian, Ye; Ross‐Degnan, Dennis; Man, Chunxia; Shi, Leyuan

doi:10.1136/bmjopen-2018-022328

Cited by 17 publications

(20 citation statements)

References 39 publications

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“…However, this is not universal. For instance in China, generic imatinib is only 10 -20% below originator prices although generic capecitabine is 50% lower than originator prices (56). There have also been low prices for generic versions of paclitaxel in Europe at just over 1% of originator prices (57).…”

Section: Introductionmentioning

confidence: 99%

Pricing of oral generic cancer medicines in 25 European countries; findings and implications

Godman¹,

Hill²,

Simoens³

et al. 2019

GaBI J

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Introduction: There are appreciable concerns among European health authorities with growing expenditure on cancer medicines and issues of sustainability. The enhanced use of low cost generics could help. Aims: Consequently, there is a need to comprehensively document current and future arrangements regarding the pricing of generic cancer medicines across Europe, and whether these are indication specific, as well as how this translates into actual prices to provide future direction. Methodology: Mixed method approach with qualitative research among senior health authority personnel and their advisers. Quantitative research via health authority databases to ascertain current prices for oral cancer medicines that had lost their patent and the influence of population size and economics on prices. Results: 25 European countries participated. Currently we see (a) variable approaches to the pricing of generic cancer medicines, which will continue; (b) no concerns with substitution for oral generic cancer medicines; (c) substantial price reductions versus originators for generic capecitabine (up to-93.1%), generic imatinib (up to-97.8%) and generic temozolomide (up to-80.7%). Prices for oncology medicines are not indication specific, and are not affected by population size although influenced by pricing approaches. There have also been price increases for some nonpatented cancer medicines following manufacturer changes although now stabilising. Conclusion: The considerable price reductions seen for some generics means health authorities should further encourage the use of generic oncology medicines when they become available to fund increased volumes and new valued cancer medicines. Countries are also starting to address price increases for generics following changes in the manufacturer

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Section: Introductionmentioning

confidence: 99%

Pricing of oral generic cancer medicines in 25 European countries; findings and implications

Godman¹,

Hill²,

Simoens³

et al. 2019

GaBI J

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“…The availability of the generic medications would impact the use and cost of anticancer medications in China. (18,32) Patients taking generic imatinib might not turn to branded imatinib even when the originator became listed on the PDRL.…”

Section: Discussionmentioning

confidence: 99%

“…We used the data from China Medicine Economic Information (CMEI), a large database of public hospital medication procurement records in mainland China. (18) We extracted data of the 6 TAMs in the study group and the 4 TAMs in the control group purchased by 22 tertiary hospitals from Zhejiang province between January 2014 and March 2017. Aggregated procurement data included the HPV and the HPS of the TAMs selected in this study, as well as their dosage form, strength, purchase time, the Anatomical Therapeutic Chemical (ATC) code (19) and manufacturer.…”

Section: Data Sourcesmentioning

confidence: 99%

Assessing the impact of the Provincial Reimbursement Scheme on the use of Targeted Anticancer Medications in Zhejiang, China: A Controlled Interrupted time-series Analysis

Huang

Ung

Wushouer

et al. 2020

Preprint

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Background: High prices of targeted anticancer medications (TAMs) subject patients to extreme financial burden. To alleviate problems with access and affordability, 6 TAMs were newly listed in the Provincial Reimbursement Drug List (PRDL) in Zhejiang, China in February 2015. To evaluate the implementation of the PRDL policy, this study examined differences in the hospital purchasing volume (HPV) and the hospital purchasing spending (HPS) of 6 listed TAMs pre- and post-enlistment and comparing with 4 other unlisted TAMs. Methods: Interrupted time-series analysis was employed using the pharmaceutical procurement data of 6 newly listed TAMs (study group) and 4 unlisted TAMs (control group) from 22 tertiary hospitals in Zhejiang, China dated between January 2014 and March 2017. Results: After February 2015, the average HPV per month increased significantly by 34.6 defined daily doses (DDDs) (p<0.001) and the average HPS per month increased significantly by USD 6614.9 (p<0.001) for the listed TAMs in the study group (n=6); neither the average HPV nor the average HPS changed significantly for the unlisted TAMs in the control group (n=4). Although only 4 of the 6 listed TAMs exhibited significant decrease in the monthly HPV and HPS individually, the daily cost of each TAM decreased after enlistment. Conclusions: The PRDL policy has shown positive effect on promoting the access to and improving patients’ affordability of TAMs in Zhejiang. The government should conduct further price negotiations and include more TAMs with clinical benefits into reimbursement schemes to relief patients’ financial burden and promote access.

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“…Further, generic entry, particularly for the older price-regulated cytotoxic medications, may explain why relative medication prices did not increase after government price deregulation. With the Chinese government encouraging the development of pharmaceutical enterprises, more generic medications have come to the market, which might improve the availability and the affordability of antineoplastic agents 43…”

Section: Discussionmentioning

confidence: 99%

Influence of government price regulation and deregulation on the price of antineoplastic medications in China: a controlled interrupted time series study

et al. 2019

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BackgroundIn October 2012, the Chinese government established maximum retail prices for specific products, including 30 antineoplastic medications. Three years later, in June 2015, the government abolished price regulation for most medications, including all antineoplastic medications. This study examined the impacts of regulation and subsequent deregulation of prices of antineoplastic medications in China.MethodsUsing hospital procurement data and an interrupted time series with comparison series design, we examined the impacts of the policy changes on relative purchase prices (Laspeyres price index) and volumes of and spending on 52 antineoplastic medications in 699 hospitals. We identified three policy periods: prior to the initial price regulation (October 2011 to September 2012); during price regulation (October 2012 to June 2015); and after price deregulation (July 2015 to June 2016).ResultsDuring government price regulation, compared with price-unregulated cancer medications (n=22, mostly newer targeted products), the relative price of price-regulated medications (n=30, mostly chemotherapeutic products) decreased significantly (β=−0.081, p<0.001). After the government price deregulation, no significant price change occurred. Neither government price regulation nor deregulation had a significant impact on average volumes of or average spending on all antineoplastic medications immediately after the policy changes or in the longer term (p>0.05).ConclusionCompared with unregulated antineoplastics, the prices of regulated antineoplastic medications decreased after setting price caps and did not increase after deregulation. To control the rapid growth of oncology medication expenditures, more effective measures than price regulation through price caps for traditional chemotherapy are needed.

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Interrupted time-series analysis of the impact of generic market entry of antineoplastic products in China

Cited by 17 publications

References 39 publications

Pricing of oral generic cancer medicines in 25 European countries; findings and implications

Pricing of oral generic cancer medicines in 25 European countries; findings and implications

Assessing the impact of the Provincial Reimbursement Scheme on the use of Targeted Anticancer Medications in Zhejiang, China: A Controlled Interrupted time-series Analysis

Influence of government price regulation and deregulation on the price of antineoplastic medications in China: a controlled interrupted time series study

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