Pharmaceutical expenditure and total health-care expenditure in OECD countries and China: bidirectional Granger causality on the basis of health level

Xiong, Yuqi; Cui, Youwen; Zhang, Xiaopeng

doi:10.1080/14737167.2019.1605292

Cited by 7 publications

(6 citation statements)

References 60 publications

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“…Medical expenditures as a proportion of gross domestic product (GDP) also increased steadily from 5.9% in 2010 to 8.0% in 2019 ( 3 ). Pharmaceutical expenditure in lower-middle-income countries can be up to 70% of total healthcare expenditure, much of which is out-of-pocket (OOP) ( 4 ). Medicines account for 20–60% of health spending in developing and transitional countries.…”

Section: Introductionmentioning

confidence: 99%

“…In 2016, pharmaceutical expenditures comprised 35.8% in THE in China, which was much higher than (29.5%) the highest of Organization for Economic Cooperation and Development (OECD) nations ( 9 ). Pharmaceutical expenditure in lower-middle-income countries can be up to 70% of THE, much of which is OOP, compared to up to 17% in higher-income countries ( 4 , 10 ). Pharmaceutical expenditures depended on drug prices and drug volume, which were corresponding to the supply and demand sides of drugs, respectively ( 11 ).…”

Section: Introductionmentioning

confidence: 99%

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The Effects of the National Centralized Drug Purchasing Pilot Program on Nucleos(t)ide Analogs in Shenzhen City: An Interrupted Time Series Analysis

Wen

Yin

Cui

et al. 2021

Front. Public Health

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Objectives: To assess the effects of the National Centralized Drug Purchasing Pilot Program on nucleos(t)ide analogs (NAs) in Shenzhen city.Methods: Drugs procurement records in medical institutions were analyzed covering the period from January 2018 to December 2019. An interrupted time series (ITS) analysis was used to evaluate the impact of the “4+7” pilot policy on NAs in Shenzhen city. The outcome measures were usage volume, expenditures, daily cost, and distribution structure of NAs.Findings: After the introduction of the “4+7” pilot policy, the defined daily doses (DDDs) of NA drugs increased by 76.48%, the expenditures and defined daily dose cost (DDDc) of NAs decreased by 45.43 and 69.08%, respectively. The proportion of winning products in Entecavir and Tenofovir Fumarate DDDs was increased by 64.21 and 19.20%, respectively. The post-intervention period witnessed a significant increase in the regression level for NAs DDDs (level coefficient: β2 = 631.87, p < 0.05). The expenditures (trend coefficient: β3 = 392.24, p < 0.05) and DDDc (level coefficient: β2 = −6.17, p < 0.001; trend coefficient: β3 = −0.21, p < 0.05) of NAs showed decreasing trend in the post-intervention period. The expenditures of original products and generic products both showed a decreasing trend in the post-intervention period (trend coefficient: β3 = −372.78, p < 0.05, trend coefficient: β3 = −130.78, p < 0.05, respectively). The DDDc of original products in the policy-related varieties was a significant decrease in the regression slope and level (level coefficient: β2 = −2.18, p < 0.05; trend coefficient: β3 = −0.32, p < 0.01).Conclusion: After the implementation of the“4+7” policy, the DDDc of NAs decreased, the accessibility of policy-related drugs was improved, and the usage of generic medicine was promoted.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Effects of the National Centralized Drug Purchasing Pilot Program on Nucleos(t)ide Analogs in Shenzhen City: An Interrupted Time Series Analysis

Wen

Yin

Cui

et al. 2021

Front. Public Health

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“…Drug expenditure is one of the main components of total healthcare expenditures. In lower-middle-income countries, drug expenditure can be up to 70% of total healthcare expenditures, much of which is out-of-pocket ( Xiong et al, 2019 ). As a result, drug spending has induced an increasing financial burden on patients ( Cameron et al, 2009 ).…”

Section: Introductionmentioning

confidence: 99%

A quasi-experimental study of the volume-based procurement (VBP) effect on antiviral medications of hepatitis B virus in China

Wen,

Xu,

Chen

et al. 2023

Front. Pharmacol.

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Background: The Pilot Plan of National Centralized Volume-Based Procurement (NCVBP) was adopted to cope with the rapid increase in drug expenditures. This research aimed to quantitatively evaluate the impact of the NCVBP on antiviral medications for the hepatitis B virus.Methods: Data on nucleoside analogs (NAs) medications of hepatitis B virus monthly procurement records in the pilot cities from January 2018 to December 2019 were extracted from the China Drug Supply Information Platform (CDSIP). The impacts of the NCVBP on purchased volumes, expenditures, and pre-defined daily dose costs were evaluated by interrupted time-series (ITS) analysis using Stata 16.0. We constructed two segments with one interruptive point (March 2019).Results: Compared to the same period between pre-and post-intervention, the purchased volume of NAs medications were increased by 92.85%, and selected medications were increased by 119.09%. Analysis of changes in the level of NAs medication followed a decrease in purchased expenditure (coefficient: 5364.88, p < 0.001), meanwhile, the purchased volume was increased with statistical significance (coefficient:605.49, p < 0.001). The Defined Daily Dose cost (DDDc) of NAs medication followed a decrease (coefficient: 8.90, p < 0.001). The NCVBP reform was followed by an increase of 618.41 ten thousand Defined Daily Dose (DDD) (p < 0.001) in purchased volume and a reduction of 5273.84 ten thousand Chinese Yuan (CNY) (p < 0.001) in the purchased expenditure of selected medications in the level. The DDDc of selected medications decreased in the level (coefficient: 9.87, p < 0.001), while the DDDc of alternative medications increased in the slope (coefficient:0.07, p = 0.030). The purchased volume and expenditure of bid-winning products increased by 964.08 ten thousand DDD and 637.36 ten thousand CNY in the level (p < 0.001). An increase of 633.46 ten thousand DDD (p < 0.001) in purchased volume and a reduction of 4285.32 ten thousand CNY (p < 0.001) in the purchased expenditure of generic drugs in the level was observed.Conclusion: The NCVBP reduced the DDDc of NAs medication, improved the utilization of the selected medications, and promoted the usage of generic products.

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“…With the growing demand for medical care, health spending and pharmaceutical expenditure has increased rapidly over the past few decades [ 1 , 2 ]. Drug expenditure accounts for 30% of total health expenditure in China [ 3 ], far higher than that proportion in the Organization for Economic Co-operation and Development (OECD) countries [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Were economic evaluations well reported for the newly listed oncology drugs in China’s national reimbursement drug list

Liu

Jiang

et al. 2022

BMC Health Serv Res

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Purpose To assess the reporting quality of published economic evaluations of the negotiated oncology drugs listed for China’s 2020 National Reimbursement Drug List (NRDL). Methods A comprehensive search was conducted to identify economic evaluation studies of negotiated oncology drugs listed in China’s 2020 NRDL using the PubMed/MEDLINE, Embase, Web of Science, CNKI, SinoMed, and WanFang Database up to March 31, 2021. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist scored the reporting quality between 0 and 100. A linear regression analysis was employed to examine the influence of various characteristics on the reporting quality scores. Results Eighty papers were included in the study, with the majority published during the past decade. Furthermore, more than half of the articles (57.5%, or 46 out of 80) were written in English. The average CHEERS score was 74.63 ± 12.75 and ranged from 43.48 to 93.75. The most inadequately reported items included choice of model, characterization of heterogeneity, and discussion, as well as currency, price date and conversion. Higher scores were associated with articles published from 2019 to 2021 and English publications. Conclusion The economic evaluation studies of negotiated oncology drugs listed in 2020 NRDL had moderate reporting quality. The Chinese economic evaluation publications could improve the reporting quality if the CHEERS checklist is consistently implemented. Also, the Chinese journals maybe explore introducing a reporting standard for economic evaluations.

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Pharmaceutical expenditure and total health-care expenditure in OECD countries and China: bidirectional Granger causality on the basis of health level

Cited by 7 publications

References 60 publications

The Effects of the National Centralized Drug Purchasing Pilot Program on Nucleos(t)ide Analogs in Shenzhen City: An Interrupted Time Series Analysis

The Effects of the National Centralized Drug Purchasing Pilot Program on Nucleos(t)ide Analogs in Shenzhen City: An Interrupted Time Series Analysis

A quasi-experimental study of the volume-based procurement (VBP) effect on antiviral medications of hepatitis B virus in China

Were economic evaluations well reported for the newly listed oncology drugs in China’s national reimbursement drug list

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