The Effects of a New Public Medicine Procurement Policy on Medicine Price in Shaanxi Province, Western China: An Interrupted Time Series Analysis

Hu, Shuchen; Chen, Chen; Yuan, Shengfang; Xue, Fei; Shi, Li; Fang, Yu; Yang, Caijun

doi:10.3389/fphar.2019.00950

Cited by 7 publications

(8 citation statements)

References 13 publications

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“…In 2015, the government price ceiling was eliminated. Starting from the second half of 2015, the bidding procedure was abolished for specific formulary of medicines ( Hu et al, 2019 ). The second and third editions of the National Essential Medicine List were issued in 2012 and 2018, with 520 and 685 generics, respectively.…”

Section: Introductionmentioning

confidence: 99%

Evaluating Price and Availability of Essential Medicines in China: A Mixed Cross-Sectional and Longitudinal Study

Yang

et al. 2020

Front. Pharmacol.

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Objectives: To evaluate the price and availability of medicines in China.Methods: A standard methodology developed by WHO and Health Action International was used to collect medicine price and availability data. We obtained cross-sectional data for 48 medicines from 519 facilities (280 public hospitals and 239 private retail pharmacies) in five provinces in China in 2018. We also collected longitudinal data for 31 medicines in Shaanxi Province in 2010, 2012, 2014, and 2018. Medicine price was compared with the international reference price to obtain a median price ratio (MPR). The availability and price in five provinces were compared in matched sets. We used general estimating equations to calculate differences in availability and median prices from 2010 to 2018.Findings: Mean availability of surveyed medicines in five provinces was low in both public (4.29–32.87%) and private sectors (13.50–43.75%). The MPR for lowest priced generics (LPGs) was acceptable (1.80–3.02) and for originator brands (OBs) was much higher (9.14–12.65). The variation was significant for both availability and price of medicines across provinces. In Shaanxi Province, the availability of medicines decreased between 2010 and 2018, but this was not significant in the public or private sector. Compared with 2010, the median adjusted patient price was significantly lower in 2018 for nine OBs (difference −22.4%; p = 0.005) and 20 LPGs (−20.5%; p = 0.046) in the public sector and 10 OBs (−10.2%; p = 0.047) in the private sector.Conclusion: Access to medicines was found to be poor and unequal across China in 2018. Future interventions are needed, and possible strategies include effective and efficient procurement, promoting the development of retail pharmacies and increasing medicine price transparency.

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Section: Introductionmentioning

confidence: 99%

Evaluating Price and Availability of Essential Medicines in China: A Mixed Cross-Sectional and Longitudinal Study

Yang

et al. 2020

Front. Pharmacol.

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“…Learning from the qualitative analysis, the implementation of volume-price contracts made a contribution to explain this finding. According to the theory of economies of scale, this new collective tendering and procurement arrangement for drugs generates dropped marginal costs with increased purchase volume ( 29 , 30 ). In this case, manufacturers are required to sell contracted products to hospitals at a lower price.…”

Section: Discussionmentioning

confidence: 99%

“…Two reasons are responsible for it. Firstly, the implementation of volume-price contracts made a remarkable contribution to the reduction in the cost of medicines and consumables ( 29 , 30 ). Secondly, pricing reform reduced physicians' incentives of relying on medicines and consumables sales by shifting profit margins to medical services ( 34 ).…”

Section: Discussionmentioning

confidence: 99%

Intended and unintended impacts of the comprehensive reform of urban public hospitals: A mixed-method study in Hangzhou, China

Zhang

Liu

et al. 2022

Front. Public Health

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ObjectivesPublic hospital reform is a key area in the Chinese healthcare system reform with the aim of controlling excessive growth of medical expenditures. This study aims to evaluate the impacts of two rounds of urban public hospital reforms respectively starting in 2018 and 2019.MethodA mixed-method method was conducted in Hangzhou. In the quantitative phase, monthly data covering 7 provincial, 12 municipal, and 35 district hospitals from March 2017 to June 2020 was analyzed using a panel-interrupted time-series. Thematic content analysis was conducted using qualitative data collected from 32 in-depth interviews.ResultsQuantitative data showed a considerable reduction in the proportion of drug revenue (provincial hospitals: −4.937%; municipal hospitals: −2.765%; district hospitals: −2.189%) and an increase in the proportion of consumable (provincial hospitals: β2 = 2.025; municipal hospitals: β3 = 0.206) and examinations (provincial hospitals: β2 = 1.354, β3=0.159; municipal hospitals: β2 = 1.179) revenue after the first reform. In post-reform 2, The respective instant decrease and increase in the proportion of consumable (provincial hospitals: −2.395%; municipal hospitals: −0.898%) and medical services (provincial hospitals: 2.115%; municipal hospitals: −2.604%) revenue were observed. Additionally, quantitative and qualitative data indicated inpatient expenditures dropped considerably after the reform. However, insufficient compensation for medical services and increased financial pressure on hospitals were repeatedly mentioned as unintended consequences in qualitative interviews.ConclusionsOverall, the urban public hospital reforms in China created positive effects in adjusting hospital revenue structure and constraining soaring medical expenditures. Unintended consequences remind policymakers to establish rational and dynamic compensation mechanisms for public hospitals.

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“…To analysis the changes in medicine prices in different years, the change rate of medicine was adopted to describe the speed of price change. 16 The price change rate of medicine I in year J (2015, 2016, 2017, and 2018) was calculated according to the following equation:…”

Section: Methodsmentioning

confidence: 99%

Substantial Increase in Accessibility to Essential Anticancer Medicines in Anhui, China: A Longitudinal Study

et al. 2023

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The study aimed to evaluate the change in accessibility of essential anticancer medicines, from 2015 to 2018 in a pilot province for health care reform in China. Data on access to 23 essential anticancer medicines was obtained from 6 provincial tertiary hospitals. A comprehensive analysis was applied to explore these trends. The total utilization of anticancer medicines had increased by an average of 2.57 times ( P < .001) during the study period, of which targeted anticancer medicines had the fastest growth rate of 6.45 times ( P < .001). The prices of all targeted medicines and original brands (OBs) were showing a downward trend, with the average change rate of −32% and −28% respectively (both P < .001). In contrast, the price of non-targeted medicines and lowest-price generics (LPG) increased by an average of 98% ( P < .001) and 117% ( P < .004) respectively. All targeted anticancer medicines were found to be unaffordable under this standard of this study, but the affordability of these medicines is on the rise. The study suggested positive changes in the utilization, price, and affordability of the most essential anticancer medicines. In the future, comprehensive strategies need to be conducted to further increase the affordability of targeted anticancer medicines.

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The Effects of a New Public Medicine Procurement Policy on Medicine Price in Shaanxi Province, Western China: An Interrupted Time Series Analysis

Cited by 7 publications

References 13 publications

Evaluating Price and Availability of Essential Medicines in China: A Mixed Cross-Sectional and Longitudinal Study

Evaluating Price and Availability of Essential Medicines in China: A Mixed Cross-Sectional and Longitudinal Study

Intended and unintended impacts of the comprehensive reform of urban public hospitals: A mixed-method study in Hangzhou, China

Substantial Increase in Accessibility to Essential Anticancer Medicines in Anhui, China: A Longitudinal Study

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