Using strategic price negotiations to contain costs and expand access to medicines in China

Liu, Si; Xu, Lei; Chen, Mingsheng; Jan, Stephen

doi:10.1136/bmjgh-2019-002256

Cited by 23 publications

(20 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Though health technology assessments were a key aspect during NRDL negotiations, our results showed no association between daily costs of cancer treatment and their QALY, an essential factor in technical assessments supporting decisions in setting reimbursement and pricing [52]. China's government has strong bargaining power and plays a decisive role in price negotiations and achieving favorable prices for health systems [24]. Manufacturers would thus strategically bid with low prices in order to be considered by NRDL and to secure a market share.…”

Section: Policy Implicationsmentioning

confidence: 63%

Prices and Clinical Benefit of National Price-Negotiated Anticancer Medicines in China

Zhang

Wei

et al. 2022

PharmacoEconomics

View full text Add to dashboard Cite

Background High prices of anticancer medicines have increased the economic burden for both patients and health insurance systems. Since 2017, China has implemented national price negotiations for medicines, relying on evidence from health technology assessments. We aim to assess the relation between negotiated price and value of anticancer medicines listed in China's National Reimbursement Drug List (NRDL). Methods For all price-negotiated anticancer medicines and corresponding indications listed in the latest NRDL between 2017 and 2020, we collected their clinical outcomes data, including overall survival (OS) and progression-free survival (PFS), in supporting trials. Pearson correlation coefficient was calculated to estimate the association between the daily cost and clinical benefit of each indication. Results In total, 75 indications of 46 branded anticancer medicines were included for analysis. The median daily costs for the anticancer therapies that had gone through negotiation in 2017-2020

show abstract

Section: Policy Implicationsmentioning

confidence: 63%

Prices and Clinical Benefit of National Price-Negotiated Anticancer Medicines in China

Zhang

Wei

et al. 2022

PharmacoEconomics

View full text Add to dashboard Cite

show abstract

“…However, considering cost-effectiveness is crucial in medical decisions for physicians and policy decision-makers to reasonably allocate limited health resources. To reduce the price of medicines, the Chinese government adopted a process of centralized strategic price negotiation with pharmaceutical companies underpinned by health technology Abbreviations: AE, adverse event; CI, confidence interval; HCC, Hepatocellular carcinoma; HR, hazard ratio; ICER, incremental cost-effectiveness ratio; INHB, incremental net health benefit; INMB, incremental monetary benefit; LY, life-year; OS, overall survival; PD, progressed disease; PFD, progression-free disease; PFS, progression-free survival; WTP, willingness-to-pay; QALY, quality-adjusted life-year assessment evidence [7]. Herein, by adopting an economic modeling approach (Supplementary Materials and Methods), we report the cost-effectiveness of atezolizumab plus bevacizumab as first-line therapy for advanced HCC from the Chinese health sector perspective.…”

Section: Dear Editormentioning

confidence: 99%

Atezolizumab plus bevacizumab versus sorafenib as first‐line treatment for unresectable hepatocellular carcinoma: a cost‐effectiveness analysis

Hou

Wu²

2020

Cancer Communications

View full text Add to dashboard Cite

“…After the price negotiation, the prices of innovative medicines were reduced and some new medicines were included in the National Insurance Medicine List. Moreover, the pharmaceutical enterprises obtained the market share under the premise of ensuring their business profits (23,24). A total of 44 new medicines were included in the price negotiation, and a reduction in the price of 36 medicines was successfully negotiated.…”

Section: Introductionmentioning

confidence: 99%

Impact of the National Health Insurance Coverage Policy on the Utilisation and Accessibility of Innovative Anti-cancer Medicines in China: An Interrupted Time-Series Study

Fang

Zhu

et al. 2021

Front. Public Health

View full text Add to dashboard Cite

Objective: The study aimed to evaluate the impact of the National Health Insurance Coverage (NHIC) policy on the utilisation and accessibility of innovative anti-cancer medicines in Nanjing, China.Methods: We used the adjusted World Health Organisation and Health Action International methodology to calculate the price and availability of 15 innovative anti-cancer medicines included in the National Health Insurance drug list in 20 tertiary hospitals and six secondary hospitals in Nanjing before and after NHIC policy implementation. Interrupted time-series regression was used to analyse the changes in the utilisation of the study medicines.Results: The price reduction rates of innovative anti-cancer medicines ranged between 34 and 65%. The mean availability rate was 27.44% before policy implementation and increased to 47.33% after policy implementation. The utilisation of anti-cancer medicines suddenly increased with a slope of 33.19–2,628.39 when the policy was implemented. Moreover, the usage rate of bevacizumab, bortezomib, and apatinib significantly increased (p < 0.001, p = 0.009, and p < 0.001, respectively) after policy implementation. With regard to price reduction and medical insurance reimbursement, the medicines became more affordable after policy implementation (0.06–1.90 times the per capita annual disposable income for urban patients and 0.13–4.46 times the per capita annual disposable income for rural patients).Conclusion: The NHIC policy, which was released by the central government, effectively improved the utilisation and affordability of innovative anti-cancer medicines. However, the availability of innovative anti-cancer medicines in hospitals remained low and the utilisation of innovative anti-cancer medicines was affected by some factors, including the incidence of cancer, limitation of indications within the insurance program, and the rational use of innovative anti-cancer medicines. It is necessary to improve relevant supporting policies to promote the affordability of patients. The government should speed up the process of price negotiation to include more innovative anti-cancer medicines in the medical insurance coverage, consider including both medical examinations and adjuvant chemotherapy in the medical insurance, and increase investment in health care.

show abstract

Using strategic price negotiations to contain costs and expand access to medicines in China

Cited by 23 publications

References 3 publications

Prices and Clinical Benefit of National Price-Negotiated Anticancer Medicines in China

Prices and Clinical Benefit of National Price-Negotiated Anticancer Medicines in China

Atezolizumab plus bevacizumab versus sorafenib as first‐line treatment for unresectable hepatocellular carcinoma: a cost‐effectiveness analysis

Impact of the National Health Insurance Coverage Policy on the Utilisation and Accessibility of Innovative Anti-cancer Medicines in China: An Interrupted Time-Series Study

Contact Info

Product

Resources

About