Affordability of Original and Generic Antihypertensive Drugs Under the National Centralized Drug Procurement Policy and Basic Medical Insurance System: A Cross-Sectional Survey in Xi’an, China

IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Yamin Zou, Jing Mao, Yalin Dong, Luting Yang, Weihua Dong, Yan Hao
{"title":"Affordability of Original and Generic Antihypertensive Drugs Under the National Centralized Drug Procurement Policy and Basic Medical Insurance System: A Cross-Sectional Survey in Xi’an, China","authors":"Yamin Zou,&nbsp;Jing Mao,&nbsp;Yalin Dong,&nbsp;Luting Yang,&nbsp;Weihua Dong,&nbsp;Yan Hao","doi":"10.1155/ijcp/4355310","DOIUrl":null,"url":null,"abstract":"<div>\n <p>Chinese government had implemented 8 rounds of National Centralized Drug Procurement (NCDP) in mainland China from 2019 to 2023. The purpose of this study is to assess the affordability profile and variation of policy-related antihypertensive drugs in the context of NCDP, generic substitution, and basic medical insurance policy pre-NCDP (in 2018) and post-NCDP (in 2023) in Xi’an. The affordability of 34 NCDP policy-related drugs, including 17 bid-winning generic drugs (GDs) in the NCDP list and 17 originator brands (OBs) containing the same ingredients with these GDs, was analyzed and compared, respectively, by the standard survey method of World Health Organization and Health Action International (i.e., the ratio of monthly out-of-pocket expenditure to minimum daily wage standard). Under pre-NCDP policy, the monthly out-of-pocket drug cost of all OBs and 10 GDs was more than 1 day’s wage and was unaffordable. Under post-NCDP policy, the affordability of all drugs was improved dramatically; for uninsured patients, 11 OBs and only GD (lercanidipine tablets) were still unaffordable; for patients with Urban Employee Basic Medical Insurance, all of OBs and GDs were affordable, and for patients with Urban and Rural Residents Basic Medical Insurance, 7 OBs were unaffordable, and all of GDs was considered affordable. The implementation of the NCDP policy had remarkably enhanced affordability of selected drugs. GDs are more affordable than OBs. There was obvious affordability discrepancy between outpatients with different types of medical insurance in Xi’an. To enhance affordability of antihypertensive drugs, more effective and long-term measures should be implemented, such as expanding the scope of centralized purchased drugs, promoting substitution of GDs for OBs, and increasing reimbursement of outpatient drug expenses for patients with urban and rural residents’ basic medical insurance.</p>\n </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2024 1","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/4355310","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Clinical Practice","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1155/ijcp/4355310","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0

Abstract

Chinese government had implemented 8 rounds of National Centralized Drug Procurement (NCDP) in mainland China from 2019 to 2023. The purpose of this study is to assess the affordability profile and variation of policy-related antihypertensive drugs in the context of NCDP, generic substitution, and basic medical insurance policy pre-NCDP (in 2018) and post-NCDP (in 2023) in Xi’an. The affordability of 34 NCDP policy-related drugs, including 17 bid-winning generic drugs (GDs) in the NCDP list and 17 originator brands (OBs) containing the same ingredients with these GDs, was analyzed and compared, respectively, by the standard survey method of World Health Organization and Health Action International (i.e., the ratio of monthly out-of-pocket expenditure to minimum daily wage standard). Under pre-NCDP policy, the monthly out-of-pocket drug cost of all OBs and 10 GDs was more than 1 day’s wage and was unaffordable. Under post-NCDP policy, the affordability of all drugs was improved dramatically; for uninsured patients, 11 OBs and only GD (lercanidipine tablets) were still unaffordable; for patients with Urban Employee Basic Medical Insurance, all of OBs and GDs were affordable, and for patients with Urban and Rural Residents Basic Medical Insurance, 7 OBs were unaffordable, and all of GDs was considered affordable. The implementation of the NCDP policy had remarkably enhanced affordability of selected drugs. GDs are more affordable than OBs. There was obvious affordability discrepancy between outpatients with different types of medical insurance in Xi’an. To enhance affordability of antihypertensive drugs, more effective and long-term measures should be implemented, such as expanding the scope of centralized purchased drugs, promoting substitution of GDs for OBs, and increasing reimbursement of outpatient drug expenses for patients with urban and rural residents’ basic medical insurance.

Abstract Image

求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
5.30
自引率
0.00%
发文量
274
审稿时长
3-8 weeks
期刊介绍: IJCP is a general medical journal. IJCP gives special priority to work that has international appeal. IJCP publishes: Editorials. IJCP Editorials are commissioned. [Peer reviewed at the editor''s discretion] Perspectives. Most IJCP Perspectives are commissioned. Example. [Peer reviewed at the editor''s discretion] Study design and interpretation. Example. [Always peer reviewed] Original data from clinical investigations. In particular: Primary research papers from RCTs, observational studies, epidemiological studies; pre-specified sub-analyses; pooled analyses. [Always peer reviewed] Meta-analyses. [Always peer reviewed] Systematic reviews. From October 2009, special priority will be given to systematic reviews. [Always peer reviewed] Non-systematic/narrative reviews. From October 2009, reviews that are not systematic will be considered only if they include a discrete Methods section that must explicitly describe the authors'' approach. Special priority will, however, be given to systematic reviews. [Always peer reviewed] ''How to…'' papers. Example. [Always peer reviewed] Consensus statements. [Always peer reviewed] Short reports. [Always peer reviewed] Letters. [Peer reviewed at the editor''s discretion] International scope IJCP publishes work from investigators globally. Around 30% of IJCP articles list an author from the UK. Around 30% of IJCP articles list an author from the USA or Canada. Around 45% of IJCP articles list an author from a European country that is not the UK. Around 15% of articles published in IJCP list an author from a country in the Asia-Pacific region.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信