Study on the Effects of National Volume-Based Procurement of Chemical Drugs on Chinese Patent Medicines: Lipid-Lowering Drugs as an Example

Zhao Yang, Xiao Han, Pei Liang, Xiaoting Zhao, Qiyun Zhu, Hui Ye, Chao Yang, Bin Jiang
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Abstract

Background

Atherosclerotic cardiovascular disease remains the leading cause of death worldwide. This study aims to explore the impact of national volume-based procurement (NVBP) on Chinese patent medicines and provide evidence for improving policies and promoting rational drug use.

Methods

The study was based on data from the China National Health Insurance Agency that spanned January 2019 to December 2020. Descriptive analysis was conducted using volume and expenditure as variables. Interrupted time series analysis was applied to further analyze Chinese patent medicines.

Results

The unit prices of atorvastatin and rosuvastatin decreased by 25%–96%, whereas the prices of Zhibitai and Xuezhikang fluctuated slightly. The affordability is measured as the monthly expenditure on treatment divided by the daily wage. After policy implementation, the affordability of atorvastatin and rosuvastatin improved from 0.242 to 0.014 and from 0.247 to 0.019, respectively. The defined daily doses (DDDs) for atorvastatin and rosuvastatin also increased, whereas total expenditures decreased in hospitals of all levels. Both at the national level and at all levels of hospital, the policy had no significant impact on expenditures for Zhibitai and Xuezhikang and their defined daily doses.

Conclusions

The NVBP saved costs in the short term by incorporating high-quality, widely used lipid-lowering drugs. Notably, the policy impacted lipid-lowering chemical drugs, whereas Chinese patent medicines remained largely unaffected. Doctors' use of Chinese patent medicines did not decline, highlighting the clinical specificity of these medicines.

Abstract Image

化学药品国家批量采购对中成药的影响研究——以降脂药为例
背景动脉粥样硬化性心血管疾病仍然是世界范围内死亡的主要原因。本研究旨在探讨国家批量采购对中成药的影响,为完善政策、促进合理用药提供依据。该研究基于中国国家健康保险局2019年1月至2020年12月的数据。以数量和支出为变量进行描述性分析。采用中断时间序列分析对中成药进行进一步分析。结果阿托伐他汀和瑞舒伐他汀的单价下降幅度在25% ~ 96%之间,止必泰和血脂康的单价波动较小。可负担性的衡量标准是每月治疗支出除以每日工资。政策实施后,阿托伐他汀和瑞舒伐他汀的可负担性分别从0.242提高到0.014和0.247提高到0.019。阿托伐他汀和瑞舒伐他汀的限定日剂量(DDDs)也有所增加,而各级医院的总支出则有所下降。在国家层面和各级医院,该政策对止痹泰、血致康及其限定日剂量的支出均无显著影响。结论NVBP采用高质量、广泛使用的降脂药物可在短期内节省成本。值得注意的是,该政策影响了降脂化学药物,而中成药基本上没有受到影响。医生对中成药的使用没有下降,突出了中成药的临床特异性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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