Utilization and Determinants of Anticancer Drugs Under China's National Drug Price Negotiation Policy.

Abstract

Purpose: The Chinese government began to take national drug price negotiation (NDPN) in 2016, aiming to enhance the accessibility and affordability of anticancer drugs. This study aims to assess the utilization and influence factors of anticancer drugs under NDPN policy in China.

Patients and methods: Gastric cancer patients within chemotherapy were included. Independent variables were measured by age, gender, insurance type, total medical expenditure (THE), length of stay (LOS), drug-to-total-expense ratio (DTR). The primary outcomes were negotiated drugs usage, costs and treatment outcome. Two-part model was used to identify influence factors of anticancer drugs utilization. Propensity Score Matching (PSM) was employed to evaluate the impact of negotiated drug utilization on treatment outcomes among inpatients.

Results: The sample included 9868 gastric cancer patients from three cities. Outpatient patients demonstrated limited utilization of negotiated drugs (1.33%). Patients aged 61-75 (β=0.923, P < 0.01) and over 75 years (β=0.946, P < 0.05) were more likely to use negotiated drugs. Key factors influencing inpatient drug utilization included medical insurance type (β=-0.245, P<0.01), LOS (β=-0.122, P<0.001), and the DTR (=0.037, P<0.001). The use of negotiated drugs had no significant effect on treatment outcomes.

Conclusion: Their limited utilization of negotiated drugs for outpatients arises an urgent necessity for more comprehensive insurance coverage, and the no significant outcome effect dedicated the importance to rigorously validate the effectiveness of these drugs with abundant real-world evidence in the foreseeable future.