{"title":"中国政府报销谈判后PD-1药物价格、数量和支出变化的评价：多治疗期间断时间序列分析","authors":"Hongbin Yi, Mengtian Cai, Xiaoxia Wei, Yingdan Cao, Liping Kuai, Dongyan Xu, Yue Qiu, Sheng Han","doi":"10.7189/jogh.15.04069","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Government reimbursement negotiation (GRN) is an important policy tool to increase the accessibility of drugs. In China, the impact of GRN implementation on programmed death-1 (PD-1) drugs price, procurement volume, and expenditure is unknown.</p><p><strong>Methods: </strong>This study used a multiple-treatment period interrupted time series design covering the period from the first-time recorded in Chinese Medical Economic Information database to 2022 to examine changes in hospital procurement price, volume and expenditure of PD-1 drugs after the implementation of GRN in China. Data were obtained from 698 public hospitals of 30 provinces in China.</p><p><strong>Results: </strong>A total of four PD-1 drugs have been selected in the National Reimbursement Drug List via GRN between March 2019 and 2022. After the implementation of the first-time GRN, the prices of all PD-1 drugs decreased significantly, with Camrelizumab experiencing the largest reduction in price and the largest increase in volume and expenditure. The Camrelizumab's price decreased by 1151.75 Chinese Yuan (CNY) (β<sub>2</sub> = -1151.75; 95% confidence interval (CI) = -1254.534, 1048.96), volume increased by 159.549 thousand defined daily doses (β<sub>2</sub> = 159.549; 95% CI = 119.12, 199.979) and expenditure increased by 11.172 million CNY (β<sub>2</sub> = 11.172; 95% CI = 1.653, 20.692). Following the implementation of the second-time of GRN, Sintilimab showed the largest decrease in price, with price decreased by 164.099 CNY (β<sub>4</sub> = -164.099; 95% CI = -171.867, 156.331), Tislelizumab had the largest increase in volume and expenditure, with the volume increased by 102.185 thousand defined daily doses (β<sub>4</sub> = 102.185; 95% CI = 47.862, 156.509) and expenditure increased by 4.119 million CNY (β<sub>4</sub> = 4.119; 95% CI = -3.808, 12.047).</p><p><strong>Conclusions: </strong>The GRN policy improved the accessibility and affordability of PD-1 drugs. Health insurance policy-makers need to consider the legitimate interests of PD-1 drug manufacturers while ensuring the sustainability of the basic health insurance fund.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04069"},"PeriodicalIF":4.5000,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12006830/pdf/","citationCount":"0","resultStr":"{\"title\":\"Evaluation of changes in price, volume and expenditure of PD-1 drugs following the government reimbursement negotiation in China: a multiple-treatment period interrupted time series analysis.\",\"authors\":\"Hongbin Yi, Mengtian Cai, Xiaoxia Wei, Yingdan Cao, Liping Kuai, Dongyan Xu, Yue Qiu, Sheng Han\",\"doi\":\"10.7189/jogh.15.04069\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Government reimbursement negotiation (GRN) is an important policy tool to increase the accessibility of drugs. In China, the impact of GRN implementation on programmed death-1 (PD-1) drugs price, procurement volume, and expenditure is unknown.</p><p><strong>Methods: </strong>This study used a multiple-treatment period interrupted time series design covering the period from the first-time recorded in Chinese Medical Economic Information database to 2022 to examine changes in hospital procurement price, volume and expenditure of PD-1 drugs after the implementation of GRN in China. Data were obtained from 698 public hospitals of 30 provinces in China.</p><p><strong>Results: </strong>A total of four PD-1 drugs have been selected in the National Reimbursement Drug List via GRN between March 2019 and 2022. After the implementation of the first-time GRN, the prices of all PD-1 drugs decreased significantly, with Camrelizumab experiencing the largest reduction in price and the largest increase in volume and expenditure. The Camrelizumab's price decreased by 1151.75 Chinese Yuan (CNY) (β<sub>2</sub> = -1151.75; 95% confidence interval (CI) = -1254.534, 1048.96), volume increased by 159.549 thousand defined daily doses (β<sub>2</sub> = 159.549; 95% CI = 119.12, 199.979) and expenditure increased by 11.172 million CNY (β<sub>2</sub> = 11.172; 95% CI = 1.653, 20.692). Following the implementation of the second-time of GRN, Sintilimab showed the largest decrease in price, with price decreased by 164.099 CNY (β<sub>4</sub> = -164.099; 95% CI = -171.867, 156.331), Tislelizumab had the largest increase in volume and expenditure, with the volume increased by 102.185 thousand defined daily doses (β<sub>4</sub> = 102.185; 95% CI = 47.862, 156.509) and expenditure increased by 4.119 million CNY (β<sub>4</sub> = 4.119; 95% CI = -3.808, 12.047).</p><p><strong>Conclusions: </strong>The GRN policy improved the accessibility and affordability of PD-1 drugs. Health insurance policy-makers need to consider the legitimate interests of PD-1 drug manufacturers while ensuring the sustainability of the basic health insurance fund.</p>\",\"PeriodicalId\":48734,\"journal\":{\"name\":\"Journal of Global Health\",\"volume\":\"15 \",\"pages\":\"04069\"},\"PeriodicalIF\":4.5000,\"publicationDate\":\"2025-04-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12006830/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Global Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.7189/jogh.15.04069\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Global Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.7189/jogh.15.04069","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
摘要
背景：政府报销谈判（GRN）是提高药品可及性的重要政策工具。在中国，实施GRN对程序性死亡-1 （PD-1）药品价格、采购量和支出的影响尚不清楚。方法：采用从中国医药经济信息数据库首次录入到2022年的多治疗期间断时间序列设计，考察中国实施GRN后PD-1药物的医院采购价格、数量和支出的变化。数据来自中国30个省份的698家公立医院。结果：2019年3月至2022年3月，共有4种PD-1药物通过GRN入选国家医保报销药品目录。第一次GRN实施后，所有PD-1药物的价格都有明显下降，其中Camrelizumab的价格降幅最大，数量和支出增幅最大。Camrelizumab的价格下降1151.75元人民币(β2 = -1151.75；95%可信区间(CI) = -1254.534, 1048.96)，体积增加15954.9万限定日剂量(β2 = 159.549；95% CI = 119.12, 199.979)，支出增加117.2万元(β2 = 11.172；95% ci = 1.653, 20.692)。第二次GRN实施后，辛替单抗价格降幅最大，下降164.099元(β4 = -164.099；95% CI = -171.867, 156.331)， Tislelizumab的用量和支出增加最大，用量增加了10218.5万定义日剂量(β4 = 102.185；95% CI = 47.862, 156.509)，支出增加419.9万元(β4 = 4.119；95% ci = -3.808, 12.047)。结论：GRN政策提高了PD-1药物的可及性和可负担性。健康保险决策者在确保基本健康保险基金可持续性的同时，需要考虑PD-1药品制造商的合法利益。
Evaluation of changes in price, volume and expenditure of PD-1 drugs following the government reimbursement negotiation in China: a multiple-treatment period interrupted time series analysis.
Background: Government reimbursement negotiation (GRN) is an important policy tool to increase the accessibility of drugs. In China, the impact of GRN implementation on programmed death-1 (PD-1) drugs price, procurement volume, and expenditure is unknown.
Methods: This study used a multiple-treatment period interrupted time series design covering the period from the first-time recorded in Chinese Medical Economic Information database to 2022 to examine changes in hospital procurement price, volume and expenditure of PD-1 drugs after the implementation of GRN in China. Data were obtained from 698 public hospitals of 30 provinces in China.
Results: A total of four PD-1 drugs have been selected in the National Reimbursement Drug List via GRN between March 2019 and 2022. After the implementation of the first-time GRN, the prices of all PD-1 drugs decreased significantly, with Camrelizumab experiencing the largest reduction in price and the largest increase in volume and expenditure. The Camrelizumab's price decreased by 1151.75 Chinese Yuan (CNY) (β2 = -1151.75; 95% confidence interval (CI) = -1254.534, 1048.96), volume increased by 159.549 thousand defined daily doses (β2 = 159.549; 95% CI = 119.12, 199.979) and expenditure increased by 11.172 million CNY (β2 = 11.172; 95% CI = 1.653, 20.692). Following the implementation of the second-time of GRN, Sintilimab showed the largest decrease in price, with price decreased by 164.099 CNY (β4 = -164.099; 95% CI = -171.867, 156.331), Tislelizumab had the largest increase in volume and expenditure, with the volume increased by 102.185 thousand defined daily doses (β4 = 102.185; 95% CI = 47.862, 156.509) and expenditure increased by 4.119 million CNY (β4 = 4.119; 95% CI = -3.808, 12.047).
Conclusions: The GRN policy improved the accessibility and affordability of PD-1 drugs. Health insurance policy-makers need to consider the legitimate interests of PD-1 drug manufacturers while ensuring the sustainability of the basic health insurance fund.
期刊介绍：
Journal of Global Health is a peer-reviewed journal published by the Edinburgh University Global Health Society, a not-for-profit organization registered in the UK. We publish editorials, news, viewpoints, original research and review articles in two issues per year.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
