Observational studyBMJ open2020
Impact of the zero-mark-up drug policy on drug-related expenditures and use in public hospitals, 2016-2018: an interrupted time series study in Shaanxi.
Observational study in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- The universal zero markup drug policy and gastric cancer hospitalization expenses: an analysis of trends and influencing factors in Shanghai from 2014 to 2021.BMC health services research · 2025Article
- A study on the impact of DRG payment on physicians' prescribing behavior in China: a case study of a healthcare consortium in J City.Frontiers in public health · 2025Article
- Article
- Impact of Medical-Pharmaceutical Separation Reform on Hospitalization Expenditure in Tertiary Public Hospitals: Difference-in-Difference Analysis Based on Panel Data from Beijing.Risk management and healthcare policy · 2024Article
- Risk factors for self-reported medication adherence in community-dwelling older patients with multimorbidity and polypharmacy: a multicenter cross-sectional study.BMC geriatrics · 2023Article
- Trends in pharmaceutical expenditure in the Taiwan National Health Insurance database at different hospital levels.Journal of comparative effectiveness research · 2023Article
- Evaluating the direct medical cost, drug utilization and expenditure for managing Parkinson's disease: a costing study at a medical center in China.Annals of translational medicine · 2022Article
- Intended and unintended impacts of the comprehensive reform of urban public hospitals: A mixed-method study in Hangzhou, China.Frontiers in public health · 2022Article
- The Impact of a National Stewardship Policy on the Usage Patterns of Key Monitoring Drugs in a Tertiary Teaching Hospital: An Interrupted Time Series Analysis.Frontiers in pharmacology · 2022Article
- The Impact of Sanming Healthcare Reform on Antibiotic Appropriate Use in County Hospitals in China.Frontiers in public health · 2022Observational
- Impact of zero-mark-up medicines policy on hospital revenue structure: a panel data analysis of 136 public tertiary hospitals in China, 2012-2020.BMJ global health · 2021Article
- Lowering drug prices and enhancing pharmaceutical affordability: an analysis of the national volume-based procurement (NVBP) effect in China.BMJ global health · 2021Review
- Impact of China's zero mark-up drug policy on drug cost of NCDs' outpatients: an interrupted time series analysis.BMC health services research · 2021Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe aim of this study was to measure the impact of zero-mark-up drug policy (ZMDP) on drug-related expenditures and use in urban hospitals.
designThis was a retrospective observational study of trends in drug expenses and use in the context of the ZMDP using an interrupted time series analysis.
settingTwelve hospitals (three tertiary hospitals and nine secondary hospitals) in Xi'an, which is the capital of Shaanxi Province in Western China. DATA AND
participantsThe prescription information for all outpatients and inpatients in the study hospitals from January 2016 to April 2018 was used in this study.
interventionsThe Chinese government announced the policy intervention measure of the ZMDP, which was implemented in all public hospitals as of 1 April 2017. PRIMARY MEASURES: Monthly drug expenditures, monthly medical expenditures, the percentage of drug expenditures among total medical expenditures, the average outpatient drug expenditure per visit, the percentage of prescriptions that include an injection and the percentage of prescriptions that include an antibiotic.
resultsMonthly total medical expenses increased in both tertiary and secondary hospitals after the ZMDP was implemented. In tertiary hospitals, the average outpatient drug expenditures per visit showed a slow decreasing trend before the intervention and an increasing trend after the intervention, with statistically significant changes in both the level (p<0.001) and the trend (p=0.02). Secondary hospitals showed a slow increasing trend both before and after the policy implementation, with no significant change in the trend (p=0.205). The proportion of prescriptions, including injections, was over 20% in secondary hospitals and less than 20% in tertiary hospitals, with no significant changes to this indicator observed after implementation of ZMDP.
conclusionsThe effect of the ZMDP on drug-related expenditures and use in Chinese public hospitals was not substantially evident. Future pharmaceutical reform measures should give more consideration to physician prescription behaviours.
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