Evidence map›Paper›PMID 38951849›Full record

ArticleBMC health services research2024

The vacated space of volume/price of the drugs centralized procurement with quantity in secondary and above public hospitals of China.

Jingliang Wang, Siyu Zhang, Canghong Wang, Jun Li, Rui Wang, Liang Zhu

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Article in BMC health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

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11citing papers in PubMed
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11 citing papers in PubMed.

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5 · Who and what money

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6 authors.

Jingliang Wang *Department of Health Service Management and Medical Education, School of Public Health, Air Force Medical University, Xi'an, 710032, Shaanxi, China.
Siyu Zhang *Department of Health Service Management and Medical Education, School of Public Health, Air Force Medical University, Xi'an, 710032, Shaanxi, China.
Canghong Wang *Xi'an Peihua University, Xi'an, Shaanxi, 710125, China.
Jun Li *Department of Burns and Cutaneous Surgery, The First Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi, 710032, China.
Rui WangArchives Room, Air Force Medical University, Xi'an, Shaanxi, 710032, China.
Liang ZhuDepartment of Health Service Management and Medical Education, School of Public Health, Air Force Medical University, Xi'an, 710032, Shaanxi, China. Liangjulia0317@163.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn 2018, the National Centralized Drug Procurement (NCDP) policy has been implemented in 11 provinces, and promoted across the country in 2019. The main feature of the policy is "volume for price", therefore, it is necessary to measure the price relationship, not only to reduce the price of drugs, reduce the burden of patients' medical costs, but also facilitate pharmaceutical companies to access enough innovation incentives. The aim of this study was to assess the vacated space effect of the drug centralized procurement by national organizations in exchange of price for quantity.

methodsA difference-in-differences (DID) model was employed to analyze the effect of the 4 + 7 pilot drugs centralized purchasing policy on drug sales volume and selected versus clinically substitutable unselected varieties, using observational data from 2018 to 2019. We compared drug procurement data between secondary and above public hospitals in pilot and non-pilot cities throughout China.

resultsThe study showed that the average treatment effect (ATE) of sales in the in-hospital market for the selected supply varieties in centralized purchasing is -0.42, and with a sales volume of 0.49. This indicates a volume-price vacated space of 1.16 ~ 1.17 DDD (defined daily dose)/Yuan, implying that for every 1 defined daily dose (DDD) increase in reported volume, the standardized price decreased by 1.16-1.17 Yuan. The ATE of in-hospital market sales for drugs not selected in centralized procurement shows a decrease of 0.13. This finding highlights the presence of the price linkage effect. The ATE of sales volume is 0.57, indicating a volume-price space of 4.38 ~ 4.39 DDD/Yuan for unselected drugs, approximately 3.75 higher relative to that of the selected ones.

conclusionsThe ratio of the volume-price space of clinically substitutable unselected and selected drugs may serve as direct evidence for evaluating the shift from centralized purchasing of drug varieties to clinically substitutable other ones. To strengthen the volume-based negotiation approach and maximize the effectiveness of centralized purchasing policies, we recommend the strategic implementation of a three-tiered centralized purchasing system, the expansion of drug coverage, and the introduction of relevant constraints and incentives.

Indexed as

Drug CostsHospitals, PublicChinaHumansPurchasing, HospitalDifference in differenceExchange a sales volume for a priceNational Centralized Drug Procurement policy

Identifiers

PMID38951849
PMCPMC11218069

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.