ArticleBMJ public health2026
Impacts of national volume-based procurement policy on insulin price, volume and expenditure in China: a quasi-experimental study.
Article in BMJ public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: To alleviate the diabetes economic burden, the Chinese government implemented the national volume-based procurement (NVBP) policy exclusively for insulin in May 2022. However, there is limited evidence on the impact of NVBP policy on insulin procurement prices, volumes and expenditures. Methods: We conducted an interrupted time series analysis (ITSA) to evaluate the policy's impacts on insulin procurement prices, volumes and expenditure. Quarterly data for 15 insulins were extracted from the China Medicine Economic Information database, covering 761 public hospitals in 30 provinces from Q3 2020 to Q4 2023. The intervention time of the ITSA model is Q2 2022. Insulin prices are measured using the defined daily dose (DDD) cost, while the volumes are measured using DDDs. Results: Following the NVBP implementation, all NVBP bid-winning insulin prices decreased by 51.61%, volume increased by 16.73% and expenditure decreased by 43.52%. All NVBP bid-winning insulin volumes increased by 9152.73 thousand DDDs and showed an upward trend (p<0.05). The expenditure decreased by 176.65 million Chinese yuan (CNY) (p<0.05). The prices of all six NVBP insulin groups decreased significantly, and the prices of the three NVBP insulin groups showed a downward trend (p<0.05). The volumes of all six NVBP insulin groups showed significant increases in either level or trend. Except for premixed human insulin analogues, expenditure significantly changed in level or trend in the remaining five groups (p<0.05). Individually, all 15 insulins exhibited significant price reductions, while 10 of them also showed significant increases in both volumes and expenditures. Conclusions: China's NVBP policy exclusively for insulin significantly reduced prices, increased overall volumes and lowered expenditures. These changes indicate that this policy enhances insulin utilisation and affordability, providing evidence for centralised procurement's effectiveness in mitigating diabetes-related economic burden.
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