ArticleBMJ open2026
Impact of two consecutive rounds of National Volume-Based Procurement (NVBP) for insulin on utilisation and structure: a quasi-experimental study using interrupted time series analysis in Hubei, China.
Article in BMJ open, 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
objectivesTo examine the impacts of two consecutive rounds of the National Volume-Based Procurement (NVBP) programme for insulin on medication utilisation and structure in Hubei province, China.
designInsulin procurement records were extracted from the Hubei Provincial Drug Procurement Trading Platform from May 2020 to December 2025. Descriptive statistics and interrupted time series analysis with segmented regression were employed.
settingAll medical institutions on the Hubei Provincial Drug Procurement Trading Platform. PRIMARY OUTCOME MEASURES: Defined daily doses (DDDs), defined daily dose cost (DDDc) and procurement amount.
resultsAfter two consecutive rounds of NVBP for insulin, average monthly DDDs increased by 2.33 million and 1.80 million DDD (first and second NVBP, respectively), with growth rates of 65.47% and 30.51% (both p<0.01). Interrupted time series analysis showed a stable monthly DDD trend after the first NVBP (trend: 13 230 DDD per month, p>0.05) and a significant increase after the second (trend: 78 280 DDD per month, p<0.01). DDDc declined immediately at both intervention points (¥-4.818 and ¥-0.174, respectively; both p<0.01), with no further monthly trend thereafter. Further subgroup analysis revealed that the growth rate of consumption for insulin analogues was faster than human insulin; the growth rate of consumption for domestic enterprises was faster than imported enterprises. Tertiary, secondary and primary medical institutions all achieved significant increases in procurement volume over two consecutive procurement periods.
conclusionsThis study suggests that two consecutive rounds of the NVBP for insulin have achieved sustained price reductions accompanied by steady growth in overall procurement volume. The policy has significantly improved insulin medication utilisation patterns, sustained optimisation of the market structure and balanced development of the pharmaceutical supply.
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