ArticleFrontiers in medicine2026
Drug-cost trajectories after national volume-based procurement in Chinese public hospitals: a 31-province interrupted time-series analysis.
Article in Frontiers in medicine, 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
Background: China's national volume-based procurement (NVBP) policy reduced prices for selected medicines, but national aggregate drug-cost trends are exposed to concurrent reforms and nonlinear prepolicy trajectories. We assessed public-hospital drug-cost trajectories around 2019 and explored hospital revenue structure. Methods: This uncontrolled ecological interrupted time-series study used a balanced panel of 31 province-level units from 2011 through 2024 (434 province-years). Province fixed-effects segmented regressions estimated immediate level and annual trend changes in per-encounter drug costs and drug-cost shares. Sensitivity analyses examined nonlinear and piecewise pretrends, non-drug costs as a control series, calendar-year fixed effects in drug-versus-non-drug comparative models, consumer-price-index deflation, multiple testing, and influential years. Revenue structure was described in 35 observations from 4 data-available provinces, with wild cluster bootstrap inference reported only as exploratory. Results: No primary outcome showed a clear immediate 2019 level change (all
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