The impacts of national centralized drug procurement policy on drug utilization of medical institutions: an empirical study in a county-level hospital in China

Haoye Li; Fanyu Lin; Rui Wang; Chenxuan Zhu; Keyao Cao; Yu Chen; Gang Fang; Jiaming Li; Jinxi Ding; Wei Li

doi:10.1186/s12913-024-10964-7

The impacts of national centralized drug procurement policy on drug utilization of medical institutions: an empirical study in a county-level hospital in China

BMC Health Serv Res. 2024 Apr 24;24(1):513. doi: 10.1186/s12913-024-10964-7.

Authors

Haoye Li^#¹, Fanyu Lin^#¹, Rui Wang¹, Chenxuan Zhu¹, Keyao Cao¹, Yu Chen¹, Gang Fang¹, Jiaming Li¹, Jinxi Ding^#^{2

3}, Wei Li^#^{4

5}

Affiliations

¹ School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China.
² School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China. jinxi_ding@163.com.
³ Pharmaceutical Market Access Policy Research Center, China Pharmaceutical University, Nanjing, China. jinxi_ding@163.com.
⁴ School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China. cpuliwei@cpu.edu.cn.
⁵ Pharmaceutical Market Access Policy Research Center, China Pharmaceutical University, Nanjing, China. cpuliwei@cpu.edu.cn.

^# Contributed equally.

Abstract

Purpose: Under the background of the regular implementation of the National Centralized Drug Procurement (NCDP) policy, this study aimed to assess the impacts of the NCDP policy on drug utilization of county-level medical institutions, and probe into the influencing factors of the changes in drug utilization.

Method: A pre-post study was applied using inpatient data from a county-level medical institution in Nanjing. Drug utilization behavior of medical institutions of 88 most commonly used policy-related drugs (by generic name, including bid-winning and bid-non-winning brands) was analyzed, and the substitution of bid-winning brands for brand-name drugs after policy intervention was evaluated.

Results: After policy intervention, 43.18% of policy-related drugs realized the substitution of bid-winning brands for bid-non-winning brands (6.82% of complete substitution, 36.36% of partial substitution). Meanwhile, 40.90% of policy-related drugs failed to realize brand substitution. Multiple factors affected brand substitution, including: (1) Policy effect: brand substitution was more obvious after the intervention of the first and third round of NCDP. (2) Drug market competition: the greater the price reduction of bid-non-winning brands, the more the drugs for the same indication, the more likely that medical institutions keep using the same brands as they did before policy intervention. (3) Previous drug utilization of medical institutions: brand substitution was more obvious in drugs with large number of prescriptions and weak preference for brand-name drugs.

Conclusion: The NCDP policy promoted the substitution of bid-winning brands for bid-non-winning brands. However, the NCDP policy remained to be further implemented in county-level medical institutions. Policy implememtation efforts, drug market competition and drug utilization of medical institutions would affect the implementation of the NCDP policy.

Keywords: County-level hospital; Drug utilization; Influencing factors; National centralized drug procurement policy.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

China
Drug Utilization* / statistics & numerical data
Health Policy
Hospitals, County / statistics & numerical data
Humans