The Distribution and Influential Factors Analysis of National Price-Negotiated Drugs in Medical Institutions and Pharmacies in China: A Case Study of Hyperkalemia

OBJECTIVES: To collate the medical insurance policies in different provinces in China, and describe the distribution and the impact factors of the national price-negotiated drug in medical institutions and pharmacies under different payment policies in China, taking sodium zirconium cyclosilicate (SZC) for hyperkalemia as an example.

METHODS: Policy discourse analysis was used to mine policy commonalities and tendencies in 31 provinces in China. The number of medical institutions and pharmacies were searched and calculated from the National Medical Insurance Service website. Descriptive statistics and correlation analysis were used to analyze the relationship between the distribution of SZC in institutions and medical insurance policies and per capita disposable income.

RESULTS: The policy analysis found that the dual-channel management mainly focused on medicine accessibility. Provinces varied in the mode and manner of coverage and certification standards under outpatient chronic and special critical diseases policy, most included over 20 types of illnesses. On average, 64 medical institutions were equipped with SZC for each province, with a maximum of 172 (Shandong Province) and a minimum of one (Qinghai Province). An average of 24 pharmacies were equipped with SZCs for each province, with a range of 1 to 82. Correlation analysis showed moderate and positive correlation between the number of institutions equipped with SZC and per capita disposable income. The correlation coefficients were 0.511 (P<0.01) and 0.787 (P<0.01) for the number of medical institutions and pharmacies equipped with SZC respectively. Different payment modes of the drug under the dual-channel policy in the included province affected the number of pharmacies equipped with SZC(P<0.05).

CONCLUSIONS: The economic status of the province influences the availability of designated medical institutions equipped with SZC. It is suggested that the provision of nationally price-negotiated drugs, such as SZC, should be assessed concurrently with diverse policies, requiring individual province-level consideration in China.