Monitoring Drug Volume-Based Procurement in Shanghai, China: A Data-Driven Situation Analysis

OBJECTIVES: To explore the data-driven situation of the monitoring of drug volume-based procurement (VBP) implementation in Shanghai, China.

METHODS: Literature review and key informant interview were used to develop the monitoring model framework and indicator system. The data-driven situation of VBP monitoring including the issues of data infrastructure were investigated through the empirical analysis based on data of first to seventh round of VBP and post-contract procurement in Shanghai, China.

RESULTS: Four key dimensions with specific indicators were identified for the VBP monitoring model framework, say, price monitoring, procurement supply monitoring, clinical utilization monitoring, and safety and quality monitoring. Price monitoring focused on price differentials around tender drug price and abnormal price fluctuations along the VBP implementation. Procurement supply monitoring examined the level and change of supply volume in addition to price monitoring. Clinical utilization monitoring described the drug use and expenditures in clinical settings. Safety and quality monitoring surveyed quality non-compliance and adverse events of VBP drugs.

Our investigation based on empirical analysis of VBP data showed some gaps to narrow regarding the development of data-driven nature of monitoring and associated data infrastructure. Firstly, data from different procurement periods were fragmented, preventing effective data linkage and leading to problems of missing fields. Secondly, monitoring may lag to some extent because of the necessity of adequate length of time-series data. Thirdly, data concerning clinical utilization of tender drugs were stored in hospital islanding from the current agency in charge of VBP. And fourthly, the data after VBP contract period challenged a consistent analysis because of the diverse post-contract policies across different provinces.

CONCLUSIONS: Although the monitoring of key VBP implementation issues could be overall possible with the above four-dimension monitoring framework, the data-driven situation of monitoring and related data infrastructure development are to be substantially enhanced.