Impacts of National Drug Price Negotiation on Type 2 Diabetes Drugs Price, Volume, and Spending in China

OBJECTIVES: Diabetes imposes a significant disease burden worldwide, with the majority of cases being diabetes mellitus type 2 (T2DM). China attempted to reduce the prices of T2DM drugs through national drug price negotiation (NDPN). Previous studies have focused more on the impact of NDPN on anti-cancer drugs rather than on chronic disease drugs. Therefore, this research aimed to explore the policy effects of NDPN on the price, volume, spending, and usage share of T2DM drugs.

METHODS: All GLP-1RA and SGLT2i drugs marketed in China by 2020 were selected samples, including seven types of GLP-1RA and four types of SGLT2i. Purchasing data from an eastern province between 2018 and 2021 was used. The outcome indicators were defined daily doses (DDDs), defined daily cost (DDC), and expenditure. Single-group interrupted time series (ITS) models and multiple-treatment-period ITS models were used to figure out impacts of NDPN.

RESULTS: After NDPN, the average reduction of DDC for GLP-1RA and SGLT2i was 60.79% and 68.61%. There was a significant increase in the usage share of negotiated drugs after NDPN, replacing same-indication drugs. After the implementation of NDPN 2019, the total purchasing volume of GLP-1RA increased by 13,344.54 DDDs immediately (p=0.007), and by 9,278.42 DDDs per month (p<0.001). The total purchase volume of GLP-1RA after NDPN 2020 and SGLT2i after NDPN 2019 also increased. After the second intervention in GLP-1RA and the intervention in SGLT2i, their spending increased by US$252,954.8 (p<0.000) and US$216,244.4 immediately (p=0.022), and by US$49,136.7 (p<0.001) and US$118,818.9 (p<0.001) per month. However, there was no immediate increase in spending of GLP-1RA after the 2019 NDPN. Similar results were also shown with each individual sample drug.

CONCLUSIONS: NDPN on T2DM drugs has reduced prices and enhance accessibility, similar to the impacts on anti-cancer drugs. It is suggested that China should further implement regular NDPN for chronic disease drugs.