The Difference Between Contracted and Actual Drug Purchasing Volumes Under the Volume-Based Procurement Policy: Evidence From Shanghai, China

OBJECTIVES: To describe the difference between contracted and actual drug purchasing volumes, and investigate the influential factors under the National Drug Centralized Volume-Based Procurement (VBP) policy of China.

METHODS: Data on VBP contracted volumes and actual drug purchasing volumes were from the Shanghai Sunshine Medical Procurement Center All-In One (SMPA) for the first wave of VBP drugs along the time horizon between March 2019 and July 2023, including the succession procurement period after the end of contract. The ratios of the actual drug purchasing to contracted volume were computed for each of the four contract periods along the VBP time horizon. A multiple regression model was used to assess factors influencing the ratios, including the order of contract period, contract execution speed, and some attributes of drugs such as national essential medicine, Anatomical Therapeutic Chemical (ATC) classification, and dosage form.

RESULTS: A total of 25 first-wave VBP drugs were analyzed to compare the contracted and actual purchasing volumes of the four continuous contract periods along VBP horizon. The average ratios of the actual purchasing to contracted volume were 2.19, 1.89, 1.52, and 1.69 for the four contract periods, respectively. The difference between contracted and actual drug purchasing volumes was smaller in later contract periods compared to the start period. Rapid contract execution speed correlated with a higher ratio of actual purchasing to contracted volume. The attributes of drugs such as national essential medicine, Anatomical Therapeutic Chemical (ATC) classification, and dosage form were not found to have statistically significance.

CONCLUSIONS: The significant differences between contracted and actual drug purchasing volumes were found for the first-wave VBP drugs in China. The gradual decrease of the ratio of actual drug purchasing to contracted volume along the VBP horizon might be associated with execution speed across the contract periods.