Impacts of National Volume-Based Procurement Policy on Prices of Non-Winning Drugs in China: An Interrupted Time Series

OBJECTIVES: The national volume-based procurement (NVBP) policy is one key measure of healthcare reform with success of decreasing patients’ economic burden and strengthening rational allocation of medical resources. We aimed to reveal the impacts of NVBP on drug prices of non-winning drugs.

METHODS: Procurement data of 12 diabetic medicines were extracted from the national drug procurement database, including all dosages and specifications of each drug nationwide from January 2020 to September 2023. The weighted average price of each drug was measured. An interrupted time series analysis was performed to estimate policy impacts on the price of non-winning drugs.

RESULTS: In accordance with drug classification on formulations, specifications, and certificates, 33 categories of medicines were included. The price of 26 drugs (78.8%) decreased significantly, with 20 drugs (76.9%) showing an immediate average decrease of 17.2% (𝛽₂<0.05) at the time point of policy implementation. The price of repaglinide (tablet, 30mg) showed the greatest decrease of 145.2% (𝛽₂= 0.291, p<0.05), which increased to 207.2% 1-year post-policy (𝛽₃= 0.002, p<0.05). After 1-year implementation of NVBP, the greatest price reduction occurred in drugs with different specifications (29.5% of reduction), followed by the prices of drugs with different formulations (6.1% of reduction) and certificates (26.4% of reduction).

CONCLUSIONS: The winning bidders in NVBP has significant price impacts on the non-winning drugs. The prices of majority non-winning drugs decreased dramatically after implementation of NVBP in China.