Comparison of Generic Drug Prices Between China and the United States

OBJECTIVES: To compare the generic drug procurement prices between China and the United States (US).

METHODS: We compared generic drugs under the National Drug Centralized Volume-based Procurement (VBP) in China and the counterpart drugs with the same dosage forms and specifications procured by the major US public sectors. Drug price data of China were retrieved from public announcement of the 9 waves of VBP. We sourced US Federal Supply Schedule prices, National Contract prices, and Big4 prices from the Department of Veterans Affairs website. After calculating the average price for each generic drug, prices in China and the US were adjusted to 2023 using consumer price index (CPI), with further adjustment to US dollar price according to annual average exchange rate (AAER) and purchasing power parity (PPP), respectively. Then the price ratios of China to the US for each generic drug were calculated.

RESULTS: China has seen a total of 321 winner generics in the 9 waves of VBP tender since 2018. After screening the winner generic drugs in terms of comparable dosage forms and specifications across China and the US, 150 generics with 192 dosage forms and specifications were analyzed. The overall median price ratio was 37.9% (IQR 11.5%-113.2%) under AAER, however, the prices of 52 (27.1%) generic drugs in China were higher than that in the US. Under PPP, the overall median price ratio was 74.2% (IQR 22.5%-221.6%), while the prices of 78 (40.6%) generic drugs in China were higher than that in the US.

CONCLUSIONS: Although VBP resulted in deep cut of generic drug price, a certain number of VBP generic drugs in China still had a higher price than that in the US.