THE IMPACT OF THE NATIONAL VOLUME-BASED PROCUREMENT (NVBP) EXCLUSIVELY FOR INSULIN ON ACCESSIBILITY AND AFFORDABILITY IN CHINA
Author(s)
Jinran Zhao, PhD, Yubei Han, PhD, Ying-dan Cao, PhD, Xiaodong Liu, PhD, Chenglong Lin, Master, jing peng, Master, weiyu Tian, Master, Sijia Song, Master, HANG REN, Master, Caijun Yang, PhD, Amna Saeed, PhD, Yu Fang, PhD.
Xi’an Jiaotong University, Xi'an, China.
Xi’an Jiaotong University, Xi'an, China.
OBJECTIVES: In May 2022, China implemented the sixth round of National Volume-Based Procurement (NVBP) exclusively for insulin, marking the first application of this policy to biologics. This study aimed to evaluate the policy’s impact on drug procurement volume, expenditure, price, and affordability.
METHODS: Monthly procurement data from 968 secondary and tertiary hospitals across 31 provincial-level regions were obtained for the period January 2021 to December 2023. Drug volume was measured by Defined Daily Doses (DDDs), expenditure by total procurement spending, and price by Defined Daily Dose cost (DDDc). Descriptive analyses compared pre‑policy and post‑policy changes in volume, expenditure, and market shares across drug categories, regions, and hospital tiers. An interrupted time‑series (ITS) analysis was employed to quantify immediate level changes and trend shifts following the May 2022 implementation, while affordability was measured using the WHO/HAI method.
RESULTS: After NVBP implementation, total insulin volume increased by 11.75%, while expenditure fell by 40.56%. Bid‑winning biosimilars demonstrated a 63.86% volume increase and a 60.81% reduction in DDDc. ITS analysis revealed a statistically significant immediate decrease in DDDc for all insulins (P<0.001), and significant immediate volume increases were observed for bid‑winning originator and biosimilar insulins (P =0.003 and P =0.002, respectively). The market share of biosimilars rose substantially, particularly in secondary hospitals. Affordability improved markedly, with the required number of days’ wages decreasing and affordable insulin products becoming available in the vast majority of provinces.
CONCLUSIONS: The insulin‑specific NVBP effectively reduced insulin costs, improved affordability, accelerated domestic biosimilar substitution, and promoted therapeutic upgrading to insulin analogs. The policy provides a replicable model for biologic procurement that simultaneously achieves cost containment and clinical optimization.
METHODS: Monthly procurement data from 968 secondary and tertiary hospitals across 31 provincial-level regions were obtained for the period January 2021 to December 2023. Drug volume was measured by Defined Daily Doses (DDDs), expenditure by total procurement spending, and price by Defined Daily Dose cost (DDDc). Descriptive analyses compared pre‑policy and post‑policy changes in volume, expenditure, and market shares across drug categories, regions, and hospital tiers. An interrupted time‑series (ITS) analysis was employed to quantify immediate level changes and trend shifts following the May 2022 implementation, while affordability was measured using the WHO/HAI method.
RESULTS: After NVBP implementation, total insulin volume increased by 11.75%, while expenditure fell by 40.56%. Bid‑winning biosimilars demonstrated a 63.86% volume increase and a 60.81% reduction in DDDc. ITS analysis revealed a statistically significant immediate decrease in DDDc for all insulins (P<0.001), and significant immediate volume increases were observed for bid‑winning originator and biosimilar insulins (P =0.003 and P =0.002, respectively). The market share of biosimilars rose substantially, particularly in secondary hospitals. Affordability improved markedly, with the required number of days’ wages decreasing and affordable insulin products becoming available in the vast majority of provinces.
CONCLUSIONS: The insulin‑specific NVBP effectively reduced insulin costs, improved affordability, accelerated domestic biosimilar substitution, and promoted therapeutic upgrading to insulin analogs. The policy provides a replicable model for biologic procurement that simultaneously achieves cost containment and clinical optimization.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
HPR39
Topic
Health Policy & Regulatory
Topic Subcategory
Procurement Systems
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity), STA: Biologics & Biosimilars