Geographical and Temporal Variations in Availability of National Price Negotiated Novel Anticancer Drugs: A Spatial Statistical Study Based on Two Cross-Sectional Datasets in China
Author(s)
Ziqi Zhao, Bachelor, Shengwei Zhang, Undergraduate, Tao Zheng, Undergraduate, Shu Yang, PhD, Ming Hu, PhD;
West China School of Pharmacy, Sichuan University, Chengdu, China
West China School of Pharmacy, Sichuan University, Chengdu, China
Presentation Documents
OBJECTIVES: National Drug Price Negotiation (NDPN) decreased the price and increase the availability of novel anticancer drugs (NADs) nationwide in China. However, geographical variations in their availability remain concerning. This study aims to explore these variations and their changes over time and determinants using GIS and spatial statistical methods.
METHODS: Two cross-sectional datasets (the implementation date of the 6th NDPN list on January 1, 2024, and 9 months after implementation on October 1, 2024) of drug-providing institutions were collected from National Healthcare Insurance Administration platform. Drug availability was measured by the weighted supply number of drug-providing institutions per 1,000 cancer patients, including the availability in designated hospitals and designated pharmacies. Spatial distribution of drug-providing institutions was mapped using kernel density estimation (KDE). Inequality in availability was assessed using the Gini coefficient, and spatial clustering tested with Moran’s index. Multiple linear regression (OLS) and geographically weighted regression (GWR) were conducted to analyze the impact of economic development and medical development on availability.
RESULTS: 71 NADs in the 6th NDPN list were analyzed. Drug-providing institutions were more concentrated in the eastern coastal provinces in October compared to January (KDE: 1,795.90-3,120.88). Reduced inequality and increased spatial clustering were observed in both overall and hospital-based availability across provinces (Gini: 0.20-0.18; Moran’s I: 0.31-0.36). OLS and GWR models revealed a positive and increased correlation between overall and hospital-based availability and GDP per capita (OLS coef, 0.74-0.79, p < 0.002; GWR mean coef[SD], 0.73[0.12]-0.76[0.16]), and availability in designated pharmacies correlated with the number of local chain pharmacies. OLS models showed that availability was not significantly correlated with the number of local tertiary A-grade hospitals, while GWR results indicated that the correlations did exist in some western provinces.(GWR coef>0).
CONCLUSIONS: Availability of NADs spatially and increasingly clustered in the economically developed and medically advanced eastern provinces.
METHODS: Two cross-sectional datasets (the implementation date of the 6th NDPN list on January 1, 2024, and 9 months after implementation on October 1, 2024) of drug-providing institutions were collected from National Healthcare Insurance Administration platform. Drug availability was measured by the weighted supply number of drug-providing institutions per 1,000 cancer patients, including the availability in designated hospitals and designated pharmacies. Spatial distribution of drug-providing institutions was mapped using kernel density estimation (KDE). Inequality in availability was assessed using the Gini coefficient, and spatial clustering tested with Moran’s index. Multiple linear regression (OLS) and geographically weighted regression (GWR) were conducted to analyze the impact of economic development and medical development on availability.
RESULTS: 71 NADs in the 6th NDPN list were analyzed. Drug-providing institutions were more concentrated in the eastern coastal provinces in October compared to January (KDE: 1,795.90-3,120.88). Reduced inequality and increased spatial clustering were observed in both overall and hospital-based availability across provinces (Gini: 0.20-0.18; Moran’s I: 0.31-0.36). OLS and GWR models revealed a positive and increased correlation between overall and hospital-based availability and GDP per capita (OLS coef, 0.74-0.79, p < 0.002; GWR mean coef[SD], 0.73[0.12]-0.76[0.16]), and availability in designated pharmacies correlated with the number of local chain pharmacies. OLS models showed that availability was not significantly correlated with the number of local tertiary A-grade hospitals, while GWR results indicated that the correlations did exist in some western provinces.(GWR coef>0).
CONCLUSIONS: Availability of NADs spatially and increasingly clustered in the economically developed and medically advanced eastern provinces.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
HPR119
Topic
Health Policy & Regulatory
Topic Subcategory
Health Disparities & Equity
Disease
SDC: Oncology, STA: Biologics & Biosimilars