Presentation (CTI)

OBJECTIVES: Since its inception in 2017, National Drug Price Negotiation (NDPN) of China has served as a crucial mechanism for the strategic procurement of innovative drugs to enhance their affordability, with pediatric drugs representing a key and prioritized area. This study aims to evaluate the affordability of pediatric drugs in the National Reimbursement Drug List (NRDL) from 2017 to 2024, with the goal of providing insights for health policymakers.
METHODS: Pediatric drugs in this study were classified as either Co-use Medicine for Adults and Children (CMAC) or Child-Specific Medicine (CSM). Referring to the WHO/HAI standard methodology, our study firstly figured out the cost per DDD (DDDc) using negotiated prices from the YaoZH Database and defined daily doses (DDD) values from the WHO ATC/DDD Index or drug package inserts. Then we estimated Out-of-pocket (OOP) of each drug for patients after reimbursement based on median reimbursement rates for urban employees and for rural/urban residents in China. Affordability was defined as the proportion of annual household disposable income required for one year of treatment, with a ratio of ≤1 been considered affordable.
RESULTS: Among the 621 national negotiated drugs (including bid drugs), 56 pediatric drugs were included, comprising 33 CMACs and 23 CSMs. The mean (SD) DDDc for CSMs was RMB 76.30 (137.06), significantly lower than that for CMACs at RMB 257.87 (530.34) (p<0.05). Reimbursement rates ranged from 65%-85% (median 80%) for employees and 50%-80% (median 70%) for residents through policy analysis. After reimbursement, mean (SD) OOP of pediatric drugs was RMB 36.66 (85.96) for employees and RMB 54.99 (127.78) for residents. Reimbursement increased the number of affordable drugs from 40 (71.43%) to 53 (94.64%), 12 of which were CMACs.
CONCLUSIONS: The NDPN policy has substantially reduced prices for novel drugs and improved the affordability of pediatric treatments, notably for CMACs.