EVALUATING THE DUAL-CHANNEL POLICY FOR INNOVATIVE ANTI-TUMOR DRUGS IN CHINA: EVIDENCE FROM POPULATION-LEVEL CLAIMS IN CITY A
Author(s)
Jingyi Hu, M.D.1, zhao zhan, M.D.2, zixuan lyu, M.D.3, Yue-hua Liu, PhD4, Jian Wang3;
1Wuhan University, Wuhan, Hubei, China,, Wuhan, China, 2Wuhan University, Wuhan, Hubei, China,, WU HAN, China, 3Wuhan university, wuhan, China, 4China National Health Development Research Center, Beijing, China, Beijing, China
1Wuhan University, Wuhan, Hubei, China,, Wuhan, China, 2Wuhan University, Wuhan, Hubei, China,, WU HAN, China, 3Wuhan university, wuhan, China, 4China National Health Development Research Center, Beijing, China, Beijing, China
OBJECTIVES: In May 2021, China implemented the dual-channel policy, allowing both designated hospitals and contracted retail pharmacies to dispense reimbursable anti-tumor innovative drugs. The policy aims to enhance drug accessibility and affordability amid rising costs of innovative oncology treatments. Using health insurance reimbursement records for all oncology patients in City A from January 2018 to June 2024 (22,081 oncology patients generating 1,496,535 cancer-related reimbursement records), this study evaluated the policy’s impact on innovative drug utilization, channel distribution, and patient economic burden.
METHODS: Reimbursement records for targeted therapies and immunotherapies were identified and aggregated into monthly time series. Five indicators were analyzed: (1) proportion of oncology patients using innovative drugs, (2) number of pharmacy innovative drug buyers, (3) pharmacy share of purchase frequency, (4) out of pocket (OOP) cost per buyer, and (5) OOP share per buyer. Interrupted time series analysis estimated the pre policy trend (β₁), immediate change (β₂) and post policy trend change (β₃).
RESULTS: The reform significantly mobilized the pharmacy channel. The share of innovative drug purchases at pharmacies showed a significant immediate increase β₂=0.471, p<0.05) and a sustained upward trend (β₃=0.118, p<0.001). Similarly, the monthly number of patients purchasing these drugs at pharmacies trended upward (β₃=0.043, p<0.001). However, the overall proportion of cancer patients using innovative drugs decreased immediately β₂=-0.115, p<0.05) and showed a downward trend (β3=-0.010, p<0.001) post-reform. Regarding affordability, while the OOP share initially spiked (β₂=0.282, p<0.001), the post-reform period exhibited significant downward trends for both OOP expenses per buyer (β₃=-0.022, p<0.001) and the OOP share (β₃=-0.013, p<0.001).
CONCLUSIONS: The dual-channel policy successfully expanded retail pharmacy access and reduced patient OOP costs. However, overall innovative drug utilization growth slowed post-policy, possibly due to early demand release, market saturation among eligible patients, or concurrent national pricing negotiations. Sustained implementation and monitoring are needed to maintain long-term access and affordability.
METHODS: Reimbursement records for targeted therapies and immunotherapies were identified and aggregated into monthly time series. Five indicators were analyzed: (1) proportion of oncology patients using innovative drugs, (2) number of pharmacy innovative drug buyers, (3) pharmacy share of purchase frequency, (4) out of pocket (OOP) cost per buyer, and (5) OOP share per buyer. Interrupted time series analysis estimated the pre policy trend (β₁), immediate change (β₂) and post policy trend change (β₃).
RESULTS: The reform significantly mobilized the pharmacy channel. The share of innovative drug purchases at pharmacies showed a significant immediate increase β₂=0.471, p<0.05) and a sustained upward trend (β₃=0.118, p<0.001). Similarly, the monthly number of patients purchasing these drugs at pharmacies trended upward (β₃=0.043, p<0.001). However, the overall proportion of cancer patients using innovative drugs decreased immediately β₂=-0.115, p<0.05) and showed a downward trend (β3=-0.010, p<0.001) post-reform. Regarding affordability, while the OOP share initially spiked (β₂=0.282, p<0.001), the post-reform period exhibited significant downward trends for both OOP expenses per buyer (β₃=-0.022, p<0.001) and the OOP share (β₃=-0.013, p<0.001).
CONCLUSIONS: The dual-channel policy successfully expanded retail pharmacy access and reduced patient OOP costs. However, overall innovative drug utilization growth slowed post-policy, possibly due to early demand release, market saturation among eligible patients, or concurrent national pricing negotiations. Sustained implementation and monitoring are needed to maintain long-term access and affordability.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
HPR112
Topic
Health Policy & Regulatory
Topic Subcategory
Reimbursement & Access Policy
Disease
SDC: Oncology