Impacts of China’s National Price Negotiation on Innovative Cancer Drug Availability and Survival Outcomes: A Retrospective and Modeling Study
Author(s)
Yanming Lin, PhD1, Tiange Chen, MPH1, Jinyi Zhu, PhD2, Sian Tsuei, PhD3, Hongqiao Fu, PhD1.
1Peking University Health Science Center, Beijing, China, 2Vanderbilt University Medical Center, Nashville, TN, USA, 3University of British Columbia, Vancouver, BC, Canada.
1Peking University Health Science Center, Beijing, China, 2Vanderbilt University Medical Center, Nashville, TN, USA, 3University of British Columbia, Vancouver, BC, Canada.
OBJECTIVES: Ensuring the accessibility and affordability of innovative cancer drugs is a global challenge. China has implemented reimbursement-linked drug price negotiation annually since 2016, aiming to improve drug availability and patient welfare. This study evaluates the impact of this policy on innovative drugs availability and survival outcomes for nine common cancers.
METHODS: We first employed the interrupted time series (ITS) approach to quantify the effects of the drug price negotiation on the utilization and availability of innovative drugs for nine common cancers (oesophagus, stomach, colon, rectum, liver, pancreas, lung, breast, and prostate), by using sales data from the Pharmaceutical Database of China’s National Pharmaceutical Industry Information Center. We then estimated the 5-, 3-, and 1-year survival gains resulting from the price negotiation using a micro-simulation model supported by the ITS results. We calibrated the model through the Bayesian method with a stochastic optimization approach to local cancer survival data before the price negotiation.
RESULTS: The price negotiation significantly increased the availability of innovative drugs for nine common cancers. The increased availability translated into an improvement of 1.36 percentage points (pp) in 5-year survival for Chinese patients diagnosed with one of the nine common cancers in 2019. Patients with lung, breast, and prostate cancers experienced the greatest gains, with 5-year survival gains of 1.89 pp (95% UI: 0.80-3.29), 3.12 pp (95% UI: 1.31-6.39), and 3.41 pp (95% UI: 1.11-6.44), respectively. By contrast, the impacts of expanded innovative drug availability on patients with oesophagus, stomach, colon, rectal, liver, and pancreatic cancers were relatively modest. Significant gains with similar patterns were observed for 3- and 1-year survival estimates.
CONCLUSIONS: Drug price negotiation can significantly improve the availability of innovative cancer drugs and patients’ survival outcome. Other countries, especially low- and middle-income countries, can learn from China’s experience to enhance drug availability and improve patient welfare.
METHODS: We first employed the interrupted time series (ITS) approach to quantify the effects of the drug price negotiation on the utilization and availability of innovative drugs for nine common cancers (oesophagus, stomach, colon, rectum, liver, pancreas, lung, breast, and prostate), by using sales data from the Pharmaceutical Database of China’s National Pharmaceutical Industry Information Center. We then estimated the 5-, 3-, and 1-year survival gains resulting from the price negotiation using a micro-simulation model supported by the ITS results. We calibrated the model through the Bayesian method with a stochastic optimization approach to local cancer survival data before the price negotiation.
RESULTS: The price negotiation significantly increased the availability of innovative drugs for nine common cancers. The increased availability translated into an improvement of 1.36 percentage points (pp) in 5-year survival for Chinese patients diagnosed with one of the nine common cancers in 2019. Patients with lung, breast, and prostate cancers experienced the greatest gains, with 5-year survival gains of 1.89 pp (95% UI: 0.80-3.29), 3.12 pp (95% UI: 1.31-6.39), and 3.41 pp (95% UI: 1.11-6.44), respectively. By contrast, the impacts of expanded innovative drug availability on patients with oesophagus, stomach, colon, rectal, liver, and pancreatic cancers were relatively modest. Significant gains with similar patterns were observed for 3- and 1-year survival estimates.
CONCLUSIONS: Drug price negotiation can significantly improve the availability of innovative cancer drugs and patients’ survival outcome. Other countries, especially low- and middle-income countries, can learn from China’s experience to enhance drug availability and improve patient welfare.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HPR118
Topic
Clinical Outcomes, Economic Evaluation, Health Policy & Regulatory
Topic Subcategory
Pricing Policy & Schemes, Reimbursement & Access Policy
Disease
Oncology