From Price Reduction to System-Level Savings: Assessing the Ripple Effects of China's National Volume-Based Procurement Policy on Hypertension Drugs, 2020-2023
Author(s)
Mao Fu, Master1, Jin Peng, PhD2, Yifan Wu, Master2, Yue Ma, Master2, Xuelin Yao, PhD2, Minghuan Jiang, PhD2.
1Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi'an, Shaanxi Province, China, 2Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi'an, China.
1Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi'an, Shaanxi Province, China, 2Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi'an, China.
OBJECTIVES: The National Volume-Based Procurement (NVBP) policy, through its volume-price linkage mechanism, not only regulates hypertension drug prices but triggers systemic transformations in pharmaceutical expenditure containment and therapeutic substitution patterns. We aim to evaluate the economic impacts of NVBP on hypertension medications in whole China.
METHODS: We analyzed procurement data for 16 antihypertensive medications from the National Drug Centralized Procurement Platform in 2020-2023. Primary outcomes were Defined Daily Doses (DDDs) and drug expenditures, stratified by brand-name and generic drugs. The weighted average price of each drug was measured. Counterfactual scenario analysis was performed to estimate cost savings after NVBP.
RESULTS: The nationwide DDDs of brand-name drugs declined 69.9% (41.1 million in Q1 2020 vs. 12.4 million in Q3 2023), and the expenditures decreased from USD 34.9 million to USD 10.4 million. In the entire nation, the proportion of brand-name drugs on DDDs decreased from 38.2% in Q1 2020 to 9.0% in Q3 2023, with a decline of expenditures reaching 42.4% (from 63.9% to 36.9%). All 16 medicines exhibited price decline over the study period, ranging from -27.2% (calcium antagonists) to -78.3% (angiotensin-II-receptor blockers, ARBs). The prices of generic drugs decreased significantly more than those of brand-name drugs, with an average decline of 54.8% compared to a 9.8% decline for brand-name drugs. Among the various classes of drugs, generic drugs in the ARBs class showed the most pronounced price reductions, particularly candesartan and valsartan series drugs, with their generic prices decreasing by more than 50.0%. The NVBP generated USD 33.4 billion in cost savings, driven by brand-name (80.9%) and generic drugs (19.1%), especially olmesartan with the largest cost saving (USD 7387.3 million).
CONCLUSIONS: The NVBP policy generated huge cost savings, with brand-name drugs contributing a larger proportion. Future policies could persist in promoting the utilization of generic drugs and reducing the price of brand-name drugs.
METHODS: We analyzed procurement data for 16 antihypertensive medications from the National Drug Centralized Procurement Platform in 2020-2023. Primary outcomes were Defined Daily Doses (DDDs) and drug expenditures, stratified by brand-name and generic drugs. The weighted average price of each drug was measured. Counterfactual scenario analysis was performed to estimate cost savings after NVBP.
RESULTS: The nationwide DDDs of brand-name drugs declined 69.9% (41.1 million in Q1 2020 vs. 12.4 million in Q3 2023), and the expenditures decreased from USD 34.9 million to USD 10.4 million. In the entire nation, the proportion of brand-name drugs on DDDs decreased from 38.2% in Q1 2020 to 9.0% in Q3 2023, with a decline of expenditures reaching 42.4% (from 63.9% to 36.9%). All 16 medicines exhibited price decline over the study period, ranging from -27.2% (calcium antagonists) to -78.3% (angiotensin-II-receptor blockers, ARBs). The prices of generic drugs decreased significantly more than those of brand-name drugs, with an average decline of 54.8% compared to a 9.8% decline for brand-name drugs. Among the various classes of drugs, generic drugs in the ARBs class showed the most pronounced price reductions, particularly candesartan and valsartan series drugs, with their generic prices decreasing by more than 50.0%. The NVBP generated USD 33.4 billion in cost savings, driven by brand-name (80.9%) and generic drugs (19.1%), especially olmesartan with the largest cost saving (USD 7387.3 million).
CONCLUSIONS: The NVBP policy generated huge cost savings, with brand-name drugs contributing a larger proportion. Future policies could persist in promoting the utilization of generic drugs and reducing the price of brand-name drugs.
Conference/Value in Health Info
2025-09, ISPOR Real-World Evidence Summit 2025, Tokyo, Japan
Value in Health Regional, Volume 49S (September 2025)
Code
RWD200
Topic Subcategory
Distributed Data & Research Networks
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory)