OBJECTIVES: This study evaluates the potential impact of Anaprazole on the health insurance fund from the perspective of health insurance administrators and decision-making departments in the next three years after Anaprazole is included in China National Reimbursement Drug List (NRDL), using 2023 as the baseline year.

METHODS: With reference to the second edition of the Budget Impact Analysis Guidelines published by the International Society for Pharmacoeconomics and Outcomes Research (ISPOR), a budget impact analysis model was established to collect and estimate the relevant parameters, and measure the expenditure of the health insurance fund from 2024 to 2026 under the two scenarios of Anaprazole before and after their inclusion in the NRDL, respectively. The target population parameters were obtained from the peptic ulcer epidemiology literature, the Global Burden of Disease database, and healthcare organization data. Market share and cost data were obtained from the China Medical Economic Information Network (MENET). Sensitivity analyses were performed on the model input parameters.

RESULTS: In Scenario 1, Anaprazole was not included in the NRDL, and the projected Medicare fund expenditures for the treatment of duodenal ulcers from 2024 to 2026 were ¥228.771million/year, ¥226.274million/year and ¥238.034million/year, respectively. In Scenario 2, assuming that Anaprazole sodium enteric-coated tablets are included in the NRDL, the increased expenditures would be ¥228.771million/year, ¥226.274 million/year, and ¥238.034million/year. The increased expenditure on health insurance accounted for 0.001957%, 0.003205% and 0.005247%. Sensitivity analysis showed that parameters such as consultation rate, prevalence of duodenal ulcer patients, and market share of PPI drugs would have some influence on the results.

CONCLUSIONS: When Anaprazole is included in the NRDL, it has less impact on the total expenditure of health insurance, and the impact on the health insurance fund can be reduced by negotiating price reductions of health insurance drugs in exchange for volume.