OBJECTIVES: Because of its high price, monoclonal antibody (mAb) faces challenges of market access in China. Thus, this study aimed to investigate the utilization of mAb at Grade 2 and Grade 3 hospitals located in three different regions in China, expecting to provide evidence for improving mAb accessibility.

METHODS: The CHIS database (2017) was applied in this study, which collected drug procurement data from Grade 2 and Grade 3 hospitals over 30 provinces (municipalities) in China. 18 mAb products (10 imported; 8 domestic) were included. The sales value per hospital was analyzed and compared by hospital levels and regions through ANOVA analysis.

RESULTS: In 2017, for the total sample hospitals, the average sales value per hospital was 3,916,459.95 CNY (n = 640). The average sales value per Grade 2 hospital was 694,960.35 CNY (n = 136); the average sales value per Grade 3 hospital was 4,785,753.49 CNY (n = 504); with significant difference (p = 0.001). Regarding region difference among Grade 2 hospitals, the average sales value per Grade 2 hospital was 833,700.97 CNY (eastern, n = 100), 186,035.55 CNY (middle, n = 21), and 482,517.58 CNY (western; n = 15); without statistical significance (p = 0.320). Regarding region difference among Grade 3 hospitals, the average sales value per Grade 3 hospital was 5,534,684.50 CNY (eastern, n = 328), 2,987,429.67 CNY (middle, n = 120), and 4,252,708.62 CNY (western, n = 56); without statistical significance (p = 0.235).

CONCLUSIONS: The utilization of mAb in China mainly concentrated in Grade 3 hospitals without significant region differences. Future efforts need to promote mAb access to Grade 2 hospitals.