Impact of the National Reimbursement Drug List Negotiation Policy on Accessibility of Anticancer Drugs in China: An Interrupted Time Series Study

Frontiers in Public Health

article

Hong Zhu¹  Jingmin Zhu¹  Yingyu Zhou⁵  Linghan Shan¹  Cui Li¹  Yu Cui¹  Zheng Kang¹  Mingli Jiao¹  Huan Liu¹  Lijun Gao¹  Qunhong Wu¹  Yanhua Hao¹ 

[1] Department of Health Policy, Health Management College, Harbin Medical University;Department of Social Medicine, School of Public Health, Harbin Medical University;Department of Pharmacy Administration, Humanities and Social Science College, Harbin Medical University;Department of Epidemiology and Public Health, University College London;Science and Technology Development Center;Department of Medical Procurement, The Fourth Affiliated Hospital, Harbin Medical University

关键词: accessibility;    availability;    cost;    anticancer drugs;    National Reimbursement Drug List Negotiation;    China;   

DOI  :  10.3389/fpubh.2022.921093

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Objective Since 2016, the Chinese government has been regularly implementing the National Reimbursement Drug List Negotiation (NRDLN) to improve the accessibility of drugs. In the second round of NRDLN in July 2017, 18 anticancer drugs were included. This study analyzed the impact of the NRDLN on the accessibility of these 18 anticancer drugs in China. Methods National hospital procurement data were collected from 2015 to 2019. As measurements of drug accessibility, monthly average of drug availability or defined daily dose cost (DDDc) was calculated. Interrupted time series (ITS) analysis was employed to evaluate the impact of NRDLN on drug accessibility. Multilevel growth curve models were estimated for different drug categories, regions or levels of hospitals. Results The overall availability of 18 anticancer drugs increased from about 10.5% in 2015 to slightly over 30% in 2019. The average DDDc dropped from 527.93 CNY in 2015 to 401.87 CNY in 2019, with a reduction of 23.88%. The implementation of NRDLN was associated with higher availability and lower costs for all 18 anticancer drugs. We found an increasing level in monthly drug availability (β 2 = 2.1126), which ascended more sharply after the implementation of NRDLN (β 3 = 0.3656). There was a decreasing level in DDDc before July 2017 (β 2 = −108.7213), together with a significant decline in the slope associated with the implementation of NRDLN (β 3 = −4.8332). Compared to Traditional Chinese Medicines, the availability of Western Medicines was higher and increased at a higher rate (β 3 = 0.4165 vs. 0.1108). Drug availability experienced a larger instant and slope increase in western China compared to other regions, and in secondary hospitals than tertiary hospitals. Nevertheless, regional and hospital-level difference in the effect of NRDLN on DDDc were less evident. Conclusion The implementation of NRDLN improves the availability and reduces the cost of some anticancer drugs in China. It contributes to promoting accessibility of anticancer drugs, as well as relieving regional or hospital-level disparities. However, there are still challenges to benefit more patients sufficiently and equally. It requires more policy efforts and collaborative policy combination.

【 授权许可】

CC BY