Regional Inequality on Availability of National Negotiated Anticancer Drugs in China

OBJECTIVES: The national negotiation of innovative medicines in China has dramatically decreased the costs of treatment, especially in field of anticancer medicines. The access to national negotiated medicines were pivotal to reduce patients’ economic burden and improve their life quality. We aimed to assess the availability of national negotiated anticancer medicines and regional inequality among provinces in China.

METHODS: We utilized data from the National Drug Procurement Database, which reported procurement records in all public medical institutions across 31 provinces in China. 31 national negotiated anticancer drugs in 2021 were surveyed from the period of January in 2020 to December in 2022. The Dagum Gini coefficient was applied to quantify and decompose regional inequality and its dynamic variation.

RESULTS: The availability of national negotiated innovative anticancer medicines increased dramatically from 50.33% in 2020 to 78.1% in 2022. The number of varieties equipped in 19 provinces showed a significant upward trend after national negotiations, with the availability in 9 of these provinces reaching 100% in the last quarter of the statistics. The availability of drugs for treating lung cancer is the highest (with an annual availability exceeding 45%), higher than anti-cancer drugs for other indications. The overall Gini coefficient fluctuated between 0.367 and 0.411, indicating a uptrend of inequality in the availability of negotiated anticancer drugs among provinces. The intra-group Gini coefficient denoted the greatest inequality in availability of anti-cancer drugs among provinces in the eastern region. An increasing inequality in drug availability between eastern and northeast or western regions were significant by using inter-regional Gini coefficients (0.4-0.6).

CONCLUSIONS: The availability of national negotiated anticancer drug has shown an overall upward trend across China. However, the existing regional inequality of their availability was increasing to be noteworthy.