Hospital Procurement Behaviors and Prices of Non-Winning Diabetic Medicines: An Evaluation of the National Volume-Based Procurement Policy in China

OBJECTIVES: The National Volume-Based Procurement (NVBP) policy is an important measure for regulating pharmaceutical prices, employing a "volume-based pricing" strategy to obtain high-quality drugs at lower prices. We aimed to explore the impacts of NVBP policy on hospital procurement behaviors and prices of non-winning drugs.

METHODS: We used procurement data for 14 diabetic medicines from the National Drug Centralized Procurement Platform in 2020-2023. To examine procurement behaviors of hospitals, the amount and proportion of expenditures on non-winning drugs were utilized. Defined Daily Drug Cost (DDDc) was applied to explore the price variations of non-winning drugs.

RESULTS: Expenditures on diabetic medicines deceased from CNY25.1 billion in 2020 to CNY6.2 billion in 2023. The proportion of expenditures on non-winning drugs dropped from 75.5% in 2020 to 47.8% in 2023. The expenditures of non-winning drugs with same formulations and specifications as winning drugs accounted for 65.35% of the entire expenditures, which increased to 71.65% after 1-year policy implementation. Monthly expenditures on drugs that passed generic quality consistency evaluation (GQCE) decreased from CNY0.3 billion before the policy to CNY0.1 billion after the policy, making the greatest reduction of 56.9% (p<0.05).And those are followed by originator brand drugs and GQCE-unpassed drugs with decreases of 33.0% (p<0.05) and 18.7% (p<0.05), respectively. Before and after the policy, the average of DDDc decreased from 5.2 to 4.2 for 84.6% of non-winning drugs, particularly in 88.9% of GQCE-passed drugs. The prices of 84.62% of non-winning originator brand drugs declined, with acarbose (100mg, tablet) to be the highest (89.9% of reduction).

CONCLUSIONS: The hospital procurement behaviors and prices of non-winning drugs changed dramatically after the implementation of NVBP, in terms of the procurement expenditures and patients’ economic burden of non-winning drugs.