Effects of China's National Volume-Based Procurement policy on utilisation and affordability of statins in children: an interrupted time series analysis.

چکیده اصلی

BACKGROUND: Statins are effective in lowering lipids and reducing cardiovascular risk. In recent decades, rising paediatric lipid levels, especially in low- and middle-income countries (LMICs), have led to growing demand for lipid-lowering drugs. However, access remains limited in LMICs due to financial constraints. To address this, China launched its National Volume-Based Procurement (NVBP) policy in 2019, significantly improving the price and affordability of statins. This study evaluates the policy's impact on statin use and expenditures in children. METHODS: The study used interrupted time series regression to analyse all levels of children's hospitals across the country's monthly procurement records of statins, covering the period from January 2019 to December 2020. It investigated the fluctuations in monthly drug procurement quantity (measured in defined daily doses) and expenditures (affordability) at both the national level and across different tiers of child medical facilities. RESULTS: Following the implementation of the NVBP policy, the utilisation and affordability of statins across all children's hospitals nationwide exhibited a positive upward trend. After the NVBP policy, the affordability of atorvastatin in children's hospitals nationwide improved by at least 90.54% and the affordability of rosuvastatin in children's hospitals nationwide increased by no less than 89.85%. Both before and after the NVBP policy, the majority of utilisation and expenditure in statin was contributed by atorvastatin and rosuvastatin. After the NVBP policy, the utilisation of atorvastatin and rosuvastatin bid-winning generic has increased significantly, making bid-winning generic change from the variety occupying the least market to the variety occupying the most market in children's hospitals. CONCLUSION: The implementation of China's NVBP policy has resulted in a marked increase in the dosage of atorvastatin and rosuvastatin, while effectively reducing cost expenditure for children. This achievement has been realised without compromising the quality of healthcare services. China's NVBP policy provides a reference and path for the medical reform of all countries in the world especially LMICs.

متن کامل اصلی