国家药品价格谈判对中国靶向抗癌药物支出、用量和可及性的影响：一项中断时间序列分析。
Impacts of National Drug Price Negotiation on Expenditure, Volume, and Availability of Targeted Anti-Cancer Drugs in China: An Interrupted Time Series Analysis.
机构信息
Department of Health Policy and Management, School of Public Health, Peking University, Beijing 100191, China.
出版信息
Int J Environ Res Public Health. 2022 Apr 11;19(8):4578. doi: 10.3390/ijerph19084578.
The Chinese government has launched six rounds of national drug price negotiation since 2016 to lower the price and expand access to innovative drugs, many of which are anticancer drugs. This study aims to examine the effect of the second round of negotiation at the provincial level on the expenditure, volume, and availability of anti-cancer drugs. Procurement data at the provincial level from January 2017 to September 2018 were extracted from the China Drug Supply Information Platform (CDSIP). The volume, expenditure, and availability of three targeted anti-cancer drugs, rituximab, trastuzumab, and recombinant human endostatin (RHE), in 11 provinces that implemented the policy in September 2017 were analyzed through a controlled interrupted time series (ITS) analysis. A significant 6.0% increase (p < 0.1) in monthly average expenditure, an increase in the volume of 99.51 DDDs (defined daily doses) (p < 0.1), and a 0.24% (p < 0.1) increase in availability were observed for rituximab following the implementation of the policy. The volume and availability of rituximab increased by 949.6 DDDs (p < 0.05) and 1.56%, respectively, immediately after implementation. The availability of trastuzumab increased by 5.14% (p < 0.01) immediately after the implementation while no instant changes in expenditure and volume were observed. A 15% (p < 0.01) increase in monthly expenditure, 3673.17 DDDs increase in volume, and 0.66% increase in availability were observed after the inclusion of Trastuzumab. However, for RHE, only a 0.32% (p < 0.01) increase was observed after its inclusion. Eastern and middle provinces benefited more than western provinces. National negotiation related to the drug price significantly increased the volume and expenditure of anti-cancer drugs and improved their availability. The effect of the policy might be different across different regions and across different anticancer drugs.
中国政府自 2016 年以来已经进行了六轮国家药品价格谈判，以降低价格并扩大创新药物的可及性，其中许多是抗癌药物。本研究旨在考察省级第二轮谈判对抗癌药物的支出、数量和可及性的影响。从中国药品供应信息平台（CDSIP）提取了 2017 年 1 月至 2018 年 9 月省级采购数据。通过对照中断时间序列（ITS）分析，分析了 2017 年 9 月实施该政策的 11 个省份的三种靶向抗癌药物利妥昔单抗、曲妥珠单抗和重组人血管内皮抑制素（RHE）的月平均支出、数量和可及性。实施政策后，利妥昔单抗的月平均支出增加了 6.0%（p<0.1），使用量增加了 99.51 个限定日剂量（DDD）（p<0.1），可用性增加了 0.24%（p<0.1）。实施后，利妥昔单抗的数量和可用性分别增加了 949.6 DDD（p<0.05）和 1.56%。实施后，曲妥珠单抗的可用性立即增加了 5.14%（p<0.01），而支出和数量没有立即变化。纳入曲妥珠单抗后，每月支出增加了 15%（p<0.01），使用量增加了 3673.17 DDD，可用性增加了 0.66%。然而，对于 RHE，纳入后仅观察到 0.32%（p<0.01）的增长。东部和中部省份比西部省份受益更多。国家谈判相关的药品价格显著增加了抗癌药物的数量和支出，并提高了其可及性。该政策的效果可能因不同地区和不同抗癌药物而有所不同。
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