Study on the Effects of National Volume-Based Procurement of Chemical Drugs on Chinese Patent Medicines: Lipid-Lowering Drugs as an Example

Abstract

Background: Atherosclerotic cardiovascular disease remains the leading cause of death worldwide. This study aims to explore the impact of national volume-based procurement (NVBP) on Chinese patent medicines and provide evidence for improving policies and promoting rational drug use. Methods: The study was based on data from the China National Health Insurance Agency that spanned January 2019 to December 2020. Descriptive analysis was conducted using volume and expenditure as variables. Interrupted time series analysis was applied to further analyze Chinese patent medicines. Results: The unit prices of atorvastatin and rosuvastatin decreased by 25%–96%, whereas the prices of Zhibitai and Xuezhikang fluctuated slightly. The affordability is measured as the monthly expenditure on treatment divided by the daily wage. After policy implementation, the affordability of atorvastatin and rosuvastatin improved from 0.242 to 0.014 and from 0.247 to 0.019, respectively. The defined daily doses (DDDs) for atorvastatin and rosuvastatin also increased, whereas total expenditures decreased in hospitals of all levels. Both at the national level and at all levels of hospital, the policy had no significant impact on expenditures for Zhibitai and Xuezhikang and their defined daily doses. Conclusions: The NVBP saved costs in the short term by incorporating high-quality, widely used lipid-lowering drugs. Notably, the policy impacted lipid-lowering chemical drugs, whereas Chinese patent medicines remained largely unaffected. Doctors' use of Chinese patent medicines did not decline, highlighting the clinical specificity of these medicines.