Effect Evaluation of National Drug Centralized Volume-based Procurement in a Public Hospital from the Per- spective of Value-based Healthcare / 中国药房

ABSTRACT

OBJECTIVE：To evaluate the implementation of national drug centralized volume-based procurement （called “VBP”for short）in a public hospital，so as to provide reference for promoting VBP policy guided by value-based healthcare. METHODS：A total of 6 varieties and 12 specifications of antibiotics included in VBP in a public hospital in Chongqing were analyzed. The drug use data of the hospital one year before the implementation of VBP（i.e. April 20，2019- April 19，2020）and one year after the implementation（i.e. April 20，2020-April 19，2021）were collected and analyzed in respects of price change， generic drug substitution rate，average daily cost（DDDc），actual cost savings and other indicators. The problems and suggestions were put forward，and the effects of VBP policy implementation whether reflects the core connotation of value-based healthcare were evaluated. RESULTS：After the implementation of VBP，drug prices fell by an average of 63.44％，the average price drop of original drugs was 27.38％ ，and substitution rate of generic drugs was 25.59％ . DDDc of selected antibiotics in the hospital decreased in varying degrees，of which the decline of four drugs was 10％-40％，and that of Moxifloxacin hydrochloride tablets was 80.14％. Compared with bef VBP，6 kinds of antibiotics saved about 521 300 yuan，of which the imported Moxifloxacin hydrochloride tablets and Moxifloxacin hydrochloride sodium chloride injection saved 495 300 yuan（accounting for 94.97％ of the total cost savings of antibiotics）. CONCLUSIONS：The value of VBP based on the perspective of value-based healthcare is mainly reflected in the dual channel management mechanism of drugs，which improves the availability of drugs，effectively controls the unreasonable growth of medical expenses，reduces the expenditure of medical insurance fund，and helps to further reduce the drug burden of patients. At present，the implementation of VBP still faces difficulties，including the need for drug prices to return to a reasonable range，the need for foreign enterprises to change strategies to seek a breakthrough，and different therapeutic efficacy due to the difference in quality between the selected generic drugs and the original drugs. Therefore，the author believes that the pharmaceutical market structure should be transformed positively，value-based healthcare should help the regulation of medical insurance，and the consistency evaluation system should be optimized，so as to further improve the health level of patients.