The vacated space of volume/price of the drugs centralized procurement with quantity in secondary and above public hospitals of China.

BACKGROUND: In 2018, the National Centralized Drug Procurement (NCDP) policy has been implemented in 11 provinces, and promoted across the country in 2019. The main feature of the policy is "volume for price", therefore, it is necessary to measure the price relationship, not only to reduce the price of drugs, reduce the burden of patients' medical costs, but also facilitate pharmaceutical companies to access enough innovation incentives. The aim of this study was to assess the vacated space effect of the drug centralized procurement by national organizations in exchange of price for quantity. METHODS: A difference-in-differences (DID) model was employed to analyze the effect of the 4 + 7 pilot drugs centralized purchasing policy on drug sales volume and selected versus clinically substitutable unselected varieties, using observational data from 2018 to 2019. We compared drug procurement data between secondary and above public hospitals in pilot and non-pilot cities throughout China. RESULTS: The study showed that the average treatment effect (ATE) of sales in the in-hospital market for the selected supply varieties in centralized purchasing is -0.42, and with a sales volume of 0.49. This indicates a volume-price vacated space of 1.16 ~ 1.17 DDD (defined daily dose)/Yuan, implying that for every 1 defined daily dose (DDD) increase in reported volume, the standardized price decreased by 1.16-1.17 Yuan. The ATE of in-hospital market sales for drugs not selected in centralized procurement shows a decrease of 0.13. This finding highlights the presence of the price linkage effect. The ATE of sales volume is 0.57, indicating a volume-price space of 4.38 ~ 4.39 DDD/Yuan for unselected drugs, approximately 3.75 higher relative to that of the selected ones. CONCLUSIONS: The ratio of the volume-price space of clinically substitutable unselected and selected drugs may serve as direct evidence for evaluating the shift from centralized purchasing of drug varieties to clinically substitutable other ones. To strengthen the volume-based negotiation approach and maximize the effectiveness of centralized purchasing policies, we recommend the strategic implementation of a three-tiered centralized purchasing system, the expansion of drug coverage, and the introduction of relevant constraints and incentives.

The Impact of Sales Volume and Limited Quantity on Intertemporal Choice in an Online Consumption Context.

In the context of online consumption, consumers are often faced with a decision between buying now or later. This study examines intertemporal choice by conducting two mixed experimental designs on a total of 206 college students to investigate the impact of combining sales volume and limited quantity on online consumption decisions. Experiment 1 revealed that under unlimited conditions, the same option with high sales volume was relatively more attractive and participants were more inclined to choose it, leading to a herding effect. However, under limited conditions, there was no scarcity effect. Experiment 2 built upon the findings of Experiment 1 and added dynamic change in sales volume. It was found that even with dynamic changes in sales volume, high sales volumes could still lead to a herding effect. In the case of unlimited conditions, dynamic changes in sales offset the effect of sales volume on intertemporal choice. Sales volume and limited quantity are important factors that influence consumers' purchasing decisions. Therefore, this study combines sales volume and limited quantity and adds dynamic changes in sales to explore individuals' intertemporal choices in online consumption situations. The findings of the study have significant implications for both merchants and consumers.

Reporting rates of adverse reactions to specialty care medicines exhibit a direct positive correlation with patient exposure: A lack of evidence for the Weber effect.

AIMS: The classical Weber effect describes an increase in adverse reaction (AR) reports after medicinal product authorisation, with a peak in AR reporting at the end of the second year followed by a decline, despite increasing patient exposure. The present study aimed to evaluate the validity of the Weber effect in the context of authorised medicines in a specialty care setting. METHODS: Using 6-monthly sales data as a proxy for exposure, the exposure-adjusted reporting rates for AR reports for 10 selected specialty care medicines were plotted against time. These data were also evaluated based on the source of report (solicited or unsolicited) and the nature of the AR contained within the reports (listed or unlisted). Unsolicited reports were analysed against sales volumes. Goodness of fit (R2 ) was calculated and the trend representing the highest R2 was selected. RESULTS: Study data comprised a total of 1 222 852 AR reports for 10 specialty care medicines. Amongst all of the products evaluated, none of the associated data represented reporting patterns entirely consistent with the classical Weber effect (see Figure 1). The results, however, showed a systemic direct correlation between AR reporting and sales volumes, especially throughout the first 5 years post-authorisation. CONCLUSION: The study not only presents evidence of the absence of the Weber effect with specialty care medicines but also provides a substantial evidence of linear AR reporting correlating with sales volumes, especially during the first 5 years after marketing.

Factors associated with supermarket and convenience store closure: a discrete time spatial survival modelling approach.

While there is a literature on the distribution of food stores across geographic and social space, much of this research uses cross-sectional data. Analyses attempting to understand whether the availability of stores across neighborhoods is associated with diet and/or health outcomes are limited by a lack of understanding of factors that shape the emergence of new stores and the closure of others. We used quarterly data on supermarket and convenience store locations spanning seven years (2006-2012) and tract-level census data in four US cities: Birmingham, Alabama; Chicago, Illinois; Minneapolis, Minnesota; San Francisco, California. A spatial discrete-time survival model was used to identify factors associated with an earlier and/or later closure time of a store. Sales volume was typically the strongest indicator of store survival. We identified heterogeneity in the association between tract-level poverty and racial composition with respect to store survival. Stores in high poverty, non-White tracts were often at a disadvantage in terms of survival length. The observed patterns of store survival varied by some of the same neighborhood sociodemographic factors associated with lifestyle and health outcomes, which could lead to confusion in interpretation in studies of the estimated effects of introduction of food stores into neighborhoods on health.

Analysis of the Use of Anti-infectives in6Hospitals of Guang'an City from 2001 to 2004 / 中国药房

OBJECTIVE:To provide references for the application and management of anti-infectives.METHODS:Data on sale volume,DDDs etc.of anti-infection drugs in6hospitals of Guang'an city from2001to2004were statistically analyzed.RESULTS:The DDDs of oral lomefloxacin dominated the first or2nd places for the4years;The DDDs rank orders of isoniazid and rifampin were No.4and No.5respectively in the4years;The DDDs of penicillin for injection dominated the first place on the injectable preparation lists(2001～2003);The latecomer levofloxacin assumed the tendency of surpassing the early starters not only in sale volume but also the DDDs.CONCLUSION:The proportion for anti-infectives in sales volume to the sum total drug consumption of the above mentioned area were close to those of the other medical institutions in southwest area,there are less new drug varieties and the grade of drugs used in the area was low.

Analysis on Antihypertensive Use from2002to2004in50Hospitals in Guangdong Province / 中国药房

OBJECTIVE:To evaluate the situation and the tendency of antihypertensive use in guangdong province.METHODS:The sales volume,defined daily use(DDDs)and daily expense of antihypertensive from2002to2004in guangdong province were investigated and analyzed.RESULTS:The sales volume of antihypertensive from2002to2004had been in?creasing.Calcium antagonist dominated over all other antihypertensives in respect of sales volume and DDDs.CONCLUSION:Calcium antagonist dominate in the antihypertensive market in guangdong province.

Analysis of Antihypertensive Drug Use in 62 Hospitals in Southwestern China during the Period of 2002～2004 / 中国药房

OBJECTIVE:To evaluate the present situation and tendency of antihypertensive drug use in the southwestern districts of China.METHODS:The sales volume,drug types,DDDs,DDDc of antihypertensive drugs from 2002 to 2004 in 62 hospitals in the southwestern districts of China were statistically analyzed.RESULTS:The sales volume of antihypertensive drugs counted 18%to 20%of total sales volume of cardiovascular drugs,with the mean annual increasing rate of 20%.The sales volumes of amlodipine and enalapril ranked the first,and the second in 2004.Among the 10 manufacturers,the sales volume of antihypertensive drugs produced by multinational companies reached 81.9%of total sales volume.CONCLUSION:The sale volumes of antihypertensive drugs and cardiovascular drugs have gone on increasing sharply,calcium antagonists and angiotensin-converting enzyme inhibitor drugs dominate in the antihypertensive drug market in the southwestern district.

Analysis of Non-steroidal Anti-inflammatory Drugs(NSAID)Used in10Hospitals of Tianjin City dur-ing2002～2003 / 中国药房

OBJECTIVE:To provide references for rational,efficient and economical use of NSAID in the clinic.METH-ODS:The varieties,sales volume,DDDs etc.of NSAID used in10hospitals of Tanjin during2002～2003were analyzed sta-tistically.RESULTS:The drugs that dominated the front7places were almost the same as those that dominated the first7places on the list of sales volume for the2years.The traditional NSAID were widely used in the clinic,the markets share for a certain drug kept increasing.CONCLUSION:The clinical application of NSAID in Tianjin was rational,those drugs that of low prices but of certain curative effect take a dominance in the clinical adoption.

Analysis of Antihyperlipidemics Used in Guangdong Province from2000 to 2003 / 中国药房

OBJECTIVE:To eualuate the situation and the tondency of antihyperlipidemics used in Guangdong Province.METHODS:The sales volume,DDDs and daily expense of antihyperlipidemics in Guangdong Province from2000to2003were investigated and analyzed.RESULTS:The sales volumes of cardiovascular agents from2000to2003had been increasing.The proportion of antihyperlipidemics to cardiovascular agents in respect of sales volume assumed a decreasing tendency from2001.Simvastatin dominated over all other drugs in respect of sales volume and DDDs.CONCLUSION:HMG-CoA reductase in-hibitor and natural drugs dominate in the antihyperlipidemics market of Guangdong Province.

Analysis of Anti-infection Drugs of Our Hospital During the Two Invitation Tenders Periods / 中国药房

OBJECTIVE:To evaluate current state of the use of anti-infection drugs in our hospital during the two invi?tation tenders period so as to lead to a rational clinical drug use and to improve the drugs management level.METHODS:The data of anti-infection drugs used in our hospital from August,2002to July,2004was analysed by sequencing the sales volume and DDDs.RESULTS:During these two years,the sales volume for the anti-infection drugs amounted to28.25%and30.60%among the total respectively,with a yearly increase at30.67%,which is higher than that of the total sales which increase percentage of20.29%;the sales amount and the variety of cephalosporins ranked among the first;rank order for various vari?eties had a big change.CONCLUSION:Invitation tender for drugs led to the standardization of the purchase behavior of hos?pital,the average daily consumption for the majority varieties has decreased with little range.

The Changes and Developing Trend of Drugs Used in Hospitals of Shanghai During the Period 2000～2001 / 中国药房

OBJECTIVE:To make out the recent changes and developing trend of drugs used in hospitals of Shanghai since implementation of medial insurance system METHODS:Using HPDIS system,the data of purchase and sales volume of drugs,in 46 hospitals in Shanghai during the period 2000～2001,were collected and analysed RESULTS:The annual consumption displayed a periodic change,which was steady at the beginning of the year,restored at the middle of the year and increased vigorously at the end of the year The rise range of household essential drugs was maximum and that of drugs for critical cases minimum With the open of personal account,people have been inclined to select inexpensive domestic drugs with high quality CONCLUSION:The implemention of medical insurance system in cities and towns does not influence the consumption of drugs on the whole