Trends in accessibility of negotiated targeted anti-cancer medicines in Nanjing, China: An interrupted time series analysis

作者：Yanyan Liu, Huining Yi, Kexin Fang, Yuwen Bao, Xin Li · 发表于：Frontiers in Public Health · 年份：2022 · DOI：10.3389/fpubh.2022.942638 · 被引用次数：24 · 研究领域：Health Systems, Economic Evaluations, Quality of Life、Economic and Financial Impacts of Cancer、Pharmaceutical Economics and Policy

Background In order to establish a long-term strategy for bearing the costs of anti-cancer drugs, the state had organized five rounds of national-level pricing negotiations and introduced the National Health Insurance Coverage (NHIC) policy since 2016. In addition, the National Healthcare Security Administration (NHSA) introduced the volume-based purchasing (VBP) pilot program to Nanjing in September 2019. Taking non-small cell lung cancer as an example, the aim of the study was to verify whether national pricing negotiations, the NHIC policy and the VBP pilot program had a positive impact on the accessibility of three targeted anti-cancer drugs. Methods Based on the hospital procurement data, interrupted time series (ITS) design was used to analyze the effect of the health policy on the accessibility and affordability of gefitinib, bevacizumab and recombinant human endostatin from January 2013 to December 2020 in Nanjing, China. Results The DDDs of the three drugs increased significantly after the policy implementation ( P < 0.001, P < 0.001, P = 0.008). The trend of DDDc showed a significant decrease ( P < 0.001, P < 0.001, P < 0.001). The mean availability of these drugs before the national pricing negotiation was <30% in the surveyed hospitals, and increased significantly to 60.33% after 2020 ( P < 0.001, P = 0.001, P < 0.001). The affordability of these drugs has also increased every year after the implementation of...