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

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Abstract Background China implemented National Volume-Based Procurement (NVBP) to reduce drug prices while also changing the structure of medication in medical institutions. However, the effects of NVBP on Chinese patent medicines are unknown. Methods In this study, we examine the effect of the policy on bid-winning chemical drugs (atorvastatin and rosuvastatin) on the availability and affordability of lipid-lowering Chinese patent medicines (Xuezhikang and Zhibitai). We also investigated changes in defined daily doses (DDDs) and expenditures across all levels of hospitals and discussed their underlying influencing factors. Results The unit prices of atorvastatin and rosuvastatin were cut by 25–96%, with minor fluctuations in the prices of Zhibitai and Xuezhikang. Following the policy's implementation, the average affordability of atorvastatin increased from 0.242 to 0.014, while that of rosuvastatin increased from 0.247 to 0.019. The DDDs for atorvastatin and rosuvastatin increased, while total expenditures decreased at all levels of hospitals. Both at the national level and in all levels of hospitals, the policy had no significant impact on Zhibitai and Xuezhikang's DDDs or expenditures. Conclusions The NVBP has demonstrated an initial cost-saving effect in the short term by including high-quality and widely used lipid-lowering drugs. The policy has a significant impact on lipid-lowering chemical drugs, whereas Chinese patent medicines was little affected. Overall, doctors have not reduced their use of Chinese patent medicines, and there is no obvious substitution relationship between the two, demonstrating the specificity of Chinese patent medicines in clinical use.

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