Abstract
BACKGROUND: Tyrosine kinase inhibitors (TKIs) have been shown to improve survival rate in chronic myeloid leukemia (CML) patients, but their high costs impose a significant economic burden. This study aimed to evaluate the impact of China's National Volume-Based Procurement (NVBP) policy on the affordability, procurement volume, and costs of these drugs. METHODS: Based on the data of drug procurement transactions in the database of China Health Insurance Bureau, this study analyzed the impact of National Volume-Based Procurement policy on the affordability, Defined Daily Doses (DDDs), expenditure, and Defined Daily Dose cost (DDDc) of three tyrosine kinase inhibitor (Imatinib, Nilotinib, and Dasatinib) in 25 provinces and hospitals of different levels from January 2019 to December 2020 in China by using an interrupted time series model. RESULTS: After the implementation of the procurement policy, the unit price of policy-related Imatinib decreased, leading to increased affordability and a rise of 146.9 thousand DDDs in the month of implementation (p < 0.05), while expenditure remained unchanged. The DDDs and expenditures for Nilotinib and Dasatinib did not show significant changes. The procurement volume of bid-winning generic Imatinib increased by 215.2 thousand DDDs in the month of policy implementation (p < 0.001), with usage share rising from approximately 40% to 80%. Conversely, the DDDs of non-bidding generic and originator drugs significantly decreased post-implementation. The DDDc of Imatinib reduced 69.5 in the month of NVBP implementation (p < 0.001). Furthermore, the DDDc of both bid-winning generic and non-bidding generic Imatinib significantly decreased in the month of policy implementation (p < 0.001). CONCLUSIONS: The National Volume-Based Procurement policy effectively reduced the unit price of relevant drugs and increased their utilization, thereby improving drug affordability and reducing the financial burden on CML patients requiring long-term treatment.