AUTHOR=Wen Xiaotong , Wang Zhaolun , Xu Luxinyi , Luo Jia , Geng Xin , Chen Xiaoze , Yang Ying , Cui Dan , Mao Zongfu 

TITLE=The impacts of the “4+7” pilot policy on the volume, expenditures, and daily cost of Serotonin-Specific Reuptake Inhibitors (SSRIs) antidepressants: A quasi-experimental study

JOURNAL=Frontiers in Pharmacology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2022.829660

DOI=10.3389/fphar.2022.829660

ISSN=1663-9812

ABSTRACT=<p><bold>Objectives:</bold> The purpose of this study was to quantitatively evaluate the impacts of the”4 + 7” pilot policy on purchase volume, purchase expenditures, and daily cost and to find the changes in the use of SSRIs.</p><p><bold>Methods:</bold> Data was collected covering 31 months, before, during, and after the “4 + 7” pilot policy was implemented in Shenzhen. Interrupted time-series (ITS) analysis was used to examine whether there had been a significant effect with the onset of the “4 + 7” pilot policy in March 2019.</p><p><bold>Findings:</bold> The daily cost of policy-related drugs had a substantial drop of 2.93 yuan under the “4 + 7” pilot policy. The result has shown a 76.70% increase in volume and a 3.39% decrease in the expenditure on policy-related drugs. This study found that the “4 + 7” pilot policy increased the proportion of purchasing winning drugs, with an increment of 85.60 percent. After the implementation of the “4 + 7” pilot policy, policy-related drugs decreased by 443.55thousand Chinese yuan. The study indicated that volume of winning products significantly increased as shown in the regression with a level coefficient (<italic>β</italic><sub><italic>2</italic></sub>) of -224.17 (<italic>p</italic> &lt; 0.001) and trend coefficient (<italic>β</italic><sub><italic>3</italic></sub>) of 15.74 (<italic>p</italic> &lt; 0.001). The result revealed that both volume and expenditures on branded products showed a significant decrease in the regression in the post-intervention period (level coefficient of volume: <italic>β</italic><sub><italic>2</italic></sub> = -57.65, <italic>p</italic> &lt; 0.01, trend coefficient of volume: <italic>β</italic><sub><italic>3</italic></sub> = -3.44, <italic>p</italic> &lt; 0.01; level coefficient of expenditure: <italic>β</italic><sub><italic>2</italic></sub> = -712.98, <italic>p</italic> &lt; 0.01, trend coefficient of expenditure: <italic>β</italic><sub><italic>3</italic></sub> = -40.10, <italic>p</italic> &lt; 0.01).</p><p><bold>Conclusion:</bold> The volume-based procurement has successfully led to price reductions and improved the affordability of medicines, especially for those with chronic diseases. The volume-based procurement has demonstrated initial success in reshaping the composition of the Chinese pharmaceutical market in favor of generics with high quality and low prices.</p>