In China, the centralized volume-based procurement of drugs is a system innovation that leverages the strategic purchasing function of healthcare insurance, to reconstruct the pharmaceutical price formation mechanism, standardize the order of drug circulation, reduce the burden of patients’ drug costs, and ensure rationality and safety of drug use. This study aims to systematically review the policy connotations, operational effects, and multi-influences from the perspective of system establishment. The core mechanism includes the working mechanism of government organization, alliance procurement, and platform operation, the rule mechanism of giving priority to drug quality, guaranteeing supply and procurement based on clinical needs, as well as the operation and maintenance mechanism of centralized procurement and use. The core drug price formation mechanism includes the market exchange mechanism of “price for volume” and market contract mechanism of “four guarantees” . The implementation of the system involves 4 key links (bidding procurement, supply and delivery, distribution and use, and continuation work) and 18 core elements. After the implementation of the centralized volume-based procurement policy, there were obvious clinical substitution effects of drug use, improvement in drug accessibility, significant decrease in drug costs which mainly benefits patients, increase in drug market concentration, and gradual reshaping of the industrial pattern.

Objective: The paper analyzes the impact of the centralized procurement policy on the number of patients undergoing artificial joint replacement surgery, the total cost per time, the cost of patients per time, and the proportion of medical insurance reimbursement per time, and evaluates the implementation effect of the policy. Methods: Based on the cost data of artificial joint replacement in 29 hospitals above Level II in Anyang City, the paper applies Excel to compare and analyze the effect of artificial joint replacement and the change of cost data before and after centralized purchase. Results: After the centralized procurement policy, the number of patients with artificial hip and knee replacement increased by 50% and 79.41%, respectively, the patient cost decreased by 59.99% and 46.23%, respectively, and the actual reimbursement ratio of both cases increased by 16.76% and 4.16%, respectively. Conclusion: The national centralized procurement policy has a remarkable effect in reducing the medical cost of patients and greatly reduces the medical burden of patients. Public hospitals should play an active role in internal management and promote the sustainable development of the policy.

In 2023, the first centralized procurement for neurointerventional medical consumables by the Henan Province Public Medical Institution Alliance adopted an on-site, full-category negotiation mechanism. In 2024, the subsequent procurement chose a moderate policy of "price linkage from other provinces" as the main approach, integrating the results of centralized procurement from Beijing City,Tianjin City, Hebei Province, Jiangsu Province, and Anhui Province, effectively addressing the challenges of price troughs while ensuring clinical supply. This article conducts in-depth analysis from multiple dimensions such as background, rules, achievements, potential problems, and suggestions. In response to the high-risk and high-precision instrument demand of neurointerventional surgery, as well as the market situation dominated by imported brands, the Henan Province Alliance Procurement adopts policies such as setting differentiated pricing mechanisms and reasonable grouping to reduce consumables price and patient burden, while also taking into account clinical usage habits. Furthermore, the study offers optimization suggestions for future procurement policies for high-value medical consumables.

Objective: The paper attempts to study the impact of national centralized drug procurement on the stock prices of pharmaceutical listed companies. Methods: Using the event study method, nine batches of centralized drug procurement policies were taken as the research objects, and the impact of centralized drug procurement policies on stock prices was explored from the perspectives of selected enterprises and pharmaceutical industry. Results: The results showed that after the occurrence of each batch of centralized drug procurement, the stocks of the selected enterprises and pharmaceutical industry index produced significant abnormal returns. In terms of stock price, the policies had a negative impact on the selected companies to some extent and an overall positive impact on the pharmaceutical industry in the short term. However, this study did not compare selected drugs with the drugs that were not selected and did not participate in the centralized drug procurement. There is also no comparative analysis of stock price changes with other industries in the capital market. Conclusion: The study believes that the stock prices of the selected companies and the inverse movement of the pharmaceutical industry index lead to some arbitrage space, which is a good opportunity for long-term value investors to build positions. It is suggested that government departments should adhere to the normalization of the centralized drug procurement system, strengthen quality management and cost control of pharmaceutical listed companies, and cultivate a rational value investment concept among investors in the securities market.

Objective: The report compares the differences in the impact of VBP generic drugs and original drugs on the main clinical outcome indicators in the treatment of major diseases, and promotes the rational use of VBP drugs in the clinical practice. Methods: The main focus is on the effectiveness and safety of the second and third batches of VBP drugs in clinical diagnosis and treatment. The paper investigates a total of 29 representative medical institutions in 16 provinces and municipalities in China, covering six major categories of cardiovascular, anti-tumor, neuropsychiatric, anti-infection, metabolic and endocrinic, and digestive systems. We extract baseline information and research indicators related to drug treatment and clinical outcomes from medical record data for efficacy, safety, and economic evaluation. Statistical analysis is conducted with inter-group baseline correction and analysis method of outcome indicators. Result: There is no statistically significant difference in the effectiveness and safety between the selected generic drugs in the national centralized procurement and the original drugs, providing evidence-based basis for rational clinical medication. Conclusion: This study provides an important reference for clinical doctors in decision-making of drug use, promotes the clinical rational use of selected drugs in centralized procurement, provides evidence-based data for the implementation of national centralized procurement policies, and also provides a model and method for the implementation and effectiveness evaluation of national centralized procurement policies.

Objective: The paper analyzes the influence of centralized procurement policy on drug procurement in the agreed procurement cycle and renewal period of public medical institutions at different levels. Methods: The changes of drug purchase volume, purchase expenditure and average daily cost of public medical institutions at different levels in 7 pilot cities were analyzed by interrupted time series analysis. Results: The purchase volume of centralized drug varieties increased by 15.36% and 4.61% in the pilot period and the renewal period, respectively. The growth rate of the purchase volume of alternative drug varieties in the pilot period and the renewal period was higher than that of centralize drug varieties, which was 17.30% and 5.60%, respectively. In the base period, the procurement volume of original drugs, reviewed generic drugs and unreviewed generic drugs accounted for 27.07%, 53.00% and 19.93%, respectively. The proportion of reviewed generic drugs in the pilot period and the renewal period increased by 34.71% and 0.92%, respectively. In the base period, the purchase volume of original drugs, reviewed generic drugs and unreviewed generic drugs accounted for 40.46%, 42.87% and 16.68%, respectively, while the proportion of reviewed generic drugs in the pilot period and the renewal period increased by 20.07% and 0.07%, respectively. Conclusion: The policy effect of primary medical institutions is behind schedule. The reviewed generic drug substitution effect of the centralized drug varieties was obvious, and the drug quality of primary medical institutions was improved. The DDDc of unreviewed generic drugs in the renewal period of Level-3 and Level-2 medical institutions increased abnormally.

Objective: The paper evaluates the difference in clinical efficacy between the bid-winning generic and original drugs in the centralized procurement of Bortezomib for the treatment of first-visit multiple myeloma based on multicenter real-world data. Methods: Data of patients treated with Bortezomib in the electronic medical record system of five hospitals in Shanghai from January 2017 to June 2024 were collected retrospectively. The first-visit patients were screened out and divided into the generic and original groups according to different medications. Patients’ baseline data of the two groups were corrected by the propensity score matching method. The direct and indirect indexes of therapeutic effect, adverse reactions and residents' affordability were compared between the two groups. Results: There were 215 patients in both the generic and original groups, screened by 1:1 matching of baseline data. There was no significant difference between the two groups after 4 courses of Bortezomib-containing therapy (P>0.05). There was no significant difference in the changes of M protein, plasma cell ratio of myeloma, β2-microglobulin, creatinine, calcium and sFLC-λ between the two groups. The original group had an advantage in protecting renal function (P<0.05), and the centralized procurement group had an advantage in controlling LDH increase (P<0.05). In terms of safety, there was no significant difference in the incidence of lethargy, pain, peripheral neuropathy, rash and allergy between the two groups (P>0.05). However, the incidence of fatigue was higher in the original group (P<0.05). The generic drugs were more affordable. Conclusion: The overall effectiveness and safety of selected drugs in the centralized procurement of Bortezomib are not inferior to the original drugs, and some indicators have their own advantages.

Artificial intelligence (AI) technology is powerfully promoting the intelligence of public management services, standardization of processes, and digitalization of systems. In the field of centralized drug procurement, some regions have conducted preliminary explorations in areas such as qualification review, drug listing, price regulation, intelligent Q&A, price monitoring, and even full-process supervision. AI technology has demonstrated significant value in improving service quality, enhancing process efficiency, increasing transparency, optimizing costs, and assisting in monitoring. However, it also faces challenges in four areas: model computing power requirements, industry data aggregation, data security and ownership, and regional applicability of models. AI applications in centralized drug procurement can be promoted from perspectives such as prospective study, national guidance, innovation-driven development, continuous iteration, and shared collaboration, helping to build a fairer, more efficient, and more sustainable drug procurement system.

Objective: The paper evaluates the impact of centralized procurement policies for antibiotics on perioperative prophylactic medication in obstetrics, gynecology, and pediatric orthopedics, providing reference for promoting and improving centralized procurement of antibiotics. Methods: Taking a tertiary hospital in Linyi City as an example, a retrospective method was used to collect data on drug consumption, sales amount, medication frequency (DDDs), daily cost (DDDc), and affordability for the first half of the year (January 1, 2021 to June 30, 2021) and the second half of the year (January 1, 2022 to June 30, 2022) of cefuroxime sodium for injection, which was selected in the fifth batch of national drug centralized procurement, for comparative analysis. Results: After the implementation of the centralized procurement policy, the average length of hospital stay in obstetrics and gynecology decreased from 6.98 days to 6.21 days, with a decrease of 14.29%. The average cost of drugs per case, the proportion of drugs cost per case, the average cost of cefuroxime per case, and DDDc decreased by 30.70%, 19.26%, 7.5%, and 12.43%, respectively. The average length of hospital stay in pediatric orthopedics decreased from 9.76 days to 8.50 days, with a decrease of 12.91%. The average cost per case and DDDc of cefuroxime decreased by 1.17% and 13.69%, respectively. Conclusion: The implementation of the national centralized drug procurement policy effectively lowered the price of cefuroxime sodium for injection, improved patient affordability, increased the efficiency of medical insurance funds and reduced operating costs of hospitals.

Objective: The paper analyzes the effect of national centralized procurement of artificial joint through comparison of disease cost. Methods: According to the medical records of first page in 11 hospitals paid by diagnosis-related groups to hip joint replacement and knee joint replacement, the changes of case number, average hospitalization days, and disease costs were analyzed before and after national centralized procurement of artificial joints. Results: Compared with before the national centralized procurement of artificial joints (June to September 2022), after the procurement of (January to April 2022), the average hospitalization costs of hip joint replacement and knee joint replacement were significantly reduced by 22.50% (p<0.01) and 20.51% (p<0.01) respectively, in which the cost of medical consumable decreased by 41.73% (p<0.01) and 33.00% (p<0.01), but the cost of drugs increased by 16.15% and 12.98%, and the average hospitalization days were extended by 12.46% and 2.96% respectively. Conclusions: National centralized procurement of artificial joints can effectively promote the price of artificial joints to return to a reasonable level, and the hospitalization expenses of related diseases can be significantly reduced, which can effectively reduce the burden of patients. However, there are great differences in the cost structure of disease types among different hospitals. It is suggested that the medical insurance department should strengthen the supervision of centralized procurement of consumables, and medical institutions should improve the internal control assessment of centralized procurement of consumables, and strengthen the refined control of the cost of disease types.

Objective: The paper analyzes the practice of exploring the retention of medical insurance fund surplus in the centralized procurement of high-value medical consumables in E Autonomous Prefecture, Hubei Province, in order to provide a reference for the standardized, precise promotion of the retention of medical insurance fund surplus in the centralized procurement of high-value medical consumables. Methods: From the perspective of coordinated regions, the paper takes the centralized procurement of coronary stents as an example, uses descriptive statistical methods to review the practice of exploring the retention of medical insurance fund surplus for centralized procurement of coronary stents in E Autonomous Prefecture, summarizes measures to promote standardized, precise promotion of medical insurance fund surplus retention of high-value medical consumables centralized procurement. Results: The exploration of centralized procurement of high-value medical consumables in E Autonomous Prefecture to retain surplus medical insurance funds complies with national regulations, demonstrates strong operability, achieves good results, which is worth to be promoted

Objective: The paper attempts to investigate the impact of endoscopic stapler centralized procurement on hospitalization costs for patients undergoing lung malignant tumor surgery, evaluate the implementation effect of centralized procurement policy, and propose policy recommendations. Methods: According to the comprehensive supervision platform of medical institutions in Ningbo City, medical record homepage data of patients undergoing lung malignant tumor surgery in municipal general hospitals in Ningbo City from June 2022 to May 2024 were selected. Patients' hospitalization cost information was extracted, and the changes in average hospitalization cost, and cost structure of patients after staple centralized procurement was analyzed with degree of structure (DSV), and interrupted time series. Results: A total of 18065 patients' medical records were included, and the average hospitalization cost for patients undergoing lung malignant tumor surgery decreased from 36228.12 yuan before centralized procurement to 31126.41 yuan after centralized procurement (P<0.05). Consumables cost was highest in the cost structure (44.16%), followed by surgical treatment cost (20.23%). After endoscopic stapler centralized procurement, the proportion of consumables cost decreased by 6.52%, the proportion of drug cost decreased by 0.65%, while the proportion of surgical treatment cost, comprehensive medical service cost, and examination and testing cost increased. Among them, the contribution rate of DSV in consumables cost is the highest (45.47%), followed by surgical treatment cost (22.70%) and comprehensive medical service cost (17.45%). Through interrupted time series analysis, it was found that the average hospitalization cost for patients undergoing lung malignant tumor surgery after centralized procurement showed a significant downward trend (P<0.05). Conclusions: After stapler centralized procurement, the average hospitalization cost for patients undergoing lung malignant tumor surgery has significantly decreased, and the cost structure has been optimized to some extent. However, the increase in the proportion of medical service cost mainly depends on the decrease in consumables cost. It is suggested that the medical insurance department should take advantage of the opportunity brought by centralized procurement to promote the reform of medical service price adjustment, better reflect the technical service value of medical personnel, and further scientifically improve the rules of centralized procurement to reduce the impact of huge price difference of consumable on disease cost fluctuation.

Objective: The paper is to establish a complete evaluation index system and model for the effect of centralized drug procurement policy. Methods: Literature research, expert consultation and Delphi method were used to establish the evaluation index system of the implementation effect of centralized drug procurement policy, and fuzzy analytic hierarchy process (AHP) and comparative analysis were used to establish the evaluation model, taking data of Yunnan Province as an example to conduct empirical research. Results: The evaluation index system contains 4 first-level indicators, 11 second-level indicators and 30 tertiary indicators. Among the first-level indicators, drug accessibility and drug effects weight coefficient is relatively high. Conclusion: The index system and evaluation model follow the principle of comprehensiveness, systematicness, scientificity, operability and principal component, which can provide guidance for evaluating the effect of centralized drug procurement policy in other regions.

Objective: The paper evaluates the effect of centralized medical consumables procurement policy on expenses of patients undergoing knee arthroplasty and analyzes the law of cost change, providing evidence for reasonably controlling the cost of these surgeries. Methods: Based on the real-world data before and after the implementation of policy, RDD was applied to analyze the impact of centralized medical consumables procurement on the hospitalization costs of patients undergoing knee arthroplasty. Results: After the implementation of centralized medical consumables procurement policy, the hospitalization costs of patients undergoing knee arthroplasty have significantly decreased. The optimal bandwidth was approximately 57.48 days, and the average hospital expenses of patients decreased by 23311.29 yuan on April 30, 2022. The estimated results of 1/2 optimal bandwidth showed that the expenses decreased by 24923.05 yuan, and the estimated results of 2 times optimal bandwidth showed that the expenses decreased by 21547.30 yuan. The local average effect of different bandwidths is slightly different, but all shows a decreasing trend. Conclusion: The centralized medical consumables procurement policy has effectively reduced the hospital expenses of patients undergoing knee arthroplasty. Hospital managers should strictly implement the procurement policy, improve clinical pathways and standardize diagnosis and treatment behavior to reduce patients’ expenses. In addition, relevant departments should steadily expand the scope of procurement and strengthen supervision to ensure the effective implementation of policy and improve the accessibility and affordability of medical services.

Objective: The paper studies the long-term trend of changes in the cost of percutaneous coronary intervention (PCI) before and after coronary stent centralized procurement, so as to evaluate the implementation effect of the centralized procurement policy, and propose policy recommendations. Methods: We extracted the cost data of the first page of medical records of discharged patients undergoing PCI in a tertiary comprehensive hospital in Ningbo City of Zhejiang Province from 2019 to 2024. The disease cost, composition ratio, and cost correlation degree were analyzed through structural change degree and grey correlation analysis, and statistical methods were used to analyze the changes in various costs before and after centralized procurement. Results: A total of 14476 discharged patients were included. The median cost of PCI before coronary stent centralized procurement (2019-2020) was 41559 yuan, which decreased to 28988 yuan in the initial period of centralized procurement(2021-2022), and further decreased to 25730 yuan in the long-term period of centralized procurement(2023-2024), showing a continuous downward trend with statistical significance (J-T=-38.63, P<0.001). From long-term data, it can be seen that after the implementation of the centralized coronary stent procurement policy, the structure of PCI disease expenses has remained basically stable, and the contribution rate of consumables to the structural changes of disease expenses is the highest at 50.00%. The highest correlation between drug costs and disease costs is 0.825. Conclusions: The policy of centralized procurement of coronary stents has a sustained effect on reducing the cost of PCI, and has a positive significance in achieving healthcare reform goals such as alleviating the "high cost of medical treatment" and increasing the proportion of medical service income. However, the increase in the proportion of medical service income mainly depends on the reduction of consumable costs. It is suggested to take advantage of the opportunity brought by centralized procurement to timely promote the reform of medical service price adjustment, scientifically formulate disease payment standards according to technical difficulty and risk, in order to avoid limitations on innovative technologies in clinical application.

Objective: The paper evaluates the impact of national centralized volume-based procurement (NCVBP) on the renewal period in public medical institutions. Methods: Data on the procurement records of drugs from January 2018 to December 2020 were obtained from the China Drug Supply Information Platform (CDSIP). The change of purchase volume, purchase expenditure and daily cost of drugs with different winning bids in the public medical institutions from 7 pilot cities was analyzed. Interrupted time-series analysis (ITSA) with two intervention points was used in this study. Results: The DDDs level of generic drugs passing the consistency evaluation of quality and efficacy (CEQE) which won the bid during the agreement period but failed in the renewal period changed significantly during the agreement period (β₂=18713.23,p<0.001). The change in the DDDs level (β₄ =-22287.48,p=0.002) , the trend (β₅=-1943.60,p=0.022) , and the level of purchase expenditure (β₂=-21869.97,p=0.002) was significant in the renewal period. The DDDs level of drugs which failed in the bid during the agreement period but won the bid during the renewal period changed significantly during the renewal period (β₄=19442.77,p<0.001), and the change of purchase expenditure (β₄=8840.89,p<0.001) was significant. The results showed that purchase expenditure (β₂=-89005.99,p<0.001) of generic drugs which didn’t pass the CEQE in selected drugs decreased during the agreement period. The trend of purchase expenditure (β₄=2538.91,p=0.046) and its proportion (β₄=0.52,p=0.011) was upward in the renewal period. Conclusions: The daily average cost of unapproved generic drugs should be monitored, and the mechanism for listing and unlisting unapproved generic drugs should be improved. We should monitor whether there is an unreasonable increase in the daily cost of drugs failed in the agreement and renewal period, also we should adhere to the policy of centralized NCVBP and improve supporting measures.

Objective: The paper attempts to evaluate the impact of previous national centralized drug procurement policies on the use of drugs in hospitals.Methods: The outpatient and emergency treatment data is retrieved from a tertiary comprehensive hospital in Beijing from June to August 2018 (before the VBP, volume-based procurement), June to August 2019 (after the first batch of VBP), June to August 2020 (after the second batch of VBP), January to March 2021 (after the third batch of VBP) and June to August 2021 (after the fourth batch of VBP), and EXCEL is applied to the data analysis.Results: With the implementation of the previous centralized procurement policies, the proportion of users of successful bidders has increased year by year, reaching a maximum of 21.36%. The total cost of medicines of winning bids and the same ingredients has achieved a cumulative decrease of RMB 25151300, a decrease of 60.27%.Conclusion: The policy of centralized drug procurement and use promotes the use of winning products and reduces the burden of drug costs.

Objective: Acute myocardial infarction (AMI) seriously threatens people's health, and the medical expenses of AMI have become a significant economic burden for Chinese residents. Since 2021, the centralized procurement policy for coronary stents has been implemented in Guangxi Zhuang Autonomous Region. This study aims to evaluate the actual effectiveness of the centralized procurement policy for coronary stents after its implementation in Guangxi. Methods: A retrospective study was conducted on the first-page data of medical records of patients discharged from a tertiary hospital in Guangxi with the primary diagnosis of AMI from January 1, 2019 to December 31, 2023. The cases were divided into a pre-procurement group and a post-procurement group. The PCI treatment rate and hospitalization costs were compared between the two groups. Results: The PCI treatment rate for AMI in the pre-procurement group was 81.3%, while in the post-procurement group, it was 85.6%, increasing by 4.3%. Logistic regression analysis showed that the difference was statistically significant (P=0.033). After centralized procurement of coronary stents, the total hospitalization costs for patients with AMI undergoing PCI decreased. Multiple linear analysis showed that the difference was statistically significant (P=0.037). Conclusion: The implementation of the centralized procurement policy for coronary stents has achieved positive results.

Objective: The paper analyzes the impact of the centralized volume-based procurement policy on the use of liver function biochemical test reagents in hospitals of Jiangxi Province, and provides a reference for improving procurement policies for in vitro diagnostic reagents. Methods: Monthly data on the use of six types of liver function biochemical test reagents in five hospitals of Jiangxi Province were collected from July 2022 to June 2024. An interrupted time-series analysis was conducted to evaluate changes in the number of patients, reagent usage volume, and per capita usage before and after the implementation of the centralized procurement policy. Results: After the implementation of the centralized procurement policy, there was a significant decrease in the number of patients using the six types of liver function biochemical test reagents (β₃ = -5678.00, P = 0.022) and in the total reagent usage volume (β₃ = -12556.26, P = 0.014). Although the per capita usage showed a downward trend, the difference was not statistically significant (β₃ = -0.0140, P = 0.207). Additionally, the policy led to a significant reduction in the number of patients and reagent usage for each type of reagent, while its impact on per capita usage was not significant. Conclusion: The centralized volume-based procurement policy had a significant impact on the use of liver function biochemical test reagents, helping to reduce the economic burden on patients and meeting their clinical testing needs.

Since 2019, the national and local departments concerned have explored the centralized procurement of high-value medical consumables, and formed a certain degree of buyer monopoly by pooling the procurement volume of medical institutions, so as to give full play to the strategic purchase of medical insurance funds, promote the high-quality and coordinated development of medical security and medical services, and realize a win-win situtation. Based on the centralized procurement practice of the inter-provincial alliance of cardiac intervention electrophysiological medical consumables led by Fujian Province, this paper studies and analyzes the problems and countermeasures of centralized procurement of high-value medical consumables, and provides a reference and for improving the subsequent centralized band procurement of high-value medical.

Objective: The paper explores the evaluation objectives, angles and methods that can be used to quantitatively evaluate the quality of drugs in local pharmaceutical centralized volume-based procurement. In addition, based on the concept of value-based health care, a drug quality evaluation index pool is constructed to provide tools for local procurement practice. Methods: We collect local pharmaceutical centralized volume-based procurement documents, identify the indicators that can be used to evaluate the macro quality level of drugs, build a basic index pool, and build a classification index pool based on expert opinions. Results: The basic index pool for drug quality evaluation suitable for local pharmaceutical centralized procurement was established, which was divided into three categories of the recommended index pool, the caution index pool, and the non-recommended index pool. The recommended index pool contains 8 first-level indicators, 17 second-level indicators and 27 third-level indicators. The caution index pool contains 5 first-level indicators, 5 second-level indicators and 5 third-level indicators. The non-recommended index pool contains 9 first-level indicators, 25 second-level indicators and 29 third-level indicators. Conclusion: In the practice of local procurement, the indicators in the recommended index pool can be directly selected. The indicators in the caution index pool can be selected when necessary, or can be used to assist in ranking, and the indicators in the non-recommended index pool are not recommended.

Objective: The paper attempts to explore the features, difficulties and policy progress of centralized purchasing of biological drugs with target quantity.Methods: Using the methods of literature review, the characteristics and difficulties of centralized purchasing of biological drugs were comprehensively analyzed, and the policy frame of the centralized purchasing of biological drugs were analyzed and elaborated.Results: Centralized purchasing of biological drugs with target quantity faces three major obstacles, i.e. clinical substitutability, the difficulty of natural extrapolation of indications and supply capacity problems. The insulin-specialized centralized procurement has conducted useful explorations and accumulated experience.Conclusion: Policies of the centralized purchasing of biological drugs should be scientifically and rationally designed and implemented based on the characteristics of biological drugs.

Objective: The paper analyzes the implementation of the national centralized drug procurement in Yunnan Province, explores the problems concerned by policy stakeholders and puts forward suggestions accordingly. Methods: We conducted statistical analysis of 118 drugs of centralized procurement with a total of 3 batches, selecting the time period before and after the policy implementation for comparison. Guided by policy objectives, we analyzed policy documents and official media news, and selected four primary indicators, i.e. accessibility, impact on drugs, impact on medical treatment, and impact on medical insurance. By literature review and consulting experts, 19 secondary indicators such as affordability and average outpatient drug cost per visit were introduced. Based on the execution time of national centralized drug procurement, the first three batches of centralized drug procurement were selected as the research objects. A longitudinal analysis was conducted before and after the implementation of policies, and a horizontal analysis was conducted on the overall situation of Yunnan Province and the country. We selected some representative varieties for analysis and judgment based on indicators such as resident prevalence, medication, procurement volume, procurement completion rate, and generic drug substitution rate. Excel, spss statistics and other software were used to clean and integrate the data collected, and statistical means such as the variance analysis and Chi-square test were used to analyze the differences and trends of the data before and after the implementation of the policy. Results: After the implementation of the national centralized drug procurement policy, the proportion of drugs, the drug price and the proportion of adverse drug reactions reported decreased by 1.00%, 81.14% and 2.44%, respectively. The cost of the other 6 indicators increased, specifically, the growth rate of delivery rate was 6.00%, the average outpatient drug cost was 9.87%, the average inpatient drug cost was 2.71%, the industry concentration rate was 0.60%, the generic drug replacement sum rate was 29.03%, and the generic drug quantity replacement rate was 37.99%. Conclusions: The policy target of centralized drug procurement in Yunnan Province has been basically achieved. The drugs of national centralized drug procurement have promoted the accessibility of drugs, purified the industry conduct, gradually restructured the enterprise scale, and reduced the burden on medical insurance funds. However, the average outpatient drug costs and average inpatient drug costs are both increasing, consistent with the overall national trend. Although the national drug procurement reduced the drug price, the average outpatient drug cost per time increased instead, indicating that the control effect of centralized procurement on the total drug cost was not ideal, and the improvement effect on the concentration ratio of the industry in Yunnan Province was not obvious. It is suggested to always adhere to the leading position of the government, constantly expand the scope of national procurement, and give full play to the advantages of big data trading platform to scientifically guide the procurement and reporting work of hospitals. After the implementation of drugs, it is necessary to gradually strengthen the monitoring of drug trade, improve and implement supporting measures of policies, andcalculate of the proportion of medical insurance funds saved from centralized procurement, so as to gradually promote the progress and development of medical technology.

Provincial pharmaceutical centralized procurement platforms hold a core position in China's pharmaceutical circulation industry and possess irreplaceable advantages in carrying out supply chain financial services. This paper provides an overview of supply chain finance and its development status in the pharmaceutical field, and conducts a feasibility study on the supply chain financial services carried out by provincial pharmaceutical centralized procurement platforms. Meanwhile, by conducting case analysis of the Guangdong Pharmaceutical Exchange and the Chongqing Pharmaceutical Exchange in supply chain financial services, this paper puts forward targeted suggestions and measures from the perspective of provincial pharmaceutical centralized procurement platforms. It enriches the application research of supply chain financial services in the pharmaceutical field and provides a reference for the formulation of relevant policies by medical insurance departments.

Objective: The paper analyzes the use of antibacterial drugs in a tertiary hospital of Zhejiang Province under the centralized drug procurement policy, in order to provide a reference for the rational clinical use of antibacterial drugs and the orderly promotion of centralized procurement. Methods: We extract data on the use of antibacterial drugs before and after the implementation of the centralized drug procurement policy from the hospital information system, analyze indicators such as defined daily doses, defined daily dose cost, cost savings, and generic drug substitution rate, and explore the impact of the policy on the clinical use of antibacterial drugs. Results: After the implementation of the centralized drug procurement policy, defined daily doses of various types of antibacterial drugs have increased or decreased to varying degrees, and defined daily dose cost has shown an overall downward trend. The average potential cost savings are 590600 yuan one year, and the utilization rate of selected drugs reaches 85.31%. The substitution rate of generic drugs has increased from 33.21% to 83.18%. Conclusion: The centralized procurement of antibacterial drugs has optimized the medication structure, and reduced the economic burden on patients. From the perspective of clinical pharmacists, it is recommended to further strengthen the monitoring and management of antibacterial drugs, and steadily promote the normalization of policies.

The balance retention policy is to encourage and guide medical institutions and doctors to use the selected drugs of national centralized procurement. This article analyzes the influencing factors of the balance by the research of national, provincial, and municipal balance retention policy, and provides some suggestions for decision-making.

Objective: The paper studies the effect of intraocular lens centralized procurement on hospitalization expenses of cataract surgery patients. Methods: According to the first page of medical records in Ningbo City, the changes of disease cost, patient structure, average hospital stay of top 10 hospitals with cataract surgery cases before and after intraocular lens centralized procurement were compared and analyzed. Results: Patients with cataract surgery aged 60-80 years old accounts for nearly 70%. After intraocular lens centralized procurement, the hospitalization expenses decreased by 7.59%, among which the cost of materials decreased by 27.79%. Medical service fees, inspection fees, and drug costs increased by varying degrees, and the average length of stay was shortened by 0.32 days. Conclusions: The effect of intraocular lens centralized procurement on disease cost control is obvious, but the cost structure of different hospitals is significantly different. It is recommended that hospitals strengthen the control of disease cost under the background of DRG payment, incorporate intraocular lens into the national centralized purchase, and further reduce the cost of patients.

Objective: The paper explores the using characteristics of antitumor drugs after the national centralized volume-based drug procurement policy and provides suggestions for monitoring of antitumor alternative drugs, as well as the optimization of the policy. Methods: Descriptive statistical methods were used to analyze the expenditures, DDDs and DDDc of antitumor drugs before and after the policy using the drug purchasing data from the National Drug Supply Security Information Platform from 2019 to 2020. Results: The expenditures and DDDc of antitumor selected varieties decreased by 31.87% and 51.55%, while the DDDs increased by 40.61%. The overall expenditures and DDDs of antitumor alternative drugs increased by 49.20% and 41.62% respectively, while the DDDc changed in small increments. Among original and generic drugs, the increase of DDDs of selected generic drugs was higher than that of original drugs, and the cost of the two kinds of drugs decreased obviously. The growth rate in expenditures and DDDs of alternative original drugs was higher than that of generic drugs. Among the drugs with different degrees of substitution, the increase of expenditures, DDDs and DDDc of certain degree of substitution drugs was much higher than that of basic substitution drugs. Conclusions: The implementation of the national centralized volume-based drug procurement policy achieved obvious effects in reducing the drug price and saving the cost in antitumor selected varieties, but the substitution effect of selected varieties to alternative varieties was insignificant. Information technology should be used to monitor the limit of expenditures and dosage of higher degree of substitution varieties, and to accelerate the substitution of expensive original drugs by generic drugs passed the consistency evaluation.

With the normalization of the national centralized drug procurement, some of the first four batches of drugs have expired, and follow-up procurement of the first and the third batch have been carried out. This paper attempts to analyze the first and third batch of follow-up mode, refine and analyze the follow-up modes of different regions and alliances, analyze the effects of the first and third batches in some regions and the changes in the follow-up environment and policy requirements of the second and fourth batches, and put forward policy suggestions for the optimization of follow-up rules.

Objective: The effect of coronary stent centralized procurement on patients with coronary stent implantation was analyzed, so as to provide reference for the cost control in hospitals and departments. Methods: A retrospective study was adopted to collect data on first page of medical records before and after the implementation of coronary stent volume procurement policy, and analyze the hospitalization expenses of patients. Results: The total hospitalization cost and consumables cost (mainly coronary stent cost) of patients before and after coronary stent volume procurement decreased significantly, and the medical service fee increased (P﹤0.05). Conclusion: The centralized procurement policy of coronary stent has remarkable effect on the cost control of patients with coronary stent implantation, which can help the hospital to carry out the cost control, rationally allocate medical resources, optimize clinical pathways, and develop refined management.

Objective: Based on the cost data of a tertiary specialized hospital in Xiamen, the paper is to analyze the effect of centralized purchase policy of medical consumables and put forward targeted policy suggestions. Methods: Two independent samples t-test and nonparametric rank sum test were used to analyze the differences in total hospitalization cost, the cost of sanitary materials, consumable cost of centralized purchase and medical service structure before and after the implementation of the pooling policy. Results: After the implementation of the policy, the total hospitalization cost, the cost of sanitary materials and consumable cost of centralized purchase decreased. The proportion of the cost of sanitary materials and consumable cost of centralized purchase decreased, while the proportion of medical service income increased. The medical service structure has been continuously optimized, and the policy has achieved remarkable results. Conclusion: It is suggested to scientifically analyze and determine the purchase quantity to ensure the "quantity price linkage", improve the mechanism for guaranteeing policies and promote their implementation.

Objective: The paper evaluates the implementation effect of centralized procurement of psychotropic drugs to provide reference for promoting, improving centralized procurement of psychotropic drugs. Methods: The use of selected drugs of a psychiatric hospital from December2019to August2022were collected, compared, analyzed, including the number of selected products, the amount of use, the sales amount, the agreed task amount, average cost per time of selected key varieties of psychiatric category, the amount of prescriptions, DDDs, the average drug cost per outpatient/inpatient, adverse drug reactions, other indicators. Results: The tasks of each batch of centralized purchase were overfulfilled, the sales volume of centralized purchase varieties increased significantly, with the highest increase of1269.71%. Compared with the same period of the previous year, the total sales amount of non-selected drugs with the same generic name decreased significantly, with a maximum decrease of254.19%. The maximum ratio of prescription quantity of selected varieties/non-selected varieties was30.88. The average drug cost per outpatient/inpatient decreased gradually. The average drug cost of the selected varieties of psychiatric products decreased significantly compared with that before centralized purchase, with the maximum decrease of84.07%. Conclusion: The centralized purchase of psychotropic drugs reduces the drug costs for patients with mental diseases, improves the efficiency of medical insurance funds

Objective: The paper attempts to explore the effect of collaborative drug management in a tertiary hospital in Beijing, to provide suggestions for promoting rational drug use, improving drug management in hospitals. Methods: Excel software was used to explore the drug purchase data of the hospital from2017to2021by comparative analysis. Results: After collaborative management, the proportion of centralized procurement, national negotiation drugs in the total drug catalog of the hospital increased4.35times, the proportion of selected centralized procurement drugs quantity increased4.59times, the frequency of national negotiation drug procurement increased6.21times, the total amount of drug procurement decreased50million yuan. Conclusion: The coordinated drug management of centralized purchase, national negotiation can improve the availability of drugs, the efficiency of medical insurance funds, promote rational drug use in hospitals, optimize the drug purchase, supply management in hospitals

With the completion of the first batch of centralized volume-based drug procurement (CVDP) in Hubei Province, relevant assessments have been completed. Based on the cases of a Level III A hospital, this article analyzes the impact of CVDP on relevant stakeholders to give suggestions to public hospitals on the better implementation of volume-based drug procurement policies.

Guided by policies and actual regulatory requirements as well as the idea of closed-loop management, Shenzhen Medicine Trading Platform has built a PDCA whole process monitoring system for centralized drug procurement with big data empowerment. Through big data analysis, closed-loop monitoring technology is realized, monitoring efficiency is improved, and the national centralized procurement task is effectively implemented.

Objective: The paper attempts to provide a reference for improving the supervision of centralized procurement of medical consumables by summarizing and analyzing illegal behaviors of relevant parties in the centralized procurement process of medical consumables in China. Methods: Relevant academic literature, government documents, official reports, laws and regulations, judgment documents and other materials were searched through open channels and problems were analyzed. Results: In the centralized procurement of medical consumables in China, there may be different types of illegal behaviors involving enterprises, medical institutions, and centralized procurement agencies. There is no medical consumables procurement laws and regulations at present. Violations are mainly regulated and punished according to the drug price and credit evaluation system and local policies. Conclusion: At present, there are difficulties in the centralized procurement of medical consumables, such as imperfect laws and regulations and difficulties in supervision of illegal behaviors. It is suggested to enact the healthcare security law, improve the supervision and management mechanism, and strengthen the collaboration of multi-departments to promote the high-quality development of the centralized procurement of medical consumables.

Objective: The paper explores the motivation of public medical institutions to complete the task of centralized procurement, analyzes the factors affecting the effect of centralized procurement, and provides a reference for the government to implement supervision and decision-making. Methods: Based on the game theory, the paper analyzes the first five batches of state-organized drug procurement in 14 provincial public hospitals by constructing the game model between government and hospitals. Results: In terms of the implementation of the centralized procurement policy in hospitals, there were problems such as insufficient government supervision, decrease of drug amount declaration in public hospitals and low participation enthusiasm. Conclusion: It is suggested optimizing the government supervision mechanism, strengthening the daily supervision, improving the incentive and restraint system, and improving the net revenue of medical institutions.

National centralized drug procurement involves diversified drug types and wide geographical area, which provides important reference for regional alliances to carry out centralized procurement. This paper takes the expansion of “4+7” centralized procurement, the second to fifth batch of national centralized drug procurements, and the centralized drug procurement of regional alliances with official data published before December 2021 as examples. OLS regression model is used to analyze whether national centralized drug procurements would have a price transmission effect on the centralized drug procurements of regional alliances. The result shows that there is no significant price transmission effect between national centralized drug procurements and the regional ones. However, this result may not completely deny the existence of price transmission effect due to limited available data, along with few overlapping drug types, different purchase amount and selection rules among the studied drug procurements. This paper aims to enrich the understanding of the connotation and implementation of the centralized drug procurement policy. Meanwhile, it provides some reference for the following centralized drug procurements.

Objective: The paper systematically analyzes the four batches (including three batches of national procurement and a batch of follow-up procurement) of national high-value medical consumables centralized volume-based procurement rules and selected results, in order to reflect the trend of China's high-value medical consumables centralized volume-based procurement. Methods: By analyzing the four batches of procurement documents, the procurement rules are compared from five aspects, i.e. the proportion of intended procurement, grouping rules, quotation rules, selection rules, and volume allocation rules. Also we analyze the selected results from two aspects of selected price and selected enterprises and summarize the trend of centralized volume-based procurement of high-value medical consumables in China. Results: According to comparison of the rules, the proportion of intended procurement is increasing, grouping rules reflect homogeneous competition in the same group, the price composition becomes more detailed, selection rules tend to stabilize the clinical supply, and volume allocation rules reflect quantity-price linkage. According to the selected results, the prices of selected drugs decrease to 80%, the difference of selected price gradually narrows to less than 1.5 times, the domestic share of national varieties steadily increases, domestic substitution further strengthens, the selected rate of enterprises gradually increases and stabilizes at 90%, the leading enterprises are selected and the industry concentration further increases. Conclusion: Combining the analysis above with the current situation of the procurement, the paper summarizes the seven trends of high-value medical consumables centralized volume-based procurement in China, namely, procurement rules design is more focused on the protection of market stability, procurement scope continues to expand and almost all varieties can be selected, we form a new pattern of pharmaceutical centralized volume-based procurement with collaborative promotion, a number of initiatives support the procurement to move towards a new journey of comprehensive price management, varieties focus on low localization rate areas and domestic replacement process accelerated, centralized procurement promotes enterprise innovation and realizes the high-quality development of pharmaceutical industry, centralized procurement synergy "medical insurance-medical treatment-drugs linkage" to promote the development of pharmaceutical industry.

Objective: Through in-depth analysis of the effects and problems of the centralized procurement policy of high-value medical consumables in a first-class a hospital in Shanghai, the paper evaluates the efficiency change of medical service, and puts forward suggestions accordingly, taking the centralized procurement of intraocular lens as an example. Methods: Through the literature research, Horn-meter model, projection-after implementation comparative analysis, case study and interview, we summarize rules and methods to provide a reference for the implementation of centralized procurement policy of high-value medical consumables. Conclusion: The government should continue to promote and guarantee the implementation of centralized procurement policy. Medical institutions should actively implement the policy, strengthen the construction of compensation mechanism, optimize the price structure of medical services and ensure the diversity of clinical products. Medical insurance departments should give full play to the guiding role of medical insurance and relieve the pressure of expenditure.