Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Aug 6:9:714127.
doi: 10.3389/fpubh.2021.714127. eCollection 2021.

Impact of the National Health Insurance Coverage Policy on the Utilisation and Accessibility of Innovative Anti-cancer Medicines in China: An Interrupted Time-Series Study

Affiliations

Impact of the National Health Insurance Coverage Policy on the Utilisation and Accessibility of Innovative Anti-cancer Medicines in China: An Interrupted Time-Series Study

Wenqing Fang et al. Front Public Health. .

Abstract

Objective: The study aimed to evaluate the impact of the National Health Insurance Coverage (NHIC) policy on the utilisation and accessibility of innovative anti-cancer medicines in Nanjing, China. Methods: We used the adjusted World Health Organisation and Health Action International methodology to calculate the price and availability of 15 innovative anti-cancer medicines included in the National Health Insurance drug list in 20 tertiary hospitals and six secondary hospitals in Nanjing before and after NHIC policy implementation. Interrupted time-series regression was used to analyse the changes in the utilisation of the study medicines. Results: The price reduction rates of innovative anti-cancer medicines ranged between 34 and 65%. The mean availability rate was 27.44% before policy implementation and increased to 47.33% after policy implementation. The utilisation of anti-cancer medicines suddenly increased with a slope of 33.19-2,628.39 when the policy was implemented. Moreover, the usage rate of bevacizumab, bortezomib, and apatinib significantly increased (p < 0.001, p = 0.009, and p < 0.001, respectively) after policy implementation. With regard to price reduction and medical insurance reimbursement, the medicines became more affordable after policy implementation (0.06-1.90 times the per capita annual disposable income for urban patients and 0.13-4.46 times the per capita annual disposable income for rural patients). Conclusion: The NHIC policy, which was released by the central government, effectively improved the utilisation and affordability of innovative anti-cancer medicines. However, the availability of innovative anti-cancer medicines in hospitals remained low and the utilisation of innovative anti-cancer medicines was affected by some factors, including the incidence of cancer, limitation of indications within the insurance program, and the rational use of innovative anti-cancer medicines. It is necessary to improve relevant supporting policies to promote the affordability of patients. The government should speed up the process of price negotiation to include more innovative anti-cancer medicines in the medical insurance coverage, consider including both medical examinations and adjuvant chemotherapy in the medical insurance, and increase investment in health care.

Keywords: affordability; innovative anti-cancer medicines; interrupted time series; national health insurance coverage; utilisation.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Graphic illustration of the interrupted time-series model and measurement of the policy effect based on trend lines for data points before and after policy implementation.
Figure 2
Figure 2
Results of the regression analysis of the utilisation of study drugs before and after policy implementation shown in a scatter plot.

Similar articles

Cited by

References

    1. Sun KX, Zheng RS, Zhang SW, Zeng HM, Zou XN, Chen R, et al. . Report of cancer incidence and mortality in different areas of China, 2015. China Cancer. (2019) 28:1–11. 10.11735/j.issn.1004-0242.2019.01.A001 - DOI - PubMed
    1. Chen ZN. The frontier and innovation of biomedicine in the new era. China Food & Drug Administration Magazine. (2019) 11:8–13. 10.3969/j.issn.1673-5390.2019.11 - DOI
    1. Wilson A, Cohen J. Patient access to new cancer drugs in the United States and Australia. Value in Health. (2011) 14:944–52. 10.1016/j.jval.2011.05.004 - DOI - PubMed
    1. Zhou YP, Wang HG, Hu QH, Zhou RS, Cheng BS, Kang FH, et al. . Accessibility of high-cost anti-cancer medicines in China. Chinese J Evidence-Based Med. (2017) 17:862–8. 10.7507/1672-2531.201703028 - DOI
    1. THE STATA COUNCIL . Opinions of the State Council on implementing the Health China Action. (2019). Available online at: http://www.gov.cn/zhengce/content/2019-07/15/content_5409492.htm (accessed: December 24, 2020).

Publication types

LinkOut - more resources

-