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Yina C, Pengcheng L, Haomiao N, Yang C. An empirical study of the impact of generic drug competition on drug market prices in China. Front Public Health 2023; 11:1146531. [PMID: 37304112 PMCID: PMC10248158 DOI: 10.3389/fpubh.2023.1146531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 05/08/2023] [Indexed: 06/13/2023] Open
Abstract
Introduction Generic substitution is encouraged to reduce pharmaceutical spending in China, and with incentive policies, the market size of the generic drug continues to rise. To find out how the generic competition affects drug price in this area, this study examines how the quantity of generic drug manufacturers can influence average drug price in the Chinese market. Methods This study uses a rigorous selection of drugs from the 2021 China's National Reimbursement Drug List (NRDL), and uses drug-level fixed effects regressions to estimate the relationship between competition and price within each drug. Results We note that drug prices decline with increasing competition in the Chinese market, but not in a perfectly linear manner, with marginal price declines decreasing after the fourth entrant and "rebounding" at subsequent entrants, especially the sixth. Discussion The findings suggest the importance of maintaining effective competition between suppliers to control prices, and that the government needs to further control generic pricing, especially for late entry generics, to ensure effective competition in the Chinese market.
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Li Z, Liu C, Zuo K, Liu J, Tang Y. Effects of Volume-Price Contracts on Pharmaceutical Prices: A Retrospective Comparative Study of Public Hospitals in Hubei of China. Front Pharmacol 2021; 12:741671. [PMID: 34721029 PMCID: PMC8552023 DOI: 10.3389/fphar.2021.741671] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/30/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Pharmaceutical expenditure has been increasing worldwide. Many countries have attempted to contain the increase through collective bargaining, including in China. In 2015, the Chinese government introduced a new policy to empower regional governments to reduce pharmaceutical prices through its existing tendering system which enables a lower price for products with higher procurement volumes. Xiangyang municipality in Hubei province took a lead in piloting this initiative. Objectives: This study aimed to evaluate the effects of the volume-price contract initiative on pharmaceutical price procured by the public hospitals in Xiangyang. Methods: A retrospective comparative design was adopted. The price of cardiovascular medicines (349 products under 164 International Nonproprietary Names) procured by the public hospitals in Xiangyang was compared with those procured in Yichang municipality in Hubei. A total of 15,921 procurement records over the period from January 2017 to December 2018 were examined (Xiangyang started the volume-price contract initiative in January 2018). Generalized linear regression models with a difference-in-differences approach which could reflect the differences between the two cities between January 2018 and December 2018 were established to test the effects of the volume-price contract initiative on pharmaceutical prices. Results: On average, the procurement price for cardiovascular medicines adjusted by defined daily dosage in Xiangyang dropped by 41.51%, compared with a 0.22% decrease in Yichang. The difference-in-differences results showed that the volume-price contract initiative resulted in a 36.24% drop (p = 0.006) in the price (30.23% for the original brands, p = 0.008), in addition to the therapeutic competition effect (31.61% reduction in the price, p = 0.002). The top 100 domestic suppliers were highly responsive to the initiative (82.80% drop in the price, p = 0.001). Conclusion: The volume-price contract initiative has the potential to bring down the price of pharmaceutical supplies. Higher responses from the domestic suppliers are evident.
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Affiliation(s)
- Zhuoxian Li
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chaojie Liu
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Keyuan Zuo
- Hubei Public Resource Trading Center, Wuhan, China
| | - Junjie Liu
- School of Statistics and Mathematics, Central University of Finance and Economics, Beijing, China
| | - Yuqing Tang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Shi W, Wouters OJ, Liu G, Mossialos E, Yang X. Association between provincial income levels and drug prices in China over the period 2010-2017. Soc Sci Med 2020; 263:113247. [PMID: 32799026 DOI: 10.1016/j.socscimed.2020.113247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 07/04/2020] [Accepted: 07/22/2020] [Indexed: 10/23/2022]
Abstract
In the past decade, the Chinese central government has made sweeping reforms to national pharmaceutical policies. However, provincial authorities have retained control over most drug procurement procedures, potentially leading to cross-province differences in drug prices. The objectives of this study were to (i) examine drug price trends in 31 Chinese provinces and municipalities between 2010 and 2017; (ii) evaluate the association between provincial income levels and drug prices over this period; and (iii) compare the results for Chinese state-owned, Chinese private, and multinational pharmaceutical firms. Using publicly available data on procurement prices of the drugs manufactured by the top 30 pharmaceutical firms in China (in terms of revenues), we ran a generalized country-product-dummy regression to compare drug prices across provinces over the study period. We conducted subgroup analyses to test for differences between types of firms. Between 2010 and 2017, drug prices decreased by an average of 23% across the country. The prices of drugs sold by multinational firms dropped by 32% over this period, while the prices of drugs sold by Chinese private firms declined by 28%. By contrast, the drug prices of state-owned firms went up by 11%. There were statistically significant positive associations between drug prices and provincial income levels for the full sample in 2010, 2011, and 2013. There were no significant associations in other years. Several low-income provinces paid higher procurement prices than some high-income provinces for identical medicines, especially in later study years. The lack of association between income levels and prices poses equity concerns and may place a heavier cost burden on the poor. It also suggests that China's pharmaceutical policies may be failing to balance the dual aims of drug affordability and incentives for innovation.
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Affiliation(s)
- Wunan Shi
- School of Economics and Finance, Xi'an Jiaotong University, Xi'an, China Address: 74 Yanta West Road, Xi'an, Postcode 710061, China; Department of Health Policy, London School of Economics and Political Science, London, U.K. Address: Houghton Street, London, Postcode WC2A 2AE, UK.
| | - Olivier J Wouters
- Department of Health Policy, London School of Economics and Political Science, London, U.K. Address: Houghton Street, London, Postcode WC2A 2AE, UK.
| | - Gordon Liu
- National School of Development, Peking University, Beijing, China Address: 5 Yiheyuan Road, Haidian District, Beijing, Postcode 100871, China.
| | - Elias Mossialos
- Department of Health Policy, London School of Economics and Political Science, London, U.K. Address: Houghton Street, London, Postcode WC2A 2AE, UK.
| | - Xiuyun Yang
- School of Economics and Finance, Xi'an Jiaotong University, Xi'an, China Address: 74 Yanta West Road, Xi'an, Postcode 710061, China.
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Mahlich J, Kamae I, Sruamsiri R. Pharmaceutical pricing in Japan: market evidence for rheumatoid arthritis treatment. Expert Rev Pharmacoecon Outcomes Res 2017; 18:339-348. [PMID: 29039214 DOI: 10.1080/14737167.2018.1394187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Drug price setting is one of the key challenges faced by the Japanese health care system. This study aims to identify the determinants of drug price in Japan using the example of the rheumatoid arthritis (RA) treatment market. RESEARCH DESIGN AND METHODS In order to compare prices across different products, we calculated prices per defined daily dose using WHO methodology. Price determinants were calculated both at launch and over time using IMS quarterly data on medicines approved for RA treatment in Japan from 2012 to 2015. Pharmaceutical pricing was modeled as a function of clinical and economic variables using regression analysis. RESULTS For prices at the launch we found that differences in efficacy are not reflected in price differentials. We also report that the number of products within a molecule class had a negative effect on prices while originator drugs maintained higher prices. CONCLUSION Although the existing pricing rules in Japan are very comprehensive they do not necessarily capture differences in product characteristics. The findings here support the notion that competitive forces are weak in highly regulated markets such as Japan.
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Affiliation(s)
- Jörg Mahlich
- a Health Economics , Janssen Pharmaceutical KK , Tokyo , Japan.,b Düsseldorf Institute for Competition Economics (DICE) , University of Düsseldorf , Düsseldorf , Germany
| | - Isao Kamae
- c Graduate School of Public Policy , The University of Tokyo , Tokyo , Japan.,d The Canon Institute for Global Studies , Tokyo , Japan
| | - Rosarin Sruamsiri
- a Health Economics , Janssen Pharmaceutical KK , Tokyo , Japan.,e Center of Pharmaceutical Outcomes Research , Naresuan University , Phitsanulok , Thailand
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Liu J, Wang L, Liu C, Zhang X. Impact of price deregulation policy on the affordability of essential medicines for women's health: a panel data analysis. Expert Rev Pharmacoecon Outcomes Res 2017; 17:625-631. [PMID: 28503962 DOI: 10.1080/14737167.2017.1330151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND A new policy which required deregulation on prices of off-patent medicines for women's health during procurement was introduced in China in September 2015. The current study examines this policy's impact on the affordability of essential medicines for women's health. METHODS Based on product-level panel data, a fixed effect regression model is employed by using procurement records from Hubei Centralist Tender for Drug Purchase platform. In the model, Affordability was measured with prices. The Competition consists of two parts: generic competition and therapeutic class competition which are measured with generic competitors and therapeutic substitutes. Instrument variable is used to deal with endogeneity. RESULTS The policy helped control prices of essential medicines for women's health. Generic competition helped control prices, however, therapeutic class competition caused higher prices. CONCLUSIONS The new policy helped enhance the affordability of essential medicines for women's health as expected, which provides empirical evidence on price deregulation. Besides, generic competition is important in price control despite strict regulatory system in China.
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Affiliation(s)
- Junjie Liu
- a School of Medicine and Health Management, Tongji Medical College , Huazhong University of Science and Technology , Wuhan City , Hubei Province , China
| | - Liming Wang
- b Cancer Biology Research Center , Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan City , Hubei Province , China
| | - Chenxi Liu
- a School of Medicine and Health Management, Tongji Medical College , Huazhong University of Science and Technology , Wuhan City , Hubei Province , China
| | - Xinping Zhang
- a School of Medicine and Health Management, Tongji Medical College , Huazhong University of Science and Technology , Wuhan City , Hubei Province , China
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Zhao M, Wu J. Impacts of regulated competition on pricing in Chinese pharmaceutical market under urban employee basic medical insurance. Expert Rev Pharmacoecon Outcomes Res 2016; 17:311-320. [DOI: 10.1080/14737167.2017.1251318] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Mingyue Zhao
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China
| | - Jing Wu
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China
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Bayazidi Y, Homaie Rad E, Mojahedian M, Toroski M, Nabizadeh A, Farahmand P, Felezi Nasiri B. The impact of research and development and marketing costs on the profitability of pharmaceutical companies of Tehran Stock Exchange using panel data 2001-2013. INTERNATIONAL JOURNAL OF PHARMACEUTICAL AND HEALTHCARE MARKETING 2016. [DOI: 10.1108/ijphm-06-2015-0029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The main aim of this study is to investigate the effects of marketing and costs and research and development (R&D) investments on profitability of pharmaceutical companies of Iran.
Design/methodology/approach
In this study, pharmaceutical companies that have been accepted in Tehran Stock Exchange until March 19, 2013 were investigated. Random-effect panel data estimator was used for this purpose.
Findings
The findings indicate that variables such as company size, capital-to-total asset ratio and debt-to-asset ratio have an effect on profitability. But, company life, advertising cost and R&D investment are ineffective on profitability.
Originality/value
Legal issues like not having patent law and pricing mechanism are reasons for the ineffective relationship between R&D and marketing costs and its effect on profitability of the Iran pharmaceutical industry.
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Liang W, Xie J, Fu H, Wu EQ. The role of health economics and outcomes research in health care reform in China. PHARMACOECONOMICS 2014; 32:231-234. [PMID: 24554475 PMCID: PMC3937542 DOI: 10.1007/s40273-014-0141-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Wannian Liang
- Department of Healthcare Reform, Office of State Council Health Reform Leading Group, National Health and Family Planning Commission of the People’s Republic of China, Beijing, China
| | - Jipan Xie
- Analysis Group, Inc., 111 Huntington Ave, 10th Floor, Boston, MA 02199 USA
| | - Hongpeng Fu
- Department of Medicine Policy, China National Health Development and Research Center, Beijing, China
| | - Eric Q. Wu
- Analysis Group, Inc., 111 Huntington Ave, 10th Floor, Boston, MA 02199 USA
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