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In 2018, the Chinese government identified four municipalities and seven sub-provincial cities for the implementation of the National Drug Pooled Procurement (NDPP) pilot program (the "4 + 7" policy). In the present study, we analyzed the effects of the "4 + 7" policy with data of 25 pilot drugs from the National Healthcare Security Administration (NHSA) from the aspects of drug price, volume, and expenditure. After the implementation of the policy, the average price of total and winning drugs was decreased by 54.47% and 73.82%, respectively, while the DDDc of non-winning drugs was decreased by only 1.54%, and the DDDc of uncertificated generic drugs was increased 83.18%. The DDDs indicating the volume of total and winning drugs was increased by 21.18% and 353.98%, respectively, and the DDDs of non-winning drugs was decreased by 61.35%. The costs of total and non-winning drugs were decreased by 44.83% and 61.94%, respectively, and the cost of winning drugs was increased by 18.87%. The "4 + 7" policy reduced the price and cost of pilot drugs and improved the affordability and accessibility of drugs. However, there were also problems with unexpected excessive price increases of uncertificated generic drugs and relatively high prices of non-winning products. Therefore, we highly suggested promoting the normalization and institutionalization of pooled drug procurement, enhancing the administrative capacity of local procurement platforms, and strengthening monitoring the price of non-winning, especially for the uncertificated generic drugs. [ABSTRACT FROM AUTHOR]

Reimbursement policy for outpatient chronic diseases is an important part of the basic medical insurance scheme in China. The reimbursement policy for outpatient chronic diseases in basic medical insurance for urban residents of provincial capitals in China were analyzed from the perspectives of disease types, benefits package, qualification and health service access. Proposals to improve policy design, establish standardized disease inclusion criteria and set reasonable benefits package, strengthen management and complete supporting policy, strengthen policy coordination were put forward according the existing problems such as fragmented policy, great difference in disease types and benefit package, supervision difficulty, incomplete policy framework and lack of policy coordination. [ABSTRACT FROM AUTHOR]

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