Peer-reviewed article
Effects of China's National Volume-Based Procurement policy on utilisation and affordability of statins in children: an interrupted time series analysis.
Wu Y, Bai W, Liu F, Fan X, Liu S et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examines how China's National Volume-Based Procurement policy, launched in 2019, affected the use and affordability of statins (cholesterol-lowering medicines) in children's hospitals. Using data from January 2019 to December 2020, researchers found that after the policy was implemented, statin use increased significantly while costs decreased substantially. The affordability of the two main statins improved by over 90 percent, and more children could access these medicines. The policy successfully made statins cheaper without reducing the quality of healthcare.
Key points
- After NVBP policy implementation, affordability of atorvastatin improved by at least 90.54% and rosuvastatin by at least 89.85%
- Statin utilisation increased across all children's hospitals nationwide following the policy
- Generic bid-winning versions of atorvastatin and rosuvastatin became the most commonly used market variety after the policy, up from the least used
- The policy achieved increased drug access and reduced costs without compromising healthcare quality
- Study covered all levels of children's hospitals across China using monthly procurement records
Limitations
The study focuses only on procurement data and affordability metrics in China's formal healthcare system; it does not measure clinical outcomes (such as whether children's cardiovascular health actually improved) or access in private or rural settings outside the hospital system.
Abstract
Background Statins are effective in lowering lipids and reducing cardiovascular risk. In recent decades, rising paediatric lipid levels, especially in low- and middle-income countries (LMICs), have led to growing demand for lipid-lowering drugs. However, access remains limited in LMICs due to financial constraints. To address this, China launched its National Volume-Based Procurement (NVBP) policy in 2019, significantly improving the price and affordability of statins. This study evaluates the policy's impact on statin use and expenditures in children. Methods The study used interrupted time series regression to analyse all levels of children's hospitals across the country's monthly procurement records of statins, covering the period from January 2019 to December 2020. It investigated the fluctuations in monthly drug procurement quantity (measured in defined daily doses) and expenditures (affordability) at both the national level and across different tiers of child medical facilities. Results Following the implementation of the NVBP policy, the utilisation and affordability of statins across all children's hospitals nationwide exhibited a positive upward trend. After the NVBP policy, the affordability of atorvastatin in children's hospitals nationwide improved by at least 90.54% and the affordability of rosuvastatin in children's hospitals nationwide increased by no less than 89.85%. Both before and after the NVBP policy, the majority of utilisation and expenditure in statin was contributed by atorvastatin and rosuvastatin. After the NVBP policy, the utilisation of atorvastatin and rosuvastatin bid-winning generic has increased significantly, making bid-winning generic change from the variety occupying the least market to the variety occupying the most market in children's hospitals. Conclusion The implementation of China's NVBP policy has resulted in a marked increase in the dosage of atorvastatin and rosuvastatin, while effectively reducing cost expenditure for children. This achievement has been realised without compromising the quality of healthcare services. China's NVBP policy provides a reference and path for the medical reform of all countries in the world especially LMICs.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- National Volume-Based Procurement (NVBP) policy that significantly reduced statin prices through bulk purchasing and generic competition
- Population
- Children treated in all levels of children's hospitals across China
Key finding
Affordability of atorvastatin improved by at least 90.54% after policy implementation
Y et al. · Europe PMC · 15 Jul 2026