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Background <p>High prices of medical consumables pose a major barrier for patients. To address those inflated prices, the National Healthcare Security Administration of China implemented the Centralized Volume-Based Procurement policy (CVBP) in 2021. However, evidence assessing the effect of CVBP in Gansu is insufficient. This study aims to estimate the impact of CVBP for high-value medical consumables in Gansu on the hospitalization expenses.</p> Methods <p>Data from 8076 inpatients in Gansu who underwent surgeries involving coronary stents, artificial joints, or intraocular lenses between April 2019 and October 2024 were collected. An interrupted time series analysis (ITSA) was conducted to examine the effect of CVBP on patient hospitalization expenses. An autoregressive integrated moving average (ARIMA) model was used to assess the difference between the predicted and actual expenses after the implementation of CVBP.</p> Results <p>(i) After implementation, the material expense per patient who underwent surgeries involving artificial joints was reduced by 387.782 Chinese yuan (CNY) (<i>95%CI</i>: −592.583 to −182.981, <i>p</i> &lt; 0.001) per capita per month. The material expense of patients decreased immediately by 18,668.870 CNY (<i>95%CI</i>: −24,241.620 to −13,096.120, <i>p</i> &lt; 0.001) per capita in the month when CVBP for coronary stents was implemented. The expense changes for intraocular lenses were not statistically significant. In addition, an immediate upward trend of 0.022 CNY per capita per month (<i>95%CI</i>: −0.017 to 0.026, <i>p</i> &lt; 0.05) after the implementation of CVBP in terms of the percentage of anesthesia expenses was observed in the post-intervention month. (ii) The results of the ARIMA predictions indicated that per capita material expense savings at months post-CVBP were 14,028.187 CNY for coronary stents, 24,476.634 CNY for artificial joints and 280.039 CNY for intraocular lenses.</p> Conclusions <p>The implementation of the CVBP of high-value medical consumables saved patient hospitalization expenses and material expenses in Gansu, China. Future research should analyze the long-term effects of CVBP on medical insurance funds and total health expenses.</p>

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Impact of centralized volume-based procurement of high-value medical consumables on patients’ hospitalization expenses in Gansu, China: an interrupted time series analysis

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  • 发表日期：

    2026年3月3日

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  • Yajie Zhang,
  • Feihan Shen,
  • Qiyin Luo,
  • Zixuan Gan,
  • Zhenjie Lian,
  • Xuping Song,
  • Kehu Yang,
  • Howard White

摘要

Background

High prices of medical consumables pose a major barrier for patients. To address those inflated prices, the National Healthcare Security Administration of China implemented the Centralized Volume-Based Procurement policy (CVBP) in 2021. However, evidence assessing the effect of CVBP in Gansu is insufficient. This study aims to estimate the impact of CVBP for high-value medical consumables in Gansu on the hospitalization expenses.

Methods

Data from 8076 inpatients in Gansu who underwent surgeries involving coronary stents, artificial joints, or intraocular lenses between April 2019 and October 2024 were collected. An interrupted time series analysis (ITSA) was conducted to examine the effect of CVBP on patient hospitalization expenses. An autoregressive integrated moving average (ARIMA) model was used to assess the difference between the predicted and actual expenses after the implementation of CVBP.

Results

(i) After implementation, the material expense per patient who underwent surgeries involving artificial joints was reduced by 387.782 Chinese yuan (CNY) (95%CI: −592.583 to −182.981, p < 0.001) per capita per month. The material expense of patients decreased immediately by 18,668.870 CNY (95%CI: −24,241.620 to −13,096.120, p < 0.001) per capita in the month when CVBP for coronary stents was implemented. The expense changes for intraocular lenses were not statistically significant. In addition, an immediate upward trend of 0.022 CNY per capita per month (95%CI: −0.017 to 0.026, p < 0.05) after the implementation of CVBP in terms of the percentage of anesthesia expenses was observed in the post-intervention month. (ii) The results of the ARIMA predictions indicated that per capita material expense savings at months post-CVBP were 14,028.187 CNY for coronary stents, 24,476.634 CNY for artificial joints and 280.039 CNY for intraocular lenses.

Conclusions

The implementation of the CVBP of high-value medical consumables saved patient hospitalization expenses and material expenses in Gansu, China. Future research should analyze the long-term effects of CVBP on medical insurance funds and total health expenses.