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Potential Expanded Use of Pharmacoeconomics and Outcomes Research in China

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Pharmaceutical Development and Regulation

Abstract

In an era of cost containment and managed care, pharmacoeconomics and outcomes research are increasingly used in both public and private sectors to improve the allocation of healthcare and pharmaceutical resources. While this trend has been well observed in developed nations, little is known about its status in developing countries. This article presents an overview of pharmacoeconomics and outcomes research in China.

This article highlights the increasing demand and great market potential for pharmacoeconomics and outcomes research in China. This is largely based on a number of observations: the impact of China’s growing economy, dominant pharmaceutical expenditures, and World Trade Organization (WTO) entry.

China is among the fastest growing economies. It is currently the seventh largest economy in the world, and is creating a strong income effect on the demand for pharmaceutical use and application of pharmacoeconomics in allocating limited resources. Pharmaceutical expenditure accounts for over 50% of total healthcare costs in China, making the pharmaceutical market a central focus of recent healthcare reforms. Thus, demand for cost-effectiveness data is expected to play an increasingly critical role in shaping both public and private policy making in the pharmaceutical market.

China’s recent entry into the WTO is resulting in unprecedented changes in the pharmaceutical industry. Among other benefits, trade barriers will be reduced substantially, leading to an even more competitive pharmaceutical market than before. Furthermore, mechanisms for market competition are anticipated to change from traditional cost-based pricing to a basis of cost-effectiveness and outcomes assessment as the health insurance, drug distribution, and pharmacy markets become open to foreign vendors.

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References

  1. Boston Consulting Group. The contribution of pharmaceutical companies: what’s at stake for American. Boston (MA): Boston Consulting Group, 1993

    Google Scholar 

  2. Lichtenberg F.Do (more and better) drugs keep people out of hospitals? Am Econ Rev 1996 May; 86(2): 384–8

    Google Scholar 

  3. Lichtenberg F. Are the benefits of newer drugs worth their cost?: evidence from the 1996 MEPS. Health Aff (Millwood) 2001 Sep-Oct; 20(5): 241–51

    Article  CAS  Google Scholar 

  4. Cutler DM. Declining disability among the elderly. Health Aff (Millwood) 2001 Nov-Dec; 20(6): 11–27

    Article  Google Scholar 

  5. Cutler DM, McClellan M. Is technological change in medicine worth it? Health Aff (Millwood) 2001 Sep-Oct; 20(5): 11–29

    Article  Google Scholar 

  6. Pharmaceutical Research and Manufacturers of America (PhRMA). Pharmaceutical Industry Profile 2001: a century of progress. Washington, DC: PhRMA, 2001

    Google Scholar 

  7. Weinstein MC, Stason WB. Foundation of cost-effectiveness analysis for health and medical practices. N Engl J Med 1977; 296: 716–21

    Article  PubMed  CAS  Google Scholar 

  8. Drummond M, Torrance G, Mason J. Methods for the economic evaluation of health care programs. Oxford: Oxford University Press, 1993

    Google Scholar 

  9. Gold MR, Siegel JE, Russell LB, Weinstein MC. Cost-effectiveness in health and medicine. New York: Oxford University Press, 1996

    Google Scholar 

  10. Vogenberg RR, Vogenberg FR. Introduction to applied pharmacoeconomics. New York: McGraw-Hill Professional, 2000

    Google Scholar 

  11. DiMasi JA, Caglarcan E, Wood-Armany M. Emerging role of pharmacoeconomics in the research and development decision-making process. Pharmacoeconomics 2001; 19(7): 753–66

    Article  PubMed  CAS  Google Scholar 

  12. World Bank. World development indicators [online]. Available from URL: http://www.worldbank.org [Accessed 2002 Oct 3]

  13. Xia YQ, Jiang L. Thoughts on countermeasures and problems in cooperative medical schemes. China Primary Health Care 1999; 13(1): 6–7

    Google Scholar 

  14. Rao KQ. Economics in transition and health care reforms: thoughts on deepening health care reforms. Ministry of Public Health, Analysis Report [online]. Available from URL: http://www.moh.gov.cn [Accessed 2002 Oct 27]

  15. Wang JX. Initiation of urban health care reforms. Pharmaceutical Practice Management 1999; 18(2): 12–4

    Google Scholar 

  16. Liu GG, Yuen P, Hu T, et al. Urban health insurance reform: what can we learn from the pilot experiments? In: Chen A, Liu GG, Zhang K, et al. editors. Urbanization and social welfare in China. Aldershot: Ashgate Publishing, 2003

    Google Scholar 

  17. Liu GG, Cai R, Zhao Z, et al. Urban health care reform initiative in China: preliminary findings from the pilot experiment in Zhenjiang City. Int J Econ Dev 1999; 1(4): 504–25

    Google Scholar 

  18. Liu GG, Cai R, Chao S, et al. China’s health care insurance experiment: a cost and utilization analysis. In: Hu TW, Hsieh CR, editors. Economics of health care reform in Pacific Rim. Camberley: Edward Elgar Publishing Ltd, 2001: 143–58

    Google Scholar 

  19. Liu GG, Zhao Z, Cai R, et al. Equity in health care access: assessing the urban health insurance reform in China. Soc Sci Med 2002; 55(10): 1779–94

    Article  PubMed  Google Scholar 

  20. MOLSS. Report on labor and social security development [online]. Available from URL: http://www.stats.gov.cn [Accessed 2002 Jun 10]

  21. China Ministry of Health. National health statistics in 2001 [online]. Available from URL: http://www.moh.gov.cn [Accessed 2002 Oct 27]

  22. World Bank. World development indicators [online]. Available from URL: http://www.worldbank.org [Accessed 2002 Oct 8]

  23. China Ministry of Health. National health statistics in 1991, 1995, 2000 [online]. Available from URL: http://www.moh.gov.cn [Accessed 2002 Oct 27]

  24. Zhao Q, Gao GY, Wan Q. Calculating report on China’s national healthcare expenditure in 2000. Chin Health Econ 2002; 21(3): 29–35

    CAS  Google Scholar 

  25. State Statistics Institute. Annual report of China statistics & National economics and social development statistics in relevant years [online]. Available from URL: http://www.stats.gov.cn [Accessed 2002 Oct 27]

  26. Wang YZ. Chinese pharmaceutical industry in the progression of economic globalization: gaps and countermeasures [online]. Chin Health Econ 2001; 20(8) 24–7

    Google Scholar 

  27. State Drug Administration Information Center (SDAIC). Analytical report on economic running of pharmaceutical industry. Beijing: State Food and Drug Administration, 2002 Apr 17

    Google Scholar 

  28. Cai G. Review of drug registration in 2001. Pharm Econ Newspaper 2002 Mar 6; Sect. 1

    Google Scholar 

  29. Liu XZ, Li S. Drug policy in China: transformations, current status and future prospects. Pharmacoeconomics 1997; 12(1): 1–9

    Article  PubMed  CAS  Google Scholar 

  30. Zhao YY. 1998 China national healthcare expenditures. Health Econ Res 2000; 9: 11–3

    Google Scholar 

  31. Ministry of Health. Selected edition on health statistics of China 1991–1995 [Government document]. Beijing: Ministry of Health, 1996

    Google Scholar 

  32. IMF. World economic outlook: Economic prospects and policy issues [online]. Available from URL: http://www.imf.org [Accessed 2002 Oct 1]

  33. Fogel R. Demand for health care in urban China. Contemp Econ Policy 2003; 21(1): 1–10

    Article  Google Scholar 

  34. State Drug Administration Information Center (SDAIC). Great potential of Chinese pharmaceutical market. 2002 Feb 9 [online]. Available from URL: http://www.cpi.gov.cn [Accessed 2002 Feb 9]

  35. United Nations. Population aging 1999 [online]. Available from URL: http://www.un.org/esa/population/publications/aging99 [Accessed 2002 Oct 27]

  36. Metge C, Black C, Peterson S, et al. The population’s use of Pharmaceuticals. Med Care 1999; 37(6 Suppl.): JS42–59

    Article  PubMed  CAS  Google Scholar 

  37. The Henry J Kaiser Family Foundation. Prescription drug trends: a chart book. Menlo Park (CA): Kaiser Family Foundation, 2001

  38. Zhang J, Gou ZZ, Wang LQ. Summary to Pharmacoeconomics and thoughts on its application in China. China Pharmacy 1993; 4(5): 11

    Google Scholar 

  39. Lin XM, Xu ZY, Zhao SJ, et al. Pharmacoeconomic analysis of interferon-a in the treatment of hepatitis B in Shanghai. Chin Clin Pharmacy J 1997; 6: 172–4

    Google Scholar 

  40. Dong YL, Dong WH. Economic analysis of three antihyperlipoidemics. China Pharmacy 2001; 12(10): 599–601

    Google Scholar 

  41. Zhang Q, Xu GL, Pang YL, et al. Analysis of 3 therapeutic schemes for urinary tract infections with decision tree. China Pharmacy 2001; 12(11): 662–3

    Google Scholar 

  42. State Drug Administration Information Center (SDAIC). Panel discussion of pharmacoeconomics by experts from German and China 2000 May 9 [online]. Available from URL: http://www.cpi.gov.cn [Accessed 200 May 9]

  43. Liu GG, Weissman F. Health laws, insurance, and economic assessment of medical technology: USC/J&J/China Ministry of Health training program. Los Angles (CA): University of Southern California School of Pharmacy, 1997

    Google Scholar 

  44. Liu GG, Hao Y. Assessment of pharmaceutical industry and policies in P. R. China: USC/WHO training grant program. Los Angles (CA): University of Southern California School of Pharmacy, 1999

    Google Scholar 

  45. Liu GG. Pharmaceutical economics and administration: UNC/China Ministry of Health Training Program on Pharmacoeconomics and Outcomes Research. Los Angles (CA): University of Southern California School of Pharmacy, 2001

    Google Scholar 

  46. Liu MZ, Li YP. Evidence-based medicine, pharmacoeconomics and rationing drug use. China Pharmacy 2002; 13(6): 342–8

    Google Scholar 

  47. Wang JG, Yan HS, Wang XB. Cost-effectiveness analysis of 4 treatment protocols to patients with inborn hypertension. J Pharm Pract 2002; 20(2): 108–11

    Google Scholar 

  48. Wang J, Peng XH, Chen XC. Application of cost effectiveness analysis in 3 treatment protocols to angina pectoris patients. China Pharmacy Affairs 2002; 16(3): 184–6

    CAS  Google Scholar 

  49. Zhang XD, Chen Y. The cost-effectiveness analysis of four therapeutic schemes for nosocomial pulmonary infections. China Pharmacy 2002; 13(6): 340–1

    Google Scholar 

  50. Wei ZM, Zhang WJ, Liu LP, et al. Cost-effectiveness analysis of three pharmacotherapeutic schemes for hemorrhage of upper digestive tract caused by liver cirrhosis. China Pharmacy 2002; 13(1): 26–7

    Google Scholar 

  51. Pang J, Chen Y, Jia YM, et al. Comparison of the cost-effectiveness between Granisetroon and Ondansetron in preventing nausea and vomiting caused by cancer chemotherapy. China Pharmacy 2002; 13(1): 28–9

    Google Scholar 

  52. Zheng HH. Cost-effectiveness analysis of three preventive schemes for cisplatin- induced vomiting. China Pharmacy 2002; 13(2): 88–9

    Google Scholar 

  53. Tian H, Yang TJ. Cost effectiveness analysis of three therapeutic schemes for functional colonic diseases. China Pharmacy 2002; 13(2): 89–90

    Google Scholar 

  54. Wang Q, Zhang YC, Deng YF. Cost-effectiveness analysis of five therapeutic schemes for female’s urogential tract infections of gonococcus combining chlamydia. China Pharmacy 2002; 13(3): 152–3

    CAS  Google Scholar 

  55. Wu RL, Yang H. Problems in drug utilization and costs: domestic and foreign control measures. China Primary Health Care 1999; 13(7): 8–9

    Google Scholar 

  56. MOLSS. Regulations on essential drug formulary of basic health care insurance program for urban employees [online]. Available from URL: www.molss.gov.cn [Accessed 1999 May 12]

  57. Issuance of essential drug formulary. China Pharmacy 2000; 11(4): 1

    Google Scholar 

  58. State Drug Administration Information Center (SDAIC). Unsolved problems in falsely high drug price. 2000 Nov 21 [online]. Available from URL: http://www.cpi.gov.cn [Accessed 2002 Nov 21]

  59. State Council. Project team on “China: Post WTO entry”, Center of Development Research,“China post WTO entry”: adjustment, reform and increasing competence. Senior Forum on Chinese Development. Beijing: China State Council, 2002

    Google Scholar 

  60. Cai RH. Deepen reforms in response to WTO entry: thoughts on impact of WTO entry on Health service department and countermeasures. Chin Health Econ 2001; 20(10): 40–2

    Google Scholar 

  61. Yu MD. Countermeasures and challenges faced by pharmaceutical industry after entry of WTO. China Pharmacy 2001; 12(2): 68–70

    Google Scholar 

  62. Liu GG, Liu X, Meng Q. Privatization of the medical market in socialist China: a historical approach. Health Policy 1994; 27: 157–74

    Article  PubMed  CAS  Google Scholar 

  63. Guo SM, Fan XW. Application of pharmacoeconomics in drug administration. China Pharm Pract 1999; 13(6): 388–99

    Google Scholar 

  64. Yu R, Lei HC. Profile of development of pharmacoeconomics in pharmaceutical industry. Chin Health Econ 2002; 21(6): 33–5

    Google Scholar 

  65. State Drug Administration (SDA). Regulation on classification of prescription and non-prescription drugs [online]. Available from URL: http://www.SDA.gov.cn [Accessed 2002 Oct 27]

  66. State Drug Administration (SDA). Drug administration law [online]. Available from URL: http://www.SDA.gov.cn [Accessed 2001 Dec 1]

  67. Center For Drug Reevaluation in China (CDR). Summary of work in 2002 [online]. Available from URL: http://www.cdr.gov.cn [Accessed 2003 Mar 26]

  68. Yan M, Wu Y, Wang LM, et al. Current status and thoughts on program of post-marketing re-evaluation. Chinese New Drugs J 1999; 8(7): 15–6

    Google Scholar 

  69. Ministry of Science and Technology (MOST). Letter to 4 projects: prophylactic warnings, prevention and treatment for common disease of elderly people, et al. [online]. Available from URL: http://www.most.gov.cn [Accessed 2001 Mar 26]

  70. Li XX. Expensive drug is not always the best choice for stroke treatment: urgent need for guidance on diagnosis and treatment of stroke suited for domestic situation. Global Newspaper 2002 Sep 9; Sect. 22

    Google Scholar 

  71. Hjelmgren J, Berggren F, Andersson F. Health economic guidelines: similarities, differences and some implications. Value Health 2001; 4(3): 225–50

    Article  PubMed  CAS  Google Scholar 

  72. Hill SR, Mitchell AS, Henry DA. Problems with the interpretation of pharmacoeconomic analyses: a review of submissions to the Australian pharmaceutical benefits scheme. JAMA 2000; 283: 2116–21

    Article  PubMed  CAS  Google Scholar 

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Acknowledgements

We are grateful for comments and suggestions from Drs Susan Blalock, Andrew Mitchell, Mike Drummond and the participants in the panel discussions at the 7th Annual Meeting of International Society for Pharmacoeconomics and Outcomes Research (ISPOR), Washington DC, May 21, 2002. We also thank three anonymous reviewers for their comments. In conducting this study, we received no sources of funding from a third party, and had no conflicts of interest directly relevant to the content of this review.

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Correspondence to Gordon G. Liu.

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Liu, G.G., Liu, C. Potential Expanded Use of Pharmacoeconomics and Outcomes Research in China. Pharm Dev Regul 1, 169–177 (2003). https://doi.org/10.1007/BF03257376

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