PDF(Pubmed)
Abstract：
Drug shortages pose a serious global public health challenge, affecting China and other countries. Evidence from USA shows that short-supplied drugs demonstrated a very high price growth during and after a shortage. However, the effect of shortages on drug prices in China remains unknown. This paper aims to understand the impact of drug shortages on prices and explore implications for shortage prevention policy.
We collected the purchase prices and delivery rates of 120 drugs from April 2019 to December 2021 across whole China. We examined price progression of affected drugs using linear mixed-effects models and performed subgroup analyses based on the number of manufacturers and the severity of shortage.
Non-shortage cohort had an annual price growth of 11.62% (95% confidence interval [CI] 8.34 to 14.98). Shortage cohort demonstrated an annual price growth of 8.08% (95%CI 0.12 to 16.77) in the period preceding a shortage, 27.57% (95%CI 6.17 to 52.87) during a shortage, and 9.38% (95%CI -12.64 to 36.39) in the post-shortage period. Drug shortages\' impact on prices varied across subgroups. Compared with that of drug markets supplied by a single manufacturer, the price growth rate of markets supplied by more than one manufacture declined more after the shortage resolution.
Shortages resulted in significant price increases of study markets, especially the low-priced markets, while the shortage resolution slowed the growth. The primary shortage driver has shifted from the low price to others drivers, such as unavailability of active pharmaceutical ingredients. For currently sole-supplied drugs, the expedited review of applications from other manufacturers should be considered.
We collected the purchase prices and delivery rates of 120 drugs from April 2019 to December 2021 across whole China. We examined price progression of affected drugs using linear mixed-effects models and performed subgroup analyses based on the number of manufacturers and the severity of shortage.
Non-shortage cohort had an annual price growth of 11.62% (95% confidence interval [CI] 8.34 to 14.98). Shortage cohort demonstrated an annual price growth of 8.08% (95%CI 0.12 to 16.77) in the period preceding a shortage, 27.57% (95%CI 6.17 to 52.87) during a shortage, and 9.38% (95%CI -12.64 to 36.39) in the post-shortage period. Drug shortages\' impact on prices varied across subgroups. Compared with that of drug markets supplied by a single manufacturer, the price growth rate of markets supplied by more than one manufacture declined more after the shortage resolution.
Shortages resulted in significant price increases of study markets, especially the low-priced markets, while the shortage resolution slowed the growth. The primary shortage driver has shifted from the low price to others drivers, such as unavailability of active pharmaceutical ingredients. For currently sole-supplied drugs, the expedited review of applications from other manufacturers should be considered.
摘要：
■药物短缺构成了严重的全球公共卫生挑战，影响中国和其他国家。来自美国的证据表明，短缺药物在短缺期间和之后表现出非常高的价格增长。然而,短缺对中国药品价格的影响仍然未知。本文旨在了解药品短缺对价格的影响，并探讨对短缺预防政策的启示。
■我们收集了2019年4月至2021年12月中国120种药品的采购价格和交货率。我们使用线性混合效应模型检查了受影响药物的价格进展，并根据制造商的数量和短缺的严重程度进行了亚组分析。
■非短缺队列的年价格增长率为11.62%（95%置信区间[CI]8.34至14.98）。短缺队列显示，在短缺之前的时期，价格年增长率为8.08%(95CI0.12至16.77)，短缺期间的27.57%（95CI6.17至52.87），缺后时期为9.38%（95CI-12.64至36.39）。药品短缺对价格的影响在不同的分组中有所不同。与单一制造商提供的药品市场相比，在解决短缺问题后，由不止一种产品供应的市场的价格增长率下降得更多。
■短缺导致研究市场的价格大幅上涨，尤其是低价市场，而短缺的解决减缓了增长。主要的短缺司机已经从低价转移到其他司机，例如没有活性药物成分。对于目前唯一供应的药物，应考虑加快审查其他制造商的申请。
■我们收集了2019年4月至2021年12月中国120种药品的采购价格和交货率。我们使用线性混合效应模型检查了受影响药物的价格进展，并根据制造商的数量和短缺的严重程度进行了亚组分析。
■非短缺队列的年价格增长率为11.62%（95%置信区间[CI]8.34至14.98）。短缺队列显示，在短缺之前的时期，价格年增长率为8.08%(95CI0.12至16.77)，短缺期间的27.57%（95CI6.17至52.87），缺后时期为9.38%（95CI-12.64至36.39）。药品短缺对价格的影响在不同的分组中有所不同。与单一制造商提供的药品市场相比，在解决短缺问题后，由不止一种产品供应的市场的价格增长率下降得更多。
■短缺导致研究市场的价格大幅上涨，尤其是低价市场，而短缺的解决减缓了增长。主要的短缺司机已经从低价转移到其他司机，例如没有活性药物成分。对于目前唯一供应的药物，应考虑加快审查其他制造商的申请。
