Table 1.

Timeline for “4 + 7” policy

Date	Key events
June 20, 2018	Premier Li Keqiang presided over a State Council executive meeting to discuss the work of “National Centralized Drug Procurement (NCDP) pilot”.
November 14, 2018	President Xi Jinping presided over the fifth meeting of Commission for Deepening Overall Reform of the CPC Central Committee. This meeting approved the Pilot Program of National Centralized Procurement Drug Procurement.
November 15, 2018	Shanghai Joint Procurement Office issued the 4 + 7 City Centralized Drug Procurement Document, and announced the procurement plan. A total of 31 drug varieties were involved.
December 6, 2018	At 8:30 − 10:00 am, drug manufacturers submit quotation application and relevant materials.
December 6, 2018	At 2:00 pm, carry out negotiations and bidding.
December 7, 2018	Shanghai Joint Purchasing Office announced the proposed bidding results.
December 7, 2018	Chinese government organized the deployment meeting for the pilot work of National Centralized Drug Procurement and Use. Vice premier Sun Chunlan attended the meeting and delivered a speech, emphasized the importance of steady promoting NCDP pilot work.
December 17, 2018	Shanghai Joint Purchasing Office announced the bidding results. 25 drugs (by generic name) in the “4 + 7” List were included, with an average price cut of 52 % and the highest price cut of 96 %.
January 1, 2019	General Office of the State Council issued the Notice on Issuing the Pilot Program for National Centralized Drug Procurement and Use (GBF [2019] No.2).
March to April, 2019	From March 1 to April 1, 2019, 11 pilot cities started the procurement of winning products one after another.