TABLE 3.
Interrupted time-series regression model estimates (stratified by drug and disease categories).
| Pilot cities a | Non-pilot cities a | |||||||
|---|---|---|---|---|---|---|---|---|
| Immediate change | Monthly change | Immediate change | Monthly change | |||||
| RR (95% CI) | p-value | RR (95% CI) | p-value | RR (95% CI) | p-value | RR (95% CI) | p-value | |
| Selected Drug b | — | — | — | — | — | — | — | — |
| Cardiovascular disease | 2.53 (2.62, 2.82) | <0.001 | 1.00 (0.98, 1.02) | 0.928 | 1.06 (0.85, 1.31) | 0.617 | 0.96 (0.90, 1.03) | 0.287 |
| Mental disorder | 1.19 (1.01, 1.41) | 0.035 | 0.96 (0.94, 0.99) | 0.002 | 0.84 (0.67, 1.06) | 0.143 | 0.88 (0.82, 0.94) | <0.001 |
| Cancer | 2.18 (1.56, 3.05) | <0.001 | 1.02 (0.93, 1.10) | 0.707 | 1.78 (0.84, 3.79) | 0.135 | 0.96 (0.86, 1.07) | 0.432 |
| Originator b | — | — | — | — | — | — | — | — |
| Cardiovascular disease | 0.65 (0.60, 0.70) | <0.001 | 0.98 (0.96, 0.99) | <0.001 | 1.32 (1.02, 1.70) | 0.035 | 0.88 (0.81, 0.96) | 0.006 |
| Mental disorder | 1.06 (0.92, 1.21) | 0.416 | 0.93 (0.91, 0.95) | <0.001 | 1.12 (0.80, 1.58) | 0.504 | 0.99 (0.93, 1.05) | 0.678 |
| Cancer | 1.26 (1.20, 1.33) | <0.001 | 0.99 (0.98, 1.00) | 0.022 | 0.95 (0.68, 1.32) | 0.759 | 1.11 (1.02, 1.20) | 0.011 |
| Alternative Drug b | — | — | — | — | — | — | — | — |
| Cardiovascular disease | 1.10 (1.02, 1.19) | 0.130 | 0.99 (0.97, 1.00) | 0.128 | 0.95 (0.78, 1.15) | 0.585 | 0.93 (0.88, 0.99) | 0.019 |
| Mental disorder | 1.43 (1.17, 1.74) | <0.001 | 0.97 (0.92, 1.03) | 0.387 | 1.03 (0.80, 1.32) | 0.827 | 0.95 (0.88, 1.02) | 0.162 |
| Cancer | 1.00 (0.94, 1.07) | 0.988 | 0.98 (0.97, 0.99) | <0.001 | 1.11 (0.87, 1.43) | 0.408 | 1.05 (1.00, 1.09) | 0.030 |
| Other Drug b | — | — | — | — | — | — | — | — |
| Cardiovascular disease | 0.28 (0.22, 0.35) | <0.001 | 0.88 (0.85, 0.92) | <0.001 | 1.22 (1.01, 1.49) | 0.043 | 0.94 (0.89, 1.00) | 0.035 |
| Mental disorder | 0.64 (0.59, 0.69) | <0.001 | 0.94 (0.93, 0.96) | <0.001 | 1.22 (1.03, 1.46) | 0.025 | 0.92 (0.87, 0.97) | 0.002 |
| Cancer | 0.90 (0.82, 0.98) | 0.021 | 0.96 (0.95, 0.97) | <0.001 | — | — | — | — |
| All Non-selected drug b | — | — | — | — | — | — | — | — |
| Cardiovascular disease | 0.72 (0.66, 0.78) | <0.001 | 0.97 (0.97, 0.98) | <0.001 | 1.16 (0.94, 1.44) | 0.169 | 0.91 (0.85, 0.98) | 0.012 |
| Mental disorder | 1.09 (0.93, 1.27) | 0.297 | 0.96 (0.92, 1.01) | 0.139 | 1.11 (0.90, 1.37) | 0.320 | 0.94 (0.88, 1.00) | 0.047 |
| Cancer | 0.96 (0.89, 1.03) | 0.236 | 0.97 (0.96, 0.98) | <0.001 | — | — | — | — |
| All Drug b | — | — | — | — | — | — | — | — |
| Cardiovascular disease | 0.90 (0.82, 0.97) | 0.010 | 0.98 (0.97, 0.99) | <0.001 | 1.14 (0.92, 1.41) | 0.237 | 0.92 (0.86, 0.99) | 0.025 |
| Mental disorder | 1.13 (1.02, 1.25) | 0.018 | 0.96 (0.94, 0.99) | 0.013 | 1.10 (0.81, 1.23) | 0.999 | 0.91 (0.86, 0.98) | 0.008 |
| Cancer | 1.04 (0.95, 1.13) | 0.398 | 0.98 (0.97, 1.00) | 0.018 | — | — | — | — |
| All drug (Spending) | — | — | — | — | — | — | — | — |
| Cardiovascular disease | 0.69 (0.64, 0.75) | <0.001 | 0.96 (0.96, 0.97) | <0.001 | 1.15 (0.93, 1.42) | 0.203 | 0.92 (0.86, 0.99) | 0.020 |
| Mental disorder | 0.98 (0.91, 1.06) | 0.641 | 0.96 (0.93, 0.98) | <0.001 | 1.17 (0.99, 1.38) | 0.061 | 0.91 (0.87, 0.96) | <0.001 |
| Cancer | 1.06 (1.00, 1.12) | 0.056 | 1.02 (1.00, 1.03) | 0.023 | — | — | — | — |
a
Pilot cities include Beijing, Shanghai and Xi’an, and non-pilot cities include Changsha and Zhengzhou unless specified otherwise.
b
Monthly quantity of purchase.
Note: For cancer treatment drugs, pilot city includes Beijing, non-pilot cities include Changsha (selected drug) and Zhengzhou (originator and other drug). Immediate change refers to the change in March 2019, Monthly change refers to the gradual change from April-September 2019. Non-selected drugs include originator, alternative, and other drugs.