Impact of China’s National Volume-Based Procurement Policy on the Affordability and Utilization of Tyrosine Kinase Inhibitors for Childhood Leukemia

Background: Leukemia is the most common childhood cancer. While tyrosine kinase inhibitors (TKIs) improve survival, they impose substantial economic burdens. This study evaluates the impact of China’s National Volume-Based Procurement (NVBP) policy on the affordability and usage of TKIs in children’s hospitals. Method: We analyzed procurement data for imatinib, nilotinib, and dasatinib from children’s hospitals between January 2019 and December 2020. An interrupted time series model was employed to assess 3 outcomes: affordability (monthly cost-to-wage ratio), procurement volume (defined daily doses), and expenditure. Stratified analyses were conducted based on bid-winning status and generic versus originator drug types. Results: The NVBP policy effectively influenced some TKIs. For imatinib, which is included in the NVBP policy, imatinib procurement volume and expenditure showed significant upward trends (P < 0.05 and P < 0.01, respectively). Notably, the volume for bid-winning generics increased significantly (P < 0.05) upon policy implementation. The expenditure structure of TKI drugs underwent significant changes due to the policy, with a gradual increase in the proportion of expenditures for bid-winning generic drugs. Conclusion: The NVBP policy effectively improved TKI affordability and promoted the substitution of bid-winning generics in pediatric leukemia treatment. These changes optimized the medication expenditure structure, helping to alleviate the economic burden on families, although further policy refinements for pediatric-specific needs are warranted.