Clinical efficacy and safety of medicines procured through China’s national volume-based procurement policy: a systematic review of 81 studies
Abstract
Background China’s National Volume-Based Procurement (NVBP) policy, launched in 2018, has sharply cut drug prices through competitive bidding among manufacturers of quality-consistent generics. Concerns persist that reductions sometimes exceeding 90% may compromise efficacy or safety, and this evidence has not been systematically synthesised. Objective To evaluate the efficacy, safety and pharmacokinetics of NVBP-selected medicines. Methods Six sources (PubMed, Web of Science, Cochrane CENTRAL, CNKI, Wanfang Data, VIP) were searched in two arms for reports published between January 2018 and January 2026; CENTRAL records could not be exported. Titles and abstracts were screened by one reviewer with a second checking; all 862 full-text reports were screened in duplicate. Risk of bias was assessed in eight domains, three specific to this policy setting, and certainty with GRADE. Results were synthesised without meta-analysis by effect direction within comparator strata. PROSPERO: CRD420261303351. Results Eighty-one studies were included, 72 from the database searches and nine from citation searching; 72 were retrospective or before-and-after and 62 single-centre. Sixty-eight studies plus one comparison from a six-arm study formed the main analysis against the originator. There, 60 of 62 counted efficacy comparisons and 55 of 65 safety comparisons found no significant difference, and no efficacy comparison carries an assigned direction. Four safety comparisons favoured the…
How strong is the evidence?
Evidence Hub reads this as a systematic review. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
Read the paper
Related studies
- Structural and topological analysis of thiosemicarbazone-based metal complexes: computational and experimental study of bacterial biofilm inhibition and antioxidant activity
- Toward better cures for Mycobacterium abscessus lung disease
- Challenges for global antibiotic regimen planning and establishing antimicrobial resistance targets: implications for the WHO Essential Medicines List and AWaRe antibiotic book dosing
- Design, Synthesis and In vitro Antitubercular Effect of New Chalcone Derivatives Coupled with 1,2,3‐Triazoles: A Computational Docking Techniques
- Upregulation of pmrA, pmrB, pmrC, phoQ, phoP, and arnT genes contributing to resistance to colistin in superbug Klebsiella pneumoniae isolates from human clinical samples in Tehran, Iran
- Whole-genome sequencing of clinical isolates of Citrobacter Europaeus in China carrying blaOXA−48 and blaNDM−1
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.