First "4+7" Centralized Drug Procurement Prescription Issued in Xiamen
On the morning of March 18, Zhongshan Hospital Affiliated to Xiamen University issued the first prescription for a drug selected in the national “4+7” city-based centralized procurement program. The prescribed medication was entecavir, one of the selected products under the “4+7” initiative, with a new price of RMB 17.36 per box (28 tablets per box). Prior to the implementation of this new policy, the originator brand of entecavir was priced at RMB 175.68 per box (7 tablets per box).
This marks the official entry into the clinical usage phase of Xiamen’s implementation of the national “4+7” centralized drug procurement program, following the completion of its first purchase order on March 15. Starting today, residents of Xiamen can access high-quality, affordable drugs selected through the “4+7” program at all pilot public medical institutions across the city.
To alleviate the medication cost burden on the public and standardize the order of pharmaceutical circulation, the national pilot program for centralized drug procurement and use was officially launched in November 2018. Public medical institutions in four municipalities directly under the Central Government and seven sub-provincial cities served as the main entities for centralized procurement, pooling demand and resources to enhance negotiation and bargaining power, thereby achieving a significant “plunge” in drug prices. Compared with the lowest procurement prices for the same drugs in 2017, the average price reduction for the 25 selected drugs was 52%, with the maximum reduction reaching 96%.
Among the 11 pilot cities, Xiamen took the lead in implementing the centralized procurement and use of selected drugs, enabling local residents to benefit early from this major people-centered policy.
Ms. Hu, 32 years old, has been suffering from chronic hepatitis B for over a decade. Before the implementation of the national “4+7” city-based centralized drug procurement policy, she had long been taking the originator brand of entecavir (generic name), consuming one box per week at a cost of RMB 175.68. The annual expense for this antiviral medication alone amounted to RMB 9,135.36. After medical insurance reimbursement, Ms. Hu was responsible for nearly half of the drug costs out-of-pocket, representing a significant financial burden.
All drug varieties selected in the “4+7” centralized procurement are either generic drugs that have passed the National Consistency Evaluation or originator drugs, ensuring guaranteed quality and efficacy. Built on this high-quality foundation, the selected entecavir is priced at only RMB 17.36 per box, with the total annual medication cost amounting to just RMB 226.3.
Furthermore, the medical insurance reimbursement rate for this medication has been increased to 100%, meaning Ms. Hu will no longer need to pay out-of-pocket for it in the future.
(Figure: The doctor issues the first prescription for a drug selected in the “4+7” centralized procurement program to the patient)
“My chronic condition requires long-term antiviral therapy. In the past, I had to live frugally every month to save enough money for my medications. Since the implementation of the ‘4+7’ policy, the government has helped alleviate my medication cost burden, tangibly improving our family’s standard of living. I am grateful for the real benefits this national policy has brought to ordinary citizens!” said Ms. Hu.
Director Liu Yun of the Department of Hepatobiliary Surgery at Zhongshan Hospital Affiliated to Xiamen University also welcomed the implementation of the “4+7” policy in Xiamen.
“With government intervention, the prices of these commonly used medications have been reduced by more than 50%, with some cuts exceeding 90%. This has made medications and treatments more affordable for a greater number of patients. I believe this is an initiative of immeasurable merit,” stated Director Liu Yun.
(Figure: Patient receives the first prescription invoice for a drug selected under the “4+7” volume-based procurement program)
On March 15, at the launch ceremony in Xiamen for the national centralized drug procurement and use program under the “4+7” initiative, Guo Guirong, Deputy Mayor of Xiamen, stated that the “4+7” city-based centralized drug procurement is a major reform measure introduced by the Central Committee of the Communist Party of China and the State Council to address the public’s difficulties in accessing medical care. Xiamen’s pioneering initiation of the procurement and use of selected drugs marks the transition of this national policy from the preparatory phase to a new stage of implementation.
Xiamen will implement its initiatives with precision and attention to detail, striving to develop a “Xiamen Model” that serves as a demonstrative example for broader adoption.
It is understood that, to ensure the smooth implementation of the national “4+7” centralized drug procurement and usage program in pilot cities, Xiamen has commissioned the Haixi Pharmaceutical Trading Center to provide integrated services for procurement, trading, and settlement of drugs selected under the “4+7” initiative. Meanwhile, Xiamen has established and is operating China’s first end-to-end regulatory platform—the “Xiamen National Centralized Drug Procurement and Usage Regulatory Platform”—to oversee the entire process of procurement and use of selected drugs, thereby ensuring the effective implementation of the pilot program.
The implementation of this new policy will further enhance the local population’s sense of gain, security, and well-being.