Challenges and countermeasures for China's centralised volume-based procurement policy in healthcare

To reduce the cost of healthcare expenditures in China, the government has developed a centralised volume-based procurement (CVBP) policy for medicines and medical consumables. Based on tracking the development history of centralised procurement in China, this study explores China's CVBP model. By comparing the centralised procurement models and healthcare expenditure data among China, the United States (U.S), the United Kingdom (UK), and Singapore, we find that China still faces many challenges in implementing the CVBP policy. The main challenges are as follows. First, the policy cannot be guaranteed the effectiveness of implementation without a well-coordinated regulatory mechanism. Second, the CVBP rules and quality evaluation standards are imperfect. Third, the interests of healthcare companies cannot be guaranteed. Fourth, the policy affects the benefits of medical institutions, and the government has not built a compensation mechanism for medical institutions. Fifth, it poses a challenge to the operational capacity and innovation level of Chinese companies. Therefore, this paper posits a three-stage strategy and nine measures that could benefit China's progress in implementing the CVBP policy. We explore the evolution of centralised volume-based procurement (CVBP) models in different countries. Based on the multi-dimensional comparison of healthcare expenditure data in different countries, we find out the gap of CVBP policy development in China. We present the domestic and international challenges to China's CVBP policy. We propose a three-phase strategy and nine measures to facilitate the progress of the CVBP policy.