IntroductionHigh prices, as a main factor, contributed to the lack of adequate access to essential anticancer medicines, especially for patients in developing countries. The Chinese Government has introduced a series of policies to control the prices of medicines during the last decade, but the effect on anticancer medicine is not yet clear.MethodsTo evaluate the time trends and regional variation in the price of essential anticancer medicines in China, we used the procurement data of anticancer medicines from 2015 to 2022. We selected 29 anticancer medicines from the 2018 Chinese National Essential Medicines List. To measure the cost of a medicine, we used defined daily dose cost -the cost per defined daily doses. At national level, we focused on the price changes over time and compared the price between medicine categories. At provincial level, we assessed price variation among provinces over time.ResultsFor prices at the national level, all 6 targeted medicines exhibited a continuous decrease trend in price. Out of 23 non-targeted medicines, 4 (17·39%) experienced continuous increases in prices, and 9 (39·13%) showed price decreases from 2015 to 2019 and then an upward trend during 2019–2022; Of the remaining non-targeted medicines, 7 (30·43%) had continuous price decreases and 3 (13.04%) had price increases followed by decreases. For prices at the provincial level, provincial price variation became smaller for almost all targeted medicines, except rituximab; for 11 out of 23 non-targeted medicines, provincial price variations became larger. During the study period, the proportion of price-increased medicines in each province was geographically correlated, and no significant relationship between prices and GDP per capita was observed for both targeted and non-targeted anticancer medicines.ConclusionThe prices and regional disparity of most targeted anticancer medicines were decreasing, while for nearly half of the non-targeted anticancer medicines, the prices were increasing and the regional disparity became wider, which may lead to compromised access to these essential anticancer medicines and raise inequity health outcome among regions.

ObjectiveThe National Drug Price Negotiation (NDPN) has significantly reduced the prices and improved the nationwide availability of novel anticancer drugs (NADs) in China. However, geographical disparities in their availability remain concerning. This study aims to assess these spatial variations and temporal changes, and the determinants using geographic information system (GIS) and spatial statistical methods.MethodsTwo cross-sectional datasets were used corresponding the implementation date of the 2023 NDPN list (1 January 2024) and 9 months after (1 October 2024). Data on drug-providing institutions were extracted from National Healthcare Security Administration (NHSA) platform. Drug availability was measured by the weighted supply number of drug-providing institutions per 1,000 cancer patients, analyzed separately for hospitals and retail pharmacies. Kernel density estimation (KDE) was used to visualize spatial distribution. The Theil index assessed inequality, and Moran’s index measured spatial clustering. Multiple linear regression (OLS) and geographically weighted regression (GWR) were employed to examine the influence of economic development and healthcare infrastructure on drug availability.ResultsA total of 71 NADs in the 2023 NDPN list were analyzed. By October, drug-providing institutions had become more concentrated in the eastern coastal provinces compared to January. Availability improved in both hospitals and retail pharmacies, with higher levels observed in eastern and central provinces, with lower in the western provinces, especially in the Southwest. Inequality declined and spatial clustering increased for both hospital-based and overall availability across provinces (Theil index, hospital: 0.074–0.062, overall: 0.045–0.044; Moran’s I, hospital: 0.315–0.362, overall: 0.452–0.453). Both OLS and GWR models showed a significant and strengthening association between availability (in hospitals and overall) and GDP per capita [e.g., hospital: OLS coef, 0.787–0.833, p < 0.001; GWR mean coef (SD), 0.795 (0.047)−0.834 (0.044); overall: OLS coef, 0.744–0.794, p < 0.01; GWR mean coef (SD), 0.726 (0.119)−0.763 (0.161)]. Retail pharmacy-based availability was positively associated with the number of local chain pharmacies [OLS coef, 0.098–0.122, p < 0.05; GWR mean coef (SD), 0.084 (0.006)−0.107 (0.010)].ConclusionThe availability of price-negotiated NADs increasingly concentrated in economically developed and medically advanced eastern provinces, while remaining lower in southwest. Efforts should target economically underdeveloped areas.

ObjectiveThe National Drug Price Negotiation (NDPN) has significantly reduced the prices and improved the nationwide availability of novel anticancer drugs (NADs) in China. However, geographical disparities in their availability remain concerning. This study aims to assess these spatial variations and temporal changes, and the determinants using geographic information system (GIS) and spatial statistical methods.MethodsTwo cross-sectional datasets were used corresponding the implementation date of the 2023 NDPN list (1 January 2024) and 9 months after (1 October 2024). Data on drug-providing institutions were extracted from National Healthcare Security Administration (NHSA) platform. Drug availability was measured by the weighted supply number of drug-providing institutions per 1,000 cancer patients, analyzed separately for hospitals and retail pharmacies. Kernel density estimation (KDE) was used to visualize spatial distribution. The Theil index assessed inequality, and Moran’s index measured spatial clustering. Multiple linear regression (OLS) and geographically weighted regression (GWR) were employed to examine the influence of economic development and healthcare infrastructure on drug availability.ResultsA total of 71 NADs in the 2023 NDPN list were analyzed. By October, drug-providing institutions had become more concentrated in the eastern coastal provinces compared to January. Availability improved in both hospitals and retail pharmacies, with higher levels observed in eastern and central provinces, with lower in the western provinces, especially in the Southwest. Inequality declined and spatial clustering increased for both hospital-based and overall availability across provinces (Theil index, hospital: 0.074–0.062, overall: 0.045–0.044; Moran’s I, hospital: 0.315–0.362, overall: 0.452–0.453). Both OLS and GWR models showed a significant and strengthening association between availability (in hospitals and overall) and GDP per capita [e.g., hospital: OLS coef, 0.787–0.833, p < 0.001; GWR mean coef (SD), 0.795 (0.047)−0.834 (0.044); overall: OLS coef, 0.744–0.794, p < 0.01; GWR mean coef (SD), 0.726 (0.119)−0.763 (0.161)]. Retail pharmacy-based availability was positively associated with the number of local chain pharmacies [OLS coef, 0.098–0.122, p < 0.05; GWR mean coef (SD), 0.084 (0.006)−0.107 (0.010)].ConclusionThe availability of price-negotiated NADs increasingly concentrated in economically developed and medically advanced eastern provinces, while remaining lower in southwest. Efforts should target economically underdeveloped areas.