The Impact of Centralized Procurement on Treatment Patterns for Myocardial Infarction and More Principled Utilization of Coronary Stents

ABSTRACT

Reducing the price of expensive medical products through centralized procurement is generally considered an effective way to save public medical resources. Against this background, this paper presents an analysis of the impact of centralized procurement in China by comparing the treatment costs and patterns for acute myocardial infarction (AMI) patients before and after the introduction of this method of purchasing, with specific reference to the use of coronary stents. We found that, after the implementation of centralized procurement for coronary stents, the total expenditure of AMI cases receiving percutaneous coronary interventions with stent implantation (PCI with stents) dropped by 23.4%. The use rate of PCI with stents decreased by 32.5%, with the most significant decrease being evident in cases in which two stents were used simultaneously (32.9%). Meanwhile, percutaneous coronary interventions with balloon implantation (PCI with balloons) increased by 31.5% and coronary artery bypass grafting (CABG) increased by 80.3%. Based on these patterns, it can be observed that the use of centralized procurement significantly reduced the profits of the relevant medical manufacturers, forcing them to decrease their marketing investments, weakening their influence on providers, and ultimately resulting in a more principled use of coronary stents. We therefore conclude that, with reference to the data cited, the centralized procurement program led not only to a reduction in procurement prices but also to decreased overuse of these expensive medical products.

KEYWORDS:

• Centralized procurement
• China
• coronary stents
• myocardial infarction
• treatment patterns

Acknowledgments

We thank Yuehui Wei and Ruilin Wang for their input and support with revising the manuscript.

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Data Sharing

The Healthcare Security Administration governing the sample area of this study does not permit data sharing.

Ethics Committee Approval

Ethical approval for this study was obtained from Peking University (IRB number: IRB00001052–18005). All methods were carried out in accordance with relevant guidelines and regulations in terms of the Declaration of Helsinki. Informed consent was obtained from all subjects and/or their legal guardian(s).

Supplementary material

Supplemental material for this article can be accessed online at https://doi.org/10.1080/23288604.2024.2366167

Additional information

Funding

This study was financially supported by the National Social Science Foundation [Grant No. 22&ZD143].

Notes on contributors

Weiyan Jian

WJ contributed to study design, interpretation, and coordinated the finalization of the manuscript. SH and WZ conducted the data collection and analysis, and compiled the associated tables and figures. WJ, LZ and WZ produced the first draft. LZ and SH contributed to work undertaken in respect of surveying the existing literature and interpreting the data. WJ and LZ wrote and edited the final manuscript. All authors provided feedback during the design and interpretation of the study and contributed to revisions of the manuscript.