Availability, Prices and Affordability of Nationally Negotiated Antidiabetic Drugs in China: A National Survey

Background: This study aimed to investigate the availability, prices, and affordability of nationally negotiated antidiabetic drugs in China. Methods: Monthly data about the use of antidiabetic drugs from 2018 to 2023 were collected from the Chinese Medicine Economic Information Network (CMEI). This study covered 804 public general hospitals in 31 provincial administrative regions in China, among which 537 (66.79%) were tertiary, and 267 (33.21%) were secondary. The adjusted World Health Organization and Health Action International methodology was used to calculate the availability and affordability of 12 nationally negotiated antidiabetic drugs in the investigated hospitals. Price is expressed as the defined daily dose cost (DDDc). Results: On average, the total availability of 12 nationally negotiated antidiabetic drugs increased annually from 2018 to 2023. The median availability of all the investigated drugs in tertiary hospitals from 2018 to 2023 was 11.53%, 4.50%, 13.49%, 37.85%, 41.16% and 42.07%, respectively, while the indicator in secondary hospitals was 1.59%, 1.59%, 4.31%, 23.16%, 28.28% and 29.67%, respectively. The DDDc of the drugs newly covered by Medicare decreased noticeably. The affordability of the antidiabetic drugs has improved year by year from 2018 to 2023. In comparison, rural residents had lower affordability of the drugs than urban residents. Conclusions The overall availability, affordability and DDDc of 12 nationally negotiated antidiabetic drugs improved from 2018 to 2023. However, the overall availability of most antidiabetic drugs in China remained at a low level (less than 50%). Further efforts should be made to sufficiently and equally benefit diabetic patients.