Evaluating Centralized Drug Procurement in a Resource-Constrained Setting: Evidence from a Northwestern Province in China

DOI

10.2991/978-94-6239-825-2_57How to use a DOI?

Keywords

Centralized drug procurement; volume-based procurement; resource-constrained settings; pharmaceutical expenditure; implementation performance; TOPSIS; China

Abstract

Centralized drug procurement has become an important policy instrument for controlling pharmaceutical expenditure and improving access to medicines, yet most existing evaluations of China’s National Centralized Drug Procurement programme have focused mainly on price reductions, large urban hospitals, or economically developed regions. This study contributes new evidence by evaluating centralized drug procurement implementation in a resource-constrained northwestern provincial setting and by examining multidimensional performance across different governance models. A retrospective quantitative policy evaluation was conducted using administrative procurement data from 36 centralized procurement batches implemented between 2019 and 2024. A coefficient-of-variation-weighted composite performance index was constructed using the Technique for Order Preference by Similarity to the Ideal Solution, and differences across national, provincial, and inter-provincial alliance procurement models were assessed using the Kruskal–Wallis test. Composite performance scores ranged from 0.340 to 0.889, indicating substantial heterogeneity across procurement batches. Provincial procurement showed the highest average performance, followed by national procurement, while inter-provincial alliances demonstrated lower scores; however, these differences were not statistically significant (p = 0.199). Indicator weights showed that overall performance was driven mainly by drug expenditure savings and utilization of bid-winning medicines, rather than price reductions alone. These findings suggest that centralized procurement success should not be evaluated solely by nominal price reductions, but by whether negotiated prices are translated into actual medicine uptake and system-level financial gains. Overall, the study highlights the need for more implementation-sensitive evaluations of pharmaceutical procurement reform, particularly in resource-constrained settings where local capacity, market conditions, and batch-specific execution may strongly shape policy outcomes.

Copyright

© 2026 The Author(s)

Open Access

Open Access This chapter is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.

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TY  - CONF
AU  - Yiran Li
PY  - 2026
DA  - 2026/11/10
TI  - Evaluating Centralized Drug Procurement in a Resource-Constrained Setting: Evidence from a Northwestern Province in China
BT  - Proceedings of the 2026 5th International Conference on Public Service, Economic Management and Sustainable Development (PESD 2026)
PB  - Atlantis Press
SP  - 592
EP  - 605
SN  - 2352-5428
UR  - https://doi.org/10.2991/978-94-6239-825-2_57
DO  - 10.2991/978-94-6239-825-2_57
ID  - Li2026
ER  -