{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T15:04:44Z","timestamp":1790003084442,"version":"4.0.1"},"reference-count":46,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"unspecified","delay-in-days":20,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Hubei Medical Insurance Research Association","award":["NA"],"award-info":[{"award-number":["NA"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,8,24]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To examine the impacts of two consecutive rounds of the National Volume-Based Procurement (NVBP) programme for insulin on medication utilisation and structure in Hubei province, China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Insulin procurement records were extracted from the Hubei Provincial Drug Procurement Trading Platform from May 2020 to December 2025. Descriptive statistics and interrupted time series analysis with segmented regression were employed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>All medical institutions on the Hubei Provincial Drug Procurement Trading Platform.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome measures<\/jats:title>\n                    <jats:p>Defined daily doses (DDDs), defined daily dose cost (DDDc) and procurement amount.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After two consecutive rounds of NVBP for insulin, average monthly DDDs increased by 2.33\u2009million and 1.80\u2009million DDD (first and second NVBP, respectively), with growth rates of 65.47% and 30.51% (both p&lt;0.01). Interrupted time series analysis showed a stable monthly DDD trend after the first NVBP (trend: 13\u2009230 DDD per month, p&gt;0.05) and a significant increase after the second (trend: 78\u2009280 DDD per month, p&lt;0.01). DDDc declined immediately at both intervention points (\u00a5\u22124.818 and \u00a5\u22120.174, respectively; both p&lt;0.01), with no further monthly trend thereafter. Further subgroup analysis revealed that the growth rate of consumption for insulin analogues was faster than human insulin; the growth rate of consumption for domestic enterprises was faster than imported enterprises. Tertiary, secondary and primary medical institutions all achieved significant increases in procurement volume over two consecutive procurement periods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study suggests that two consecutive rounds of the NVBP for insulin have achieved sustained price reductions accompanied by steady growth in overall procurement volume. The policy has significantly improved insulin medication utilisation patterns, sustained optimisation of the market structure and balanced development of the pharmaceutical supply.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-122985","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T14:27:59Z","timestamp":1790000879000},"page":"e122985","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of two consecutive rounds of National Volume-Based Procurement (NVBP) for insulin on utilisation and structure: a quasi-experimental study using interrupted time series analysis in Hubei, China"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-9161-5901","authenticated-orcid":false,"given":"Jinyi","family":"Tao","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shihong","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiajie","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rufeng","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongning","family":"Lv","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"2026092107251773000_16.9.e122985.1","unstructured":"Federation ID . 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