The Chinese government is to step up scrutiny of the cost effectiveness of its medical treatments, under a new technical co-operation agreement signed with the UK’s drug advisory body.
The China National Health Development Research Centre will start work with the National Institute for Health and Clinical Excellence (Nice) on a range of projects including analysing the costs and benefits of kidney screening and childhood leukaemia.
The studies could pave the way for a wide-ranging restructuring of China’s fast-developing healthcare system.
Zhang Zhen Zhong, director-general of the centre, told the FT: “The aim is to create a new system of safe, good quality and affordable care, but which is first of all efficient and affordable to all citizens.”
Health reform is highly sensitive in China, with concerns over lack of access to medical care triggering recent riots while burgeoning demand for improved healthcare is placing increasing strains on the government’s budget.
However, the authorities are still providing only partial funding for the work with Nice, which up until now has been supported by the UK’s Department for International Development. Nice is currently also seeking support from the World Bank for its work in China.
Mr Zhang’s centre, which reports to the ministry of health, has tested a series of pilots with Nice consultants in recent months in four Chinese provinces to examine more cost effective approaches to 10 different treatment areas, including hypertension, diabetes and stroke.
That identified economies without compromises to safety, including the need to switch from longer to shorter patient stays in hospital, with less use of intravenous antibiotics and other treatments judged to be superfluous.
One reason for excessive use of costly medicines in China has been that hospitals generate substantial income from authorised mark-ups on prescription medicines, even when those drugs are not justified on clinical grounds.
Mr Zhang said he was now pushing for payment reforms. He stressed that China still had relatively modest overall health expenditures compared with the UK and the US. But he said: “If you compare with the past, it’s increasing so fast and the structure of health financing is not rational.”
They have since begun to launch reforms including “pay for performance” policies and encouragement to switch from fewer patients staying longer in hospitals to a higher turnover of patients for shorter periods.
Nice is also actively working to “export” its approach in countries including Colombia, Georgia and Jordan.
The Financial Times