title: Analysis of the influence of recent reforms in China: cardiovascular and cerebrovascular medicines as a case history to provide future direction.
abstract: BACKGROUND
  Pharmaceutical expenditure has grown by 16% per annum in China, enhanced by incentives for physicians and hospitals. Hospital pharmacies dispense 80% of medicines in China, accounting for 46% of total hospital expenditure. Principal measures to moderate drug expenditure growth include pricing initiatives as limited demand-side measures.
  
  
  OBJECTIVE
  Assess current utilization and expenditure including traditional Chinese medicines (TCMs) between 2006 and 2012.
  
  
  METHODS
  Uncontrolled retrospective study of medicines to treat cardiovascular and cerebrovascular diseases in one of the largest hospitals in southwest China.
  
  
  RESULTS
  Utilization increased 3.3-fold for cerebrovascular medicines, greatest for TCMs, with expenditure increasing 4.85-fold. Low prices for generics were seen, similar to Europe. However, there was variable utilization of generics at 29-31% of total product volumes in recent years. There continued to be irrationality in prescribing with high use of TCMs, and the utilization of different medicines dropping significantly once they achieved low prices.
  
  
  CONCLUSIONS
  Prices still have an appreciable impact on utilization in China. Potential measures similar to those implemented among western European countries could improve prescribing rationality and conserve resources.
authors.affiliation: School of Management, Chongqing Jiaotong University, Chongqing, China.
authors.forename: Wenjie
authors.initials: W
authors.lastname: Zeng
authors.forename: Junjie
authors.initials: J
authors.lastname: Zhen
authors.forename: Mengying
authors.initials: M
authors.lastname: Feng
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Campbell
authors.forename: Alexander E
authors.initials: AE
authors.lastname: Finlayson
authors.forename: Brian
authors.initials: B
authors.lastname: Godman
mesh_terms: D002318:Cardiovascular Diseases / Q000188:drug therapy*; D002561:Cerebrovascular Disorders / Q000188:drug therapy*; D002681:China; D004363:Drug Utilization / Q000639:trends; D016568:Drugs, Generic / Q000627:therapeutic use; D018166:Health Care Reform; D017721:Hospital Costs / Q000639:trends; D006801:Humans; D012189:Retrospective Studies
chemical_list: D016568:Drugs, Generic
keywords: China; cardiovascular drugs; demand-side measures; drug utilization; generics