超越成本节约：药品集中采购政策的意外后果

Abstract

This study examines the unintended consequences of China’s centralized drug procurement policy, focusing on its impact on non-winning drugs. Leveraging drug-level data, we apply a Propensity Score Matching combined with Difference-in-Differences (PSM-DID) approach to evaluate how the policy affects the prices, usage, and revenue of drugs not selected through the procurement process. Our findings reveal that, relative to winning drugs, non-winning drugs experience significant increases in price, usage, and revenue following the implementation of the centralized procurement policy. This result suggests that the policy triggers a strategic “profit compensation” response from pharmaceutical companies, who reallocate marketing resources and influnece physician prescribing preferences, thereby partially undermining the policy’s intended costcontainment objectives. Placebo tests and a series of robustness checks support the causal interpretation of these findings. Furthermore, the heterogeneity analysis reveals that drugs characterized by high-profit margins, low usage frequency, complex formulations, and specialized therapeutic categories experience more pronounced increases in both prices and revenues following the implementation of the policy. Theoretically, this study advances institutional response theory by demonstrating how partial market regulation can produce uninteded effects in unregulated segments through firms’ strategic adaptations. By integrating insights from strategic management, it sheds light on how companies actively recalibrate their behaivor in response to shifting policy environments. Empirically, the research addresses a critical gap in the literature on the spillover effects of centralized procurement policies. Our findings offer robust empirical evidence and theoretical grounding for policymakers seeking to refine centralized procurement strategies and advance pharmaceutical sector reforms, underscoring the importance of anticipating unintended consequences to safeguard fair competition and promote efficient resource allocation in healthcare markets.

Date of Award	8 Apr 2025
Original language	Chinese (Simplified)
Awarding Institution	China Europe International Business School
Supervisor	Wei Guo (Supervisor) & 胡可嘉 (Supervisor)