ObjectiveTo compare the cost changes of total knee arthroplasty (TKA) before and after the cancellation of medical consumables addition, so as to provide reference for the national medical reform policy.MethodsThe patients treated with TKA between September 2018 and February 2019 were admitted as objects of study, and 372 of them met the selection criteria and were finally included in the study. According to the time node of cancelling the medical consumables addition (December 24, 2018), all patients were allocated to pre-cancelling and post-cancelling groups (n=186). The clinical data of patients (gender, age, length of stay, disease classification), and various treatment costs (the costs of diagnosis and treatment, examination, laboratory, material, anesthesia, bed, nursing, operation, drug, and others) were collected. And the changes of various costs and proportions before and after cancelling the medical consumables addition were compared.ResultsThere was no significant difference in gender, age, and disease classification between the two groups (P>0.05); the length of stay after cancelling the medical consumables addition was significantly longer than that before cancelling (t=2.114, P=0.035). There was no significant difference in the total cost of TKA before and after cancelling the medical consumables addition (t=0.214, P=0.831). Compared with that before cancelling the medical consumables addition, the cost of material was significantly reduced, and the costs of diagnosis and treatment, anesthesia, nursing, and operation were significantly increased (P<0.05); the costs of examination, laboratory , bed, drug, and others were basically stable, and the differences were not significant (P>0.05).ConclusionThe total cost of TKA is stable, the proportion of material cost is significantly reduced, the proportion of diagnosis and treatment cost reflecting the technical content of medical staff is significantly increased, which is in line with the expectation of the national policy of cancelling the medical consumables addition.
Objective To systematically review the impact of the centralized volume-based procurement (CVBP) of medical consumables on patients' hospitalization expenses in China. Methods The PubMed, Web of Science Core Collection, Scopus, CNKI, CBM, and WanFang Data were electronically searched to collect studies on the impact of CVBP medical consumables on patients' hospitalization expenses from Jan 1, 2000 to May 13, 2025. Two researchers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using Stata 17.0 software. Results The meta-analysis showed that the implementation of the CVBP policy for medical consumables significantly reduced the average patient hospitalization expense (SMD=?4.754, 95%CI ?7.434 to ?2.075, P<0.001). Subgroup analysis indicated that the average patient hospitalization expense decreased after CVBP of coronary stents (SMD=?0.721, 95%CI ?1.040 to ?0.402, P<0.001) and intraocular lenses (SMD=?0.660, 95%CI ?0.984 to ?0.337, P<0.001), with the largest reduction observed after the procurement of artificial joints (SMD=?10.344, 95%CI ?15.147 to ?5.540, P<0.001). Conclusion Evidence from evaluations of the CVBP from the patient's perspective in China is mainly concentrated in developed provinces and cities. Moderate-quality evidence suggests that the largest reduction in average patients' hospitalization expenses occurred after the CVBP of artificial joints, followed by coronary stents and intraocular lenses. It is recommended to further expand the scope of CVBP in the future in China.
The outline of the "Healthy China 2030" states that medical institutions should serve as the primary purchasing agents for medicines and medical consumables, and joints purchasing should be encouraged. Since its establishment, the National Healthcare Security Administration has conducted five batches of national centralized procurement of high-value medical consumables, forming a nationwide collaborative framework involving national, provincial (including inter-provincial alliances), and local municipalities (including local municipal alliances). This study explains the current development status of the centralized procurement of medical consumables in representative countries, and explores the role of research evidence, such as health technology assessment (HTA), in the centralized procurement of medical consumables in China. Looking ahead, various forms of research evidence, such as HTA, will contribute to the dynamic adjustment of the catalogue for the collection and procurement of medical consumables, and the construction of a comprehensive evaluation index system for the clinical use of medical consumables, as well as the integration of evidence-based and artificial intelligence technology for the whole life-cycle management of medical consumables, will inject new impetus into the management of collection and procurement and innovation.
