(Yicai) May 20 -- China’s centralized bulk buying of coronary stents has achieved its core policy objective of lowering costs without compromising clinical outcomes over the five years since it began, a new report from the country’s public health insurance administrator shows.

The average cost per coronary stent patient fell by nearly 26 percent to CNY44,000 (USD6,460) from about CNY60,000 over the period, while the rate of major adverse cardiovascular events within two years of the procedure was unchanged, according to the report the National Healthcare Security Administration released yesterday. After medical insurance reimbursement, patient out-of-pocket expenses were even lower.

Coronary stents -- small mesh tubes inserted into narrowed or blocked coronary arteries to keep them open and restore blood flow -- were the first high-value medical consumable included in China's national centralized bulk procurement program in 2020, with prices falling to below CNY1,000 (USD145) from over CNY10,000. More than 10 million procured this way had been used in clinical settings as of last month, accounting for over 90 percent of the total.

Real-world evidence in medical insurance is essential to value-based healthcare and strategic purchasing, so that insurance funds are directed toward diagnosis, treatment, medicines, and medical consumables that are genuinely effective and cost-efficient, said Cai Haiqing, a former official at the Jiangxi branch of the NHSA.

The report was based on the findings of a study of more than 90,000 coronary stent patients across eight hospitals. The study -- led by the National Clinical Research Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, and Fuwai Hospital -- compared the number of coronary interventions in the hospitals before and after centralized procurement.

In 2022, the hospitals performed nearly 50,000 coronary interventions, up 15 percent from 43,000 in 2019. The average number of stents used per procedure fell to 1.3 from 1.5, reflecting wider availability of longer stents that reduce the need to place multiple shorter ones in series.

The study also recorded advances in procedural quality. Utilization rates for intracoronary imaging, functional assessment, and complex techniques in 2022 rose more than 200 percent, 300 percent, and 50 percent, respectively, from 2019, approaching rates seen in developed countries.

The use of drug-coated balloons -- a 'leave-nothing-behind' approach in which the device is removed after dilating the affected vessel -- climbed to 15 percent from 5 percent over the period. Drug-coated balloons were included in the sixth national round of centralized medical consumable procurement, with all major clinical brands selected.

The number of coronary interventions in China nearly doubled to 1.9 million in 2024 from about one million in 2020, while that of hospitals performing the procedure rose to more than 3,600 from 2,400, with second-tier institutions increasing to 1,700 from 1,200.

Editor: Futura Costaglione