China's Drug Pricing Policies Dramatically Increased Access to GLP-1 Medications

National price negotiation led to a significant increase of 212.28 defined daily doses (95% CI: 188.25-236.31, p<0.001) in novel hypoglycaemic drug consumption. Daily costs decreased significantly after policy implementation (p<0.001). Dulaglutide, liraglutide, semaglutide, and dapagliflozin showed significant increases in utilization post-policy (p<0.001).

Interrupted time series analysis with segmented regression using drug procurement data from the Shanghai Medical Procurement Agency covering all public and private hospitals in Shanghai, January 2016 to December 2022. Analyzed volume, expenditure, and daily cost changes for specific drugs relative to policy implementation dates.

Drug pricing policy directly affects whether patients can access effective medications. This real-world evidence shows that government price negotiation can dramatically expand access to GLP-1 receptor agonists — drugs that have proven benefits for diabetes, obesity, and cardiovascular disease — by making them affordable at scale.

As GLP-1 receptor agonists demonstrate benefits beyond diabetes — including weight loss and cardiovascular protection — their high cost is a major barrier worldwide. China's approach of centralized price negotiation offers a model for how government policy can dramatically expand access to these medications, relevant to global discussions about drug pricing and access.

Data is from Shanghai only, which is more developed than most Chinese cities — results may not generalize to rural or less economically developed regions. The study measures procurement volumes, not individual patient outcomes or adherence. It cannot distinguish whether increased utilization led to improved health outcomes. The study period ended in 2022 and doesn't capture the more recent semaglutide demand surge.