context: The decision-making of centralised procurement is largely predictable. At a national level, expensive but highly consumed products are favoured candidates; at the local level, various products can be tried out on a smaller scale. Understanding what will be centrally procured next and how they will be procured helps stakeholders mitigate the risks.

A policy insider told Health Insights that anything can be centrally procured if the product is reimbursable, widely consumed clinically and overpriced, bearing in mind that domestic manufacturers supply over 50 percent of the market share.

Nonreimbursable products are less likely to be centrally procured, says Chen Minxing 陈珉惺 Shanghai Health and Development Centre. In addition to national procurement programs, the state also encourages regional procurement programs to follow a trial and error approach. Small-scale local procurement programs help collect data to analyze the impact centralised procurement might have on product manufacturing and clinical distribution. Those products that succeed locally can later be adopted nationwide.

Centralised procurement is gradually expanding to high-value drugs and medical devices. As announced earlier, the procurement program already shook the 15 bn coronary stent market and the 10 bn hip and knee prostheses sector.

Anhui is about to trial a centralised volume-based procurement program for IVD (in vitro diagnostic) kits, reports Health Insights. The program covers 23 high value-added CLIA (chemiluminescence immunoassay) products, all extremely profitable in the market. The program could potentially include IVD medical devices paired with IVD kits.

Ningbo is considering reimbursing dental implants with BMI (basic medical insurance), says Gao Wenhui 高文辉 Ningbo BMI procurement chair. The move is striking as dental implants are expensive and are 90 percent imported. Gao says this will be limited to Ningbo as a local program because it is not affordable elsewhere.

Industry insiders expect orthopaedic implants, coronary stents and infant formula will be next on the procurement roll, says Health Insights.