China Expands Coronary Stent Procurement, Slashing Costs

China has renewed its national volume-based procurement (VBP) program for coronary stents, with the second round of follow-up procurement opening in Tianjin on May 20. All 15 participating companies won selection, and 27 out of 30 products qualified, ensuring that mainstream clinical products remain widely available at affordable prices, according to Xinhua News.

Background: A Landmark Healthcare Reform

Coronary stents were the first category of high-value medical consumables included in China’s national VBP program in November 2020 — a watershed moment for medical device pricing. The initial round saw prices plummet from over CNY 10,000 (approximately USD 1,460) to under CNY 1,000 (USD 145), representing an average price reduction of 92.67%. Since the program’s implementation in early 2021, over 10 million stents have been used clinically, benefiting approximately 7 million patients.

Key Developments in the 2026 Round

The latest procurement round marks a significant expansion of the program. A total of 4,468 medical institutions submitted demand projections — an 86% increase from the 2,408 institutions in the first round and a 23% rise from the 3,626 in the previous follow-up round in 2022. Annual demand has surged to approximately 2.73 million units, up 155% from the initial 1.07 million and 47% higher than the previous follow-up.

All 14 originally selected stent products continue to be included, alongside several newly added upgraded products such as Medtronic’s Resolute Onyx stent and Shanghai MicroPort’s Firehawk stent. The expanded selection gives clinicians and patients access to a broader range of options, including products from both international manufacturers like Abbott and Boston Scientific and domestic leaders such as Beijing Lepu Medical and Shandong JW Medical Systems.

A Maturing Procurement Strategy

Professor Lu Yun, Director of the Pharmaceutical Pricing Research Center at China Pharmaceutical University, told 21st Century Business Herald that “through previous procurement rounds, coronary stents have formed a market-oriented reasonable price.” He explained that the current follow-up procurement focuses on stabilizing clinical use, supply, and prices through an inquiry-based method that gives companies clearer expectations.

Unlike the aggressive price cuts of the initial round, the 2026 procurement emphasizes four key principles: stabilizing clinical use, ensuring quality, preventing vicious internal competition, and preventing bid-rigging. Different price levels now correspond to different volume-guaranteed ratios, reflecting a more mature “volume-for-price” exchange model. Additionally, newly approved products can apply for supplementary selection during the procurement cycle, providing companies with greater certainty for their research and development investments.

Real-World Evidence of Success

A study released by the National Healthcare Security Administration on the same day provides compelling evidence of the program’s effectiveness. According to Digital Phablet, the real-world analysis of over 90,000 patients across eight hospitals found that inpatient costs for coronary stent procedures decreased by approximately 26%, from roughly CNY 60,000 to about CNY 44,000 per intervention. Crucially, rates of major adverse cardiovascular events within two years of surgery remained stable, confirming that cost reductions have not come at the expense of patient outcomes.

The study, conducted by the National Clinical Research Center for Cardiovascular Diseases at the Chinese Academy of Medical Sciences in collaboration with Fuwai Hospital, also documented significant improvements in procedural quality. Utilization rates for intracoronary imaging, functional assessments, and complex techniques increased by over 200%, 300%, and 50% respectively since 2019, approaching levels seen in developed nations.

Broader Impact on Cardiac Care

The VBP program has catalyzed a dramatic expansion of cardiac care capacity across China. The number of coronary interventions nearly doubled from approximately 1 million in 2020 to 1.9 million in 2024. Hospitals performing these procedures grew from 2,400 to over 3,600, with second-tier institutions expanding from 1,200 to 1,700. This expansion means that patients suffering acute heart attacks in smaller cities can now receive life-saving treatment closer to home.

Looking Ahead

The next phase will focus on implementation, with the National High-Value Medical Consumables Joint Procurement Office and regional alliances working to finalize purchase agreements and ensure stable supply chains. The program’s evolution from aggressive price reduction to a more balanced approach emphasizing quality, stability, and innovation suggests that China’s VBP model is maturing — and its success is drawing attention from other countries seeking to control healthcare costs while maintaining quality of care.

As Professor Lu noted, the ability for new products to enter the procurement cycle mid-term provides companies with a “reassurance” that encourages continued innovation, ensuring that China’s patients will benefit from both affordability and access to the latest medical technology.