Huitong Yang, Shuzhen Chu
Background: The excessively high prices of High-Value Medical Consumables (HVMCs) and the substantial financial burden on patients are core issues in China's healthcare reform. Although the Volume-Based Procurement (VBP) policies have significantly reduced prices, insufficient policy coordination has led to frequent implementation deviations, constraining the effectiveness of reforms. Methods: Guided by a three-dimensional framework encompassing policy intensity, measures, and objectives, this study employed an integrated analytical process. Text mining facilitated initial thematic identification, which was then iteratively refined and validated through the Delphi method to establish quantifiable indicators within the framework. These indicators were analysed using a synergy degree model to evaluate policy alignment. 21 national-level policies from 2004 to 2024 are analysed. Results: Based on the constructed synergy indices, policy development underwent three stages: 'initial exploration, gradual development, and stable optimization'. As indicated by the model, the synergy degree showed an evolutionary trend, moving from early dispersion, to mid-term leap, and later differentiation. According to the indices, planning guidance and administrative measures showed relatively high synergy over the long term but appeared to squeeze the synergy space for other measures. The results also indicated that imbalances existed among policy objectives, with contradictions between cost control and innovation goals, and insufficient adaptation between medical insurance payment and industry development. Based on these model-based findings, optimisation strategies such as classified coordination mechanisms, dynamic weight adjustment, and closed-loop feedback for quality and supply are proposed. Conclusion: Theoretically, this study is the first to systematically quantify the degree of synergy of high-value medical consumables policies by developing a framework-based coordination analysis model using constructed indices. Practically, it provides a scientific basis for optimising policy combinations, balancing short-term cost control with long-term industrial innovation, and improving medical insurance support mechanisms.