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PurposeThe results of this study have significant policy implications for charting a new course toward enhancing agricultural productivity among Chinese farmers.Design/methodology/approachBy establishing a rural household decision-making model based on the transfer market of farmland operation rights, this paper systematically analyzes the effects of land transfer-in and land transfer-out on the productivity (per labor income) of rural households. The authors conducted basic regression analysis and robustness tests using propensity score-matching and proxy variable approaches based on the micro survey data from rural households in 30 counties in 21 provinces/municipalities/autonomous regions in 2013.FindingsAfter the completion of land transfer, the total productivity of rural households transferring in lands will increase with an increase in the agricultural productivity; the total productivity of rural households transferring out land will increase due to a rise in non-agricultural productivity and the absolute total productivity of rural households not involved in land transfer will remain unchanged.Originality/valueUnlike previous literature, this paper discusses the impacts of land transfer-in and transfer-out on total productivity, agricultural productivity and non-agricultural productivity among various rural households (i.e. those transferring in land, transferring out land or which are self-sufficient).

Centralizing procurement for prescription drugs has the potential to reduce drug spending by creating economies of scale and by improving purchasing power. In March 2019, the Chinese government launched a volume-based purchasing (VBP) pilot program using a competitive bidding process to purchase accredited generic drugs for which branded drug substitutes were available. We performed an interrupted time-series design to estimate the change in monthly drug purchase quantity and spending comparing 14 months before and 7 months after the VBP pilot. We obtained monthly prescription drug purchase data for all purchases from public medical institutions in the three large pilot cities (Beijing, Shanghai and Xi'an) and two non-pilot cities (Changsha and Zhengzhou) between January 2018 to September 2019. We used negative binomial regression and log-linked Gamma Generalized Linear Model for purchase quantity and spending respectively. We evaluated heterogeneity of impact by pilot city, drug type (selected or non-selected drugs), and therapeutic class (cardiovascular disease, mental disorder and cancer) separately. The implementation of the pilot reform was associated with a 132% (95%-CI: 104–165%, p < 0.001) increase in the purchase quantity of selected drugs in pilot cities compared to an 17% decrease (95%-CI: 9–25%, p < 0.001) in control cities. In contrast, the purchase quantity of branded and other drugs in pilot cities decreased by 38% (95%-CI: 27–46%, p < 0.001) and 77% (95%-CI: 71–81%, p < 0.001), respectively; while in control cities, these remained at similar levels. Overall, in pilot cities, there was a 35% (95%-CI: 28–41%, p < 0.001) decrease in the purchase spending for all drugs in the first post-policy month, from 8.1 billion CNY estimated in the absence of VBP down to 5.3 billion CNY; in control cities, the change was negligible. The largest reduction in spending occurred for drugs for the treatment of cardiovascular diseases. The evidence suggests a positive impact of the VBP pilot in ...