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PurposeThis study aims to fill the research gap on the moderating effect of leadership empowerment on the relationship between relational capital and firms' innovation performance in the entrepreneurial ecosystem by addressing the following research questions: (1) How do different types of relational capital positively or negatively affect firms' innovation performance in China? (2) Does leadership empowerment play a moderating role in the above relationship?Design/methodology/approachUsing data derived from the firms distributed in eastern, central and western China, the authors study the impact of relational capital, one of the dimensions of intellectual capital, on firms' innovation performance in the entrepreneurial ecosystem. Based on firms' operation process regarding the relationships with their external stakeholders, the authors divided relational capital into three aspects: trust, reciprocity and transparency. Furthermore, leadership empowerment is taken as the moderating variable in the above theoretical relationship.FindingsThere is significant evidence that trust, reciprocity and transparency have positive impact on firms' innovation performance. Leadership empowerment positively moderates the impact of trust and reciprocity on innovation performance. However, there is no significant moderating effect of leadership empowerment on the relationship between transparency and innovation performance.Originality/valueIn the era of the knowledge economy, the entrepreneurial ecosystem is a critical foundation for firms to improve their innovation capacity and performance, and intellectual capital is one of the most imperative drivers in terms of firms' innovation performance. Nevertheless, few studies have investigated thoroughly concerning the relationships among the entrepreneurial ecosystem, intellectual capital and innovation performance. As this study explores the relationships among the above three factors, it may have profound theoretical and practical significance for firms to extent external relationship networks, improve their innovation performance and strengthen their core competencies, which is of great significance to facilitate the construction of entrepreneurial ecosystem.

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 ...