Objective: It analyzes the mechanism of volume-price linkage and volume-for-price widely used in China medical reform. Methods: Based on the principle of economics, it analyzes the pursuit of volume and price by both supply and demand sides in pharmaceutical procurement transactions, explores the conditions for the realization of volume-price linkage and volume-for-price exchange, and analyzes and corroborates the issue based on centralized bidding and procurement and national negotiated access. Results: Keeping the balance of supply & demand is a key to fulfill volume-price linkage policy. Volume-price linkages and volume-for-price exchanges are not inevitable, and often require measures to reduce supply costs before they can be expected to mate- rialize. Conclusion: Comprehensive institutional arrangement was essential for volume-price linkage and volume-for-price.