| Abstract: | 與台灣全民健康保險其他部門同步成長，每年藥品支出始終佔了健保總費用的四分之一。當多數人著眼於貴重藥品以管控整體藥費，台灣健保藥品部門的一項獨特的現象卻不容忽視：低價藥品充斥。在全部口服藥丸品項中，百分之六十的品項單價低於新台幣兩元，少數品項甚至低於一角。似乎不合理的低價可能無法讓製藥產業合宜發展，也難以保障藥品品質，值得研究現象形成原因，尋求制度改善之道。本三年期研究計畫擬量化與質性分析健保低價藥品市場。第一年裡，將分析健保藥品市場的型態，特別是區分藥品單價與分類。第二年裡，將估算低價藥品的價格界線，進行國際藥價比較，分析十餘年來低價藥品市場變動趨勢，與探討數次藥價調整措施的影響。第三年裡，將進行問卷調查、訪談或座談會，對象包括藥廠、藥師、醫師、健保與產業權責部門，釐清低價藥品現象與未來產業政策。本研究計畫團隊包括經濟學家、醫師與藥師，身兼學術與行政職務，利用專業與過往使用全民健康保險研究資料庫的經驗，應能在此申請課題有深入且持續的國際論文發表，有助於我國醫務管理研究學門的發展。
Parallel to the growth of other sectors within the National Health Insurance (NHI) in Taiwan, the drug expenditure has always accounted for one fourth of the total NHI expenditure annually. While most people pay attention to expensive drugs with the intention of cost control, a unique phenomenon within the pharmaceutical sector of the NHI in Taiwan should not be overlooked: the market is abundant in low-priced drug items. Among oral pills, 60% of drug items is cheaper than 2 New Taiwan dollars per unit and some even cheaper than 0.1 dollar. The seemingly unreasonable low prices might not guarantee the quality of pharmaceutical care in the period of transition and the sustainability of a healthy pharmaceutical industry in the long run. The phenomenon of low-priced drugs involves not only health policy and health care management but also the policy setting in pharmaceutical industry. In the current three-year project, we plan to both quantitatively and qualitatively analyze the phenomenon of low-priced drugs. In the first year, we will estimate the most recent pattern of the pharmaceutical market within the NHI, specifically stratified by drug unit price and drug grouping, after the construction of a time-sensitive data table of the complete historical drug prices within the NHI. In the second year, we will finish: 1. the threshold setting for low-priced drugs within the NHI, either wholly or by drug group, 2. the international comparisons in drug prices, and 3. the trend analysis of the market of low-priced drugs within the NHI from 1997 to 2010. In the third year, we will perform questionnaire, interviews or meeting with those partners involved in low-priced drugs, from pharmaceutical manufacturers, pharmacists, physicians to health insurance and industry authorities. The team members of the current project, including an economist, a physician and a pharmacist holding both academic and administrative positions, believe our professional experiences and research adeptness with the National Health Insurance Research Database will guarantee in-depth studies about the unique phenomenon of drug prices in Taiwan, have continuous international publications, and contribute to the field of healthcare management in Taiwan. |
