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Title:	探討自費醫材納入健保給付後之競爭策略 - 以M公司頸椎人工椎間盤為例 Competitive Strategy Analysis of Self-Pay Medical Devices Following Inclusion in National Health Insurance Coverage - A Case Study of M Company's Cervical Artificial Disc
Authors:	吳淑玲 Wu, Shu-Ling
Contributors:	宋皇志 Sung, Huang-Chih 吳淑玲 Wu, Shu-Ling
Keywords:	自費醫材頸椎人工椎間盤醫療科技評估價量調查產品生命週期 Self-pay medical devices Cervical artificial disc Health technology assessment (HTA) Price-volume survey Product lifecycle
Date:	2024
Issue Date:	2025-03-03 13:33:04 (UTC+8)
Abstract:	本研究探討台灣健保給付醫材政策對自費醫材市場形成與發展的影響，並以M公司頸椎人工椎間盤產品在台灣經營為案例，分析當自費醫材經過醫療科技評估後，一旦納入健保給付，如何應對價格下降和競爭優勢削弱的挑戰。健保給付醫材政策雖提升了醫材的普及性，但隨之而來的價量調查和降價機制，對廠商利潤與市場定位產生深遠影響。本研究旨在尋找在健保給付環境下，如何維持自費時期之價格與競爭優勢的策略。透過質性研究方法，本研究訪談了兩位醫師、兩位廠商主管及兩位自費醫材使用者，從多方觀點分析健保政策與自費醫材市場的互動關係。研究發現，自費醫材市場的形成源於健保制度的資源限制和創新醫材的高附加價值需求。然而，當產品納入健保後，價格調降的政策壓力削弱了廠商的定價能力，導致品牌價值稀釋與利潤下降。同時，醫師對醫材臨床效果的需求、病患對自費醫材價值效益的高度期待，而廠商需平衡政策壓力與市場競爭，確保產品的長期生命週期與經濟效益，這些在整體市場運作中起到關鍵作用。本研究提出了三項主要策略建議：一、在產品納入健保後持續進行技術升級與創新，透過高附加價值產品或服務的推廣來增強市場競爭力；二、實行差異化定價模式，透過雙層市場策略，在健保與自費市場間建立互補機制，平衡健保與自費需求；三、強化品牌建設及增值服務，提升患者忠誠度，延長產品生命週期。本研究期望能為健保政策制定者及醫材廠商提供實務參考，促進政策與市場的協調發展與雙贏，實現醫療資源的最佳化分配與產業創新。 This study explores the impact of Taiwan’s National Health Insurance (NHI) medical device reimbursement policy on the self-pay medical device market. Using M Company's cervical artificial disc product in Taiwan as an example, it investigates the challenges faced by self-pay devices after undergoing health technology assessments (HTA) and inclusion in the NHI system, such as price reductions and diminished competitive advantages. Although the NHI reimbursement policy enhances accessibility, its price-volume surveys and price reduction mechanisms significantly affect manufacturers’ profitability and market positioning. The study proposes strategies to preserve self-pay pricing models and sustain competitive advantages under NHI reimbursement constraints. Using a qualitative research approach, the interviews were conducted with two physicians, two manufacturers, and two self-pay medical device users to analyze the interplay between NHI policies and the self-pay market. The findings reveal that the self-pay market has emerged as a response to NHI resource limitations and the growing demand for high-value innovative devices. However, inclusion in the NHI system erodes manufacturers’ pricing power through price reduction policies, diluting brand value and profitability. Physicians prioritize clinical efficacy, patients emphasize value-for-money outcomes, and manufacturers navigate a delicate balance between policy constraints and market competition. Successfully managing these factors is crucial to sustaining product lifecycles and achieving economic viability, which are essential for the market's functionality. This study proposes three key strategies: (1) Continue technological upgrades and innovations after NHI inclusion to promote high-value-added products, enhance market competitiveness, and retain the attractiveness of the self-pay market; (2) Utilize differentiated pricing and a dual-tier market strategy to balance NHI and self-pay needs; (3) Strengthen brand building and value-added services to improve patient loyalty and extend the product lifecycle. This study aims to provide practical references for NHI policymakers and medical device manufacturers, facilitating coordinated policies and market development, achieving a win-win scenario, and optimizing resource allocation and industrial innovation.
Reference:	中文參考文獻： 1.江志城. (2023). 自費醫材相關產業商業模式與行銷策略之研究. 國立台灣科技大學企業管理研究所EMBA碩士在職專班碩士學位論文. 2.全國法規資料庫.(2023, March 23). 全民健康保險藥品價格調整作業辦法. https://law.moj.gov.tw/LawClass/LawAll.aspx?PCode=L0060038 3.李伯璋、涂奇君、張淑雅、黃育文、戴雪詠. (2020). 臨床實證把關，資訊透明公開　談健保給付醫療器材的改革. 消費者報導雜誌, 469, P.63–65. 4.李佳欣. (2020, June 1). 咬著牙買單　9成民眾棄健保選自費. 康健雜誌. https://www.commonhealth.com.tw/article/81677 5.呂美秀. (2016). 全民健康保險政策對台灣醫療器材產業經營策略的影響-以心血管產業為例. 世新大學企業管理學系碩士學位論文. 6.吳書緯. (2020, June 10). 健保署訂定醫材自付差額上限時力：恐造成劣幣驅逐良幣. 自由健康網. https://health.ltn.com.tw/article/breakingnews/3193443 7.林劭璇、江翠如. (2024 March). 推薦及使用自費醫療之臨床實務及倫理反思論壇紀要(上). 臺大醫院倫理中心季刊, 1. P.39-42 8.林劭璇、江翠如. (2024 June). 推薦及使用自費醫療之臨床實務及倫理反思論壇紀要(下). 臺大醫院倫理中心季刊, 2. P.58-64 9.林坤輝. (2013). 新創骨科醫療器材公司的競爭策略分析與建議. 國立台灣大學管理學院碩士在職專班商學組碩士論文. 10.林亮瑜. (2020, October 8). 疫情風暴中，72年歷史的英國NHS公醫制陷改革困局. 報導者. https://www.twreporter.org/a/opinion-uk-health-system-insurance-nhs 11.林渝樺. (2020, September 29). 自付差額醫材採極端值,民眾真的賺到了嗎?醫師解析背後真相. 健康醫療網. https://www.healthnews.com.tw/article/47618 12.林筱庭. (2023, June 8). 低成本醫療器材傾台打價格戰！專家警告：下一波恐釀「缺醫材潮」. Uho優活健康網. https://www.uho.com.tw/article-60989.html 13.施桂雲. (2002). 以系統思考觀點探討健保總額預算制度對醫療系統影響之研究. 大葉大學事業經營研究所碩士論文. 14.孫友聯. (2020, August 12). 回歸醫材差額上限爭議原點：健保全民監督，可能嗎？. 報導者. https://www.twreporter.org/a/opinion-health-insurance-medical-device-policy-debate 15.財團法人中華民國消費者文教基金會. (2020, September 8). 嚇死人的醫療特材價差民眾知的權利不容被犧牲. https://www.consumers.org.tw/product-detail-2731527.html 16.財團法人台灣醫療改革基金會. (2020, December 8). 面對自費五大民苦，正視自費醫療管理問題. https://www.thrf.org.tw/archive/2346 17.陳志豐. (2003). 現行健保體制之研究. 國立中山大學中山學術研究所碩士論文. 18.健保署 (2023). 2023-2024全民健康保險年報。取自：https://www.nhi.gov.tw/ 19.許國川. (2005). 我國全民健保總額支付制度之研究─實施現況與檢討. 逢甲大學經營管理碩士在職專班碩士論文. 20.康健雜誌. (2020, June 13).《各科醫師回應》自費醫材差額上限風暴醫：價格資訊透明比較重要而非訂定天花板. https://www.commonhealth.com.tw/article/81862 21.陳慈純. (2019). 台灣全民健保制度下的自付醫療費用與公平性研究. 國立暨南國際大學新興產業策略與發展博士學位學程博士論文. 22.陳稚華. (2020, November 16). 【健保改革1》「無效醫療」和「過度醫療」真的是讓健保瀕臨破產的元兇？】. 信傳媒. https://www.cmmedia.com.tw/home/articles/24275 23.陳潔. (2020, June 18). 《火線背後》僅佔健保3.2％的醫材差額給付訂定上限，為何燃起醫界大火？. 報導者. https://www.twreporter.org/a/health-insurance-medical-device-policy-debate 24.陳潔、柯皓翔. (2020, August 12). 醫材風暴下的真貌醫材訂價迷宮-差額給付巿場大解密. 報導者. https://www.twreporter.org/a/health-insurance-medical-device-pricing-analysis?utm_source=chatgpt.com 25.張筠. (2022). 影響自費醫材價格的因素以特殊人工水晶體為例. 國立中央大學產業經濟研究所碩士論文 26.張華書. (2023). 國內醫療器材產業經營策略之探討-以B公司為例. 逢甲大學經營管理碩士在職學位學程碩士論文 27.張瓊方. (2010, November). 健康「不平等」的真相. 台灣光華雜誌. https://www.taiwan-panorama.com/Articles/Details?Guid=2683608e-3ded-44fe-a373-377e763be9c0&CatId=9&postname=%E5%81%A5%E5%BA%B7%E3%80%8C%E4%B8%8D%E5%B9%B3%E7%AD%89%E3%80%8D%E7%9A%8 28.莊逸洲、黃崇哲、鄭明智. (2003). 台灣醫院總額支付制度運作模式的初步探討. 醫務管理期刊, 4(3), p.1–17. https://doi.org/10.6174/JHM2003.4(3).1 29.曾于珊. (2017). 民眾選擇使用自費特殊材料的知識、態度與行為. 國立中山大學企業管理學系醫務管理碩士班碩士論文. https://hdl.handle.net/11296/56akev 30.黃珮怡. (2019). 全民健保給付規定對醫療器材產業經營策略與市場形塑計畫之影響 - 以A醫療公司之A產品為例. 國立臺灣大學管理學院企業管理碩士專班碩士論文. https://doi.org/10.6342/NTU201901842 31.黃景宏. (2018). 台灣醫療器材進入泰國市場之策略分析(以Dbi)公司為例. 國立政治大學商學院經營管理碩士學程生技醫療組碩士論文. Doi:10.6814/THE.NCCU.EMBA.053.2018.F08 32.游舒帆. (2019, July 6). 產品生命週期，如何延續？以iPhone為例，企業這樣找「衝刺新品的最佳時機」. 商周. https://www.businessweekly.com.tw/management/blog/26177 33.楊家輝. (2024). 骨科創傷植入物引進台灣的銷售模式探討(未出版之碩士論文). 國立政治大學商學院經營管理碩士學程高階經營班碩士論文. 34.楊惠君、陳潔. (2020, July 24). 醫材風暴掀開的健保國王新衣-不能說破的定價祕密. 報導者. https://www.twreporter.org/a/health-insurance-medical-device-new-policy 35.劉美恩. (2024, June 24). 健保署研擬自費醫材核准平台民眾最在意的其實是…. 經濟日報. https://money.udn.com/money/story/11800/8051850 36.葉錞蒨. (2022). 創新醫材發展策略及市場分析:以脊椎醫材為例. 科技管理學院經營管理碩士在職專班碩士論文. 37.葉瓊蔓. (2024). 我國新創醫療器材從事跨國貿易之挑戰與策略-以普瑞博公司發展歐盟市場為例. 國立政治大學國際經營與貿易學系碩士學位論文. 38.衛生福利部. (2011). 健保局針對民眾自費之相關管理措施. https://www.mohw.gov.tw/cp-3160-25375-1.html 39.衛生福利部. (2013). 厝邊好醫師，社區好醫院，家庭責任醫師為全家人健康把關. https://www.mohw.gov.tw/cp-2640-23788-1.html 40.衛生福利部. (2014). 健保「自費醫材比價網」上線，便利民眾查詢比一比! https://www.mohw.gov.tw/cp-2704-21970-1.html 41.衛生福利部. (2019). 長照基金財源收入無虞服務資源穩定提升. https://www.mohw.gov.tw/cp-4253-49404-1.html 42.衛生福利部. (2020, May). 推動健保特材改革，依「臨床實證」等級訂定健保差額負擔比例. https://www.mohw.gov.tw/cp-4632-53093-1.html 43.衛生福利部. (2020, December). 投資健康，110年健保費率調整為5.17%. https://www.mohw.gov.tw/cp-4624-57420-1.html 44.衛生福利部中央健康保險署. (2019, August 29). 全民健保運用AI科技發展智慧審查工具. https://www.nhi.gov.tw/ch/cp-1588-41b51-3255-1.html 45.衛生福利部中央健康保險署.(2024, March 27). 新興療法與精準醫療帶動自費需求. https://www.nhi.gov.tw/ch/cp-1775-2a71c-3121-1.html 46.衛生福利部長期照顧司. (2022, June 9). 長照十年計畫2.0. https://1966.gov.tw/LTC/cp-6572-69919-207.html 47.薛孝亭. (2023, July 7). 英國醫療技術戰略. OUTLOOK科技發展觀測平台. https://outlook.stpi.narl.org.tw/index/focus-news/4b11410088c8c05901892e2ca7383384 48.謝欣容. (2018). 探討自費醫材選用之關鍵決策因素-以南部醫院為例. 國立高雄科技大學企業管理系碩士在職專班碩士論文. 英文參考文獻 1.360iResearch. (2024). Cervical Total Disc Replacement Market: Global Industry Analysis, Size, Share, Growth, Trends, and Forecast, 2024-2033. Global Information. https://www.gii.tw/report/ires1572068-artificial-cervical-intervertebral-disc-market-by.html 2.AmCham Taiwan. (2024, June 6). 2024 Medical Devices Position Paper. Retrieved from https://amcham.com.tw/2024/06/2024-medical-devices-position-paper/ 3.Appleby, J., Galea, A., & Murray, R. (2014). The NHS productivity challenge: Experience from the front line. King’s Fund. Retrieved from https://www.kingsfund.org.uk/publications/nhs-productivity-challenge 4.Cheng, T.M. (2015, May 14). Taiwan’s Health Care System: The next 20 Years. Brookings. https://www.brookings.edu/articles/taiwans-health-care-system-the-next-20-years/ 5.Glied, S. A., & Zhu, B. (2020, April 17). Catastrophic Out-of-Pocket Health Care Costs: A Problem Mainly for Middle-Income Americans with Employer Coverage. The Commonwealth Fund. https://doi.org/10.26099/x0cx-cp48 6.Lu, J. F. R., & Hsiao, W. C. (2003). Does universal health insurance make health care unaffordable? Lessons from Taiwan. Health Affairs, 22(3), 77–88. https://doi.org/10.1377/hlthaff.22.3.77 7.Natasa Mihailovic, Sanja Kocic, & Mihajlo Jakovljevic. (2016). Review of Diagnosis-Related Group-Based Financing of Hospital Care. https://pubmed.ncbi.nlm.nih.gov/28462278/ 8.National Institute for Health and Care Excellence (NICE). (2021). Technology appraisal guidance: Medical devices and diagnostics. Retrieved from https://www.nice.org.uk/ 9.Pace, G.F., Janiga, N.J., & Lo, D.Y. (2020, October 16). The Value of Branding in Healthcare. HEALTHCAREAPPRAISERS.COM. https://healthcareappraisers.com/the-value-of-branding-in-healthcare/ 10.Philipson,T.J., Ling,Y., Kataria,A., Hotmartua,R., & Heller,L. (2023, November 25). The Value of Accelerated Medical Device Reimbursement. University of Chicago. https://ecchc.economics.uchicago.edu/project/the-value-of-accelerated-medical-device-reimbursement/ 11.Rao, P., Fischer, S.H., Vaiana, M.E., & Taylor, E.A. (2021, April 19). Barriers to Price and Quality Transparency in Health Care Markets. RAND. https://www.rand.org/pubs/research_reports/RRA1158-1.html 12.Schoen, C., Osborn, R., How, S. K. H., Doty, M. M., & Peugh, J. (2008). In chronic condition: Experiences of patients with complex health care needs in eight countries. Health Affairs, 28(1), 1–16. https://doi.org/10.1377/hlthaff.28.1.w1 13.Tsai, H.Y., Huang, Y.W., Chang, S.Y, Huang, L.Y., Lin, C.J., & Lee, P.C. (2022). The Reimbursement Coverage Decisions and Pricing Rules for Medical Devices in Taiwan. GMS Health Innovation and Technologies. doi: 10.3205/hta000134
Description:	碩士國立政治大學經營管理碩士學程(EMBA) 109932169
Source URI:	http://thesis.lib.nccu.edu.tw/record/#G0109932169
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