This study evaluated the changes in expenditure and prescription patterns of antibacterial agents under the global budget (GB) program and drug price adjustment of a National Health Insurance scheme. Two structural methods, that is, the Laspeyres method and Fisher\'s Ideal Index decomposition method, were used to illustrate the impacts of price, volume, and drug change.
During the first 5 years of the GB program (ie, 2001-2006), the expenses of antibacterial agents increased by 54.1%, while the volume decreased by 11% to 21.3%. Therapeutic choice was the predominant cause of expense growth. In the second and third 5-year periods (ie, 2006-2011 and 2011-2016), the driving force of therapeutic choice gradually decreased. The antibacterial expense remained stable with a slight increase in prescription volume. Periodic price adjustment contributed steadily to cost containment, by 21.9% to 39.9%.
The GB program led to a remarkable increase in antibacterial expenses mainly attributed to therapeutic choice, especially in the early stage. In contrast, periodic price adjustment, provided steady benefits to pharmaceutical budget control without a noticeable increase in drug volume.
方法:本研究评估了在全球预算(GB)计划和国家健康保险计划的药品价格调整下,抗菌药物的支出和处方模式的变化。两种结构方法,即,Laspeyres方法和Fisher理想指数分解方法,用来说明价格的影响,体积和药物变化。
结果:在GB计划的前5年内(即,2001-2006),抗菌药物费用增长54.1%,而成交量则下跌11-21.3%。治疗选择是费用增长的主要原因。在第二个和第三个5年期间(即,2006-2011年和2011-2016年),治疗选择的驱动力逐渐下降。抗菌费用保持稳定,处方量略有增加。定期价格调整稳步促进成本控制,21.9%至39.9%。
结论:GB计划导致抗菌药物费用显着增加,这主要归因于治疗选择,尤其是在早期阶段。定期价格调整,相比之下,为药物预算控制提供了稳定的好处,而药物量没有明显增加。