全民健保藥價政策問題研究：以政策利害關係人政策網絡觀點

Abstract

我國全民健康保險自1995年實施以來，雖備受民眾認同及肯定，但是健保藥價政策所產生的藥價差問題，在健保藥價費用支出持續增長，健保年年虧損下，已成為不斷爭論的議題。因此暸解包括公部門、醫療體系、藥業團體及社運團體等利害關係人，在健保藥價政策中所處的位置及角色，無疑是我國全民健康保險藥價政策是否能永續發展的關鍵。 本研究以利害關係人概念、政策網絡理論為主要的理論基礎；文獻分析法與深度訪探為研究方法；藥價政策為研究對象，並以公部門、醫療體系、藥業團體及社運團體四個面向切入。透過個案研究、希望分析藥價政策中各個不同的利害關係人，在藥價政策網絡內，探討其利益互賴、互動的過程，以及所扮演的角色。最後，在個案與理論檢證過程中，提出對解決藥價差問題的初步建議。

National Health Insurance in Taiwan has received recognition since the implementation 1995. In spite of this, due to the growing pharmacy expenditures and the deficits of NHI, the pharmaceutical price gap derived from the NHI drug price policy has become an arguing issue. Understanding the NHI drug price policy network and the positions and roles of all stakeholders, including the public sections, medical systems and social movement groups, is the key to the sustainable development for NHI. This research is based on the conception of stakeholders and the policy networks theory, and used documentary analysis and in-depth interview as research methods. The research subject is the drug price policy which is analyzed by four dimensions- the public sectors, medical systems, pharmaceutical groups and social movement groups. Through studying and analyzing every different stakeholder, this essay discusses and researches the interdependent interests, processes and the roles they played in the drug price policy networks. Finally, this essay recommends some initial solutions to the problems of pharmaceutical price gap.