總額支付制度對台灣西藥產業及企業經營策略影響之研究

Abstract

現今醫藥產業面臨諸多的挑戰。自從台灣實施全民健保制度後，醫療生態丕變，直接影響了醫藥廠商的經營與發展。總額支付制度為解決全民健保所帶來的財務問題，自1998年起分階段推行，但在實際運作的過程及結果分析發現，除了許多現存的弊端未能消除，例如偏高的就診率、門診佔整體醫療支出率依然偏高及藥價黑洞等等。另一方面，由於藥事政策缺乏長期規劃，在一昧地儘從財務角度修正其規劃方向，卻也造成了藥品費用控制與國民健康改善無法同時兼顧的困境，例如醫療院因成本壓力而不斷更換用藥品項，或是即使新藥具顯著健康效益，但仍延緩其上市等。 本研究以資料研究的方式，瞭解全民健保及總額支付制度對整個西藥產業的影響，並分析產業在面對這些挑戰之下，企業所發展出來之因應策略，包括加速新產品之上市、併購及策略聯盟及差異化目標市場等。再切入個案公司的情況、問題與未來市場趨勢進行深入分析。個案公司目前在面對制度面的衝擊，由於及早規劃採取聚焦策略，將內部資源重新分配至其專長之治療藥品領域，並將其他市場以策略合作方式，將風險分散，因此在近期銷售成長指標超越整體市場的成長率。然而在未來發展上，個案公司對外應加強產業合作，以增加對藥事政策制定的影響力，對內則應提高生產指標、持續引進新產品及強化策略夥伴的管理與規劃。如此方能持續維持其成長動力。

The pharmaceutical industry faces a great deal of challenges nowadays. In Taiwan, since health insurance took effect, it has dramatically influenced directly on the medical treatment and the development of the pharmaceutical companies. Global Budget System, introduced with the phased implementation in 1998, aimed to resolving the finance deficits resulted from the medical insurance. However, the existing issues are still prevailing, such as high patient visits, high clinical spending to total medical costs and high price gap between ex-factory price and patient price. In addition, more issues come up due to the tight price control and rigid new drug application under the governmental drug policies. Examples are hospitals’ replacing drugs with sole consideration of cost pressure and low ratio of new drug approval. The trend shows the difficulties to balance the financial control and improvement on civic health. In this research, we use the data analysis method to understand the effect of the governmental drug pricing policies on pharmaceutical industry and the strategies developed by the industry to cope with the challenges, including accelerating new product launch, seeking for merger/strategic collaboration and differentiating the target market. Then use the case study method to analyze the specific situations the case company faces and the business strategies developed by the case company to combat with the environmental changes. The case company set its strategic direction on focusing due to the limited resources. So it started with selecting the therapeutical areas, and then reallocating its resources to the certain targeted theareutical areas to gain the product synery. Then divested the off-patent products and sought for business partners to co-promote the promoted products in other territories that the case company can not reach. The case company pays off with higher-than-market sales growth. Forward looking, the suggestions are made to the case company, including externally to keep close collaboration with industries associations to gain further influence on development of government drug price policies; internally further to improve productivity, to accelerate new product launch and to strengthen the management of business partners. Only constant delivering excellent execution can keep its market advantage on the long run.