全民健康保險政策對藥品生命週期之影響 以Cefamezin®、Stilnox®為例

Abstract

中文摘要 近年來新藥之開發愈來愈困難，平均一個新藥需花費美金8億，費時12年，所以各藥品公司都將新藥視為珍寶，想盡辦法保護其產品，也就是延長其生命週期，於是各國各藥廠對”藥品生命週期管理”之鑽研不遺餘力。在這些探討、研究中甚少談及'保險政策”但如同台灣的健保局幾乎是唯一支配醫師處方用藥市場的買主，其政策是否深深影響藥品生命週期，甚至超過行銷主要因素（產品、通路、價格、促銷）相當值得探討。 本文以全民健保局主要政策實施時，對二項產品（及其同類品）之生命週期影響做觀察及探討。兩項產品一為注射用抗生素，長期市佔率第一的cefamezin®，一為口服安眠藥市佔第一名的stilnox®。結果發現: 1. 全民健保政策確實對產品生命週期影響深刻，尤其grouping的藥價改訂方式 2. 全民健保政策對產品在生命週期的不同階段（phase）有不同的影響 3. 全民健保政施策對產品生命週期的影響雖大致相同，但對不同產品之輪廓（profile）也會有不同衝擊 由於以上發現，本文也以企業的立場談如何在產品生命週期不同階段做不同資源分配，以延長藥品生命週期，並獲取產品最大利益。並站在國家主管機官署（衛生署，健保局）立場，應如何看待此一事實，以提出有利醫藥環境之政策。

英文摘要 In recent years, the development of new product becomes more difficult than ever. In average，every single new product will generally cost US$800M and take 12 years long to develop. All the pharmaceutical companies regard new drug as a precious diamond, and ensure to implement all required actions to protect its life cycle. Thus, the knowledge and task in ”product life cycle management” have been quite demanding. Among all these knowledge, “Insurance policy” is rather limited. But just like the case in Taiwan, BNHI（Bureau of National Health Insurance）dominates health care market. Any of its policy will certainly influence product life cycle profoundly, even stronger impact than marketing 4P (product、price、place and promotion). Thus, it’s worth doing further study. This thesis collects all the major policies implemented by BNHI to see its impact on 2 products and its similar class of drugs. One is injectable antibiotics—cafamezin®, and the other is oral insomnia drug —stilnox®. Both are number 1 product on market to gain majority share in the category for years. The results of the study are: 1. The policies implemented by BNHI greatly influence products life cycle. Especially, it’s “grouping” policies for price adjustment. 2. BNHI policies exert different influences based on various phases of product life cycle. 3. Though the influences by BNHI policies in product life cycle is similar, different impact is observed base on different product profile. Based on above finding, reasonable resources allocation based on different phases of product life cycle is suggested in order to extend product life cycle and gain best interest of company. Our policy makers should propose policies beneficial to pharmaceutical environment.