學名藥與原廠藥品牌權益對醫師處方意向之影響

Abstract

背景：醫療市場中，醫師為醫療服務提供者，而病人較不具醫療的專業知識，導致對於所需照護的需求通常無所知而難以抉擇，這種雙方「資訊不對等」的現象，存在著許多可能的因素而影響醫師的治療決策。由於台灣施行醫院總額支付制度，醫療院所在成本的考量下，使得醫師陷入醫療專業與財務考量的兩難，為求藥品的合理藥價差可達到最大化，常會避免開立價差小的原廠藥，而選擇具相同成分但藥價差較高的學名藥，進而影響了醫師的處方型態。因此，許多探討影響醫師處方學名藥或原廠藥的研究中，較多著重於藥品價格；然而在這些探討醫師開立原廠藥或學名藥之研究中，較少提及藥品品牌所賦予藥品的附加價值以及對於醫師處方型態造成的影響。故本研究即藉由醫師對於藥品品牌的認知情況為切入點，探討原廠藥與學名藥品之品牌權益對醫師處方意向的影響。 目的：(1)探討醫師對於原廠藥與學名藥品牌權益的認知情況 (2)探討醫師對於原廠藥與學名藥藥品品牌權益之認知情況與其處方意向之間的相關性 (3)探討醫師之不同執業年資及所屬醫院權屬別在藥品品牌權益和處方意向間的調節作用。 方法：研究工具為網路問卷，經由發送網路問卷平台網址至1331位醫師之電子信箱，由醫師自行上網填寫。以台灣地區內科醫學會會員醫師為研究對象，於2012年3月1日至2012年5月14日，採取便利抽樣進行研究，共回收94份有效問卷，回收率約為7%。 結果：醫師對於原廠藥品牌權益認知情形顯著高於學名藥，其中又以原廠藥之知覺品質更顯著高於學名藥。藥品之品牌形象與知覺品質對醫師處方意向有顯著正向影響，而藥品品牌知名度則無顯著影響。此外，在原廠藥中，醫師服務單位之權屬別為一調節因子，此一結果可推論至醫院成本考量下對醫師處方型態的影響。 關鍵字：品牌權益、品牌形象、知覺品質、品牌知名度、處方意向。

Background: In the healthcare system, information asymmetry could be caused by patients who have no medical expertise to decide the best treatment but physicians do. However, this information asymmetry situation may create potential factors to affect physicians managing the treatment strategy. Due to the global- budget system in Taiwan’s National Health Insurance limits hospital institutes’ financial growth, maximizing the reasonable pharmaceutical price gap is the way to control cost. In the pharmaceutical market, generic drugs have the higher price gap than brand-name drugs. This could affect physicians’ prescribing style because of cost consideration. In the past, researches which studied on prescribing intention of brand-name drugs or generic drugs were focusing on drug price much more than on the drug brands and their additional value. Therefore, this study focuses on the value of drug brands, researching the effects of brand equity on prescribing intention of brand-name drugs and generic drugs. Purpose: The purposes of this research include: (1) to discuss brand equity of brand-name drugs and generic drugs among physicians; (2) to discuss the influences of brand equity on prescribing intention; (3) to examine the moderating effect of seniority and ownership of hospitals. Method: We conducted an on-line cross-sectional survey on convenience sampling of 1331 member physicians of Taiwan Society of Internal Medicine. The survey was conducted during March 1 to May 14 in 2012. 94 valid data were collected, and response rate was 7%. Data were analyzed by factor analysis, correlation analysis, regression analysis and descriptive statistics with SPSS 18.0. Conclusion: The brand equity of brand-name drugs is higher than generic drugs and especially higher in the constructs of brand equity, perceived quality. The results proved that brand image and perceived quality of drugs would positively affect physician’s prescribing intention; however, the brand awareness would not. In addition, this study found that the ownership of hospitals showed the moderating effect between the brand equity of brand-name drugs and prescribing intention.

Keyword: brand equity, brand image, perceived quality, brand awareness, prescribing intention