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Title: | 口服降血糖藥品費用支出變動之影響因素解構 Decomposition of factors influencing expenditure variation of oral antidiabetic drugs |
Authors: | I-Chia Lu 魯怡佳 |
Advisor: | 楊銘欽 |
Keyword: | 口服降血糖藥品,藥費支出變動解構,非隨機解構式指數分析方程式,全民健保研究資料庫, oral antidiabetic drugs,drug expenditure decomposition,non-stochastic index-theoretical method,National Health Insurance Research Database, |
Publication Year : | 2018 |
Degree: | 碩士 |
Abstract: | 目的:本研究旨在了解台灣口服降血糖藥品利用情形變化,並探討口服降血糖藥品費用支出之主要成長原因。
方法:使用全民健保研究資料庫2010年承保抽樣歸人檔,分析2009年至2013年各年度口服降血糖藥品之利用情形。利用非隨機解構式指數分析方程式,將藥費支出變化拆解為六項因素:處方數量、處方大小、藥品單價、學名藥替代、藥理類別、用藥種類。此六項因素中,處方數量、處方大小又可歸納為數量效應;藥品單價、學名藥替代又可歸納為價格效應;而藥理類別、用藥種類則可歸納為治療選擇效應。 結果:研究期間內,每年總藥品支出逐年上升,自2009年至2013年,由2億7,034萬元上升至3億990萬元,成長約15%。其中藥品費用支出成長歸因於六項因素的貢獻分別為:處方數量8.2%、處方大小20.5%、藥品單價-24.8%、學名藥替代17.1%、藥理類別25.7%、用藥種類-20.6%。將六因素歸納為三大因素後,數量效應使藥費支出增加30%,價格效應使藥費支出減少12.0%,治療選擇效應則使之減少0.2%。 結論:2009年至2013年,口服降血糖藥品費用的支出上升原因主要來自於藥理類別改變,推測其原因為新機轉藥物DPP-4 inhibitors納入健保所導致。建議未來健保署討論新藥納入給付時,須更謹慎評估新藥加入後對健保的財務衝擊。 Objective: This study aimed to describe the trends in the use and spending on oral antidiabetic drugs and to explore factors that influenced expenditure variation in Taiwan during 2009-2013. Methods: Data were extracted from National Health Insurance Research Database (NHIRD). Using a non-stochastic, index-theoretical method, changes in expenditures on oral antidiabetic drugs were decomposed into 6 cost-impact determinants: prescription volume, prescription size, price, generic use, therapeutic mix, and drug mix. These 6 determinants could be classified into 3 broad categories: (1) volume effects, (2) price effects, and (3) therapeutic choices. Results: The expenditure of oral antidiabetic drugs increased 15% from 2009 to 2013. The changes that can be attributed to these 6 determinants are as follows: change in prescription volume contributed 8.2%, change in prescription size contributed 20.5%, change in price contributed -24.8%, change in generic use contributed 17.1%, change in therapeutic mix contributed 25.7%, and change in drug mix contributed -20.6%. For 3 broad categories, volume effects increased 30%, price effect decreased 12.0%, and therapeutic choices slightly decreased 0.2%. Conclusions: From 2009 to 2013, the main driving factor of expenditure variation of oral antidiabetic drugs was therapeutic mix. This might be because DPP-4 inhibitors started to be reimbursed from 2009. It is suggested that when facing new drugs in the future, the National Health Insurance Administration needs to pay more attention to the budget impact of those new drugs to control the growth of drug expenditure. |
URI: | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/69371 |
DOI: | 10.6342/NTU201801418 |
Fulltext Rights: | 有償授權 |
Appears in Collections: | 健康政策與管理研究所 |
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