Impacts of Cost Containment Strategies on Pharmaceutical Expenditures of the National Health Insurance in Taiwan, 1996???2003

Lee, Yue Chune; Yang, Ming‐Chin; Huang, Yu‐Tung; Liu, Chien Hsiang; Chen, Sun Bing

doi:10.2165/00019053-200624090-00006

Cited by 79 publications

(54 citation statements)

References 13 publications

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“…Table 2 shows the descriptive statistics of the variables under study. In the same way as Lee et al [8], we use the expenditure data in nominal terms, i.e. without accounting for inflation, since drug prices evolve differently from prices in general, and are not regularly adjusted according to any price index (prices are not inflation adjusted over time).…”

Section: Methodsmentioning

confidence: 99%

The impact of repeated cost containment policies on pharmaceutical expenditure: experience in Spain

2010

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The growth in expenditure on the financing of pharmaceuticals is a factor that accounts for a large part of the increase in public health spending in most developed countries. In an attempt to kerb this growth, many health authorities, particularly in Europe, have introduced numerous regulatory measures that have affected the market, especially on the supply side. These measures include the system of reference pricing, the reduction of wholesale distributors' and retailers' markups and compulsory reductions of ex-factory prices. We assess the impact of these cost containment measures on expenditure per capita, prescriptions per capita and the average price of pharmaceuticals financed by the public sector in Catalonia (Spain), from 1995 to 2006. We apply an autoregressive integrated moving average (ARIMA) time series model using dummy variables to represent the various cost containment measures implemented. Twelve of the 16 interventions analysed that were intended to contain the overall pharmaceutical expenditure were not effective in reducing it even in the short term, and the four that were effective were not so in the long term, thus amounting to a moderate annual saving.

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Section: Methodsmentioning

confidence: 99%

The impact of repeated cost containment policies on pharmaceutical expenditure: experience in Spain

2010

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“…Price adjustment exerted its strongest influence on pharmaceutical concentration during the second price adjustment, when it particularly affected the district hospitals, hospitals with monthly prescriptions below 50 (HHI_DDD: 0.64-0.57) and those with monthly prescriptions between 51 and 100 (HHI_DDD: 0.50-0.44). The second price adjustment was based on a reference price mechanism, which showed the most effective method of reducing the price variations, as also indicated by Lee et al [34] as one of the most effective pharmaceutical cost containment methods. The effect of TZD entry on reducing concentration was more significant at the second entry, though the insignificance of the statistics shows that it is hard to distinguish whether the reduced concentration was the effect of trend or the effect of the new entry.…”

Section: Discussionmentioning

confidence: 99%

“…In April 2000, the BNHI introduced a new price adjustment method based on the weighted average price obtained from market surveys on quantity and price, which was administered to obtain a ceiling price for each group of pharmaceuticals with similar ingredients. The new price adjustment method reduced price variation among offpatent drugs that had similar active ingredients in April 2001, March 2003, and November 2004 [34]. However, the reference mechanism based on weighted average price was processed separately for original brand and generic drugs.…”

Section: Characteristics Of Health Care and The Pharmaceutical Marketmentioning

confidence: 99%

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Pharmaceutical penetration of new drug and pharmaceutical market structure in Taiwan: hospital-level prescription of thiazolidinediones for diabetes

Tsai

Wen

Huang³

et al. 2009

Eur J Health Econ

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This study used Taiwan's National Health Insurance claim database (years 2000-2005) to examine how thiazolidinediones (TZD), a new class of drugs for diabetes, penetrated into Taiwan's hospitals, and its association with the concentration of all diabetes drugs at the hospital level. We collected 72 monthly summaries of diabetes prescriptions from all hospitals in Taiwan. Hospital-level pharmaceutical concentration was measured by penetration of TZD, defined as monthly market share of TZD in each hospital. Concentration of diabetes drugs was measured by Herfindahl-Hirschman indices. We found a negative association (coefficient = -0.3610) between TZD penetration and concentration of diabetes drug but a positive association between penetration of TZD and the volume of prescribed diabetes drugs (coefficient = 0.4088). In conclusion, hospital characteristics and volume of services determined the concentration of pharmaceuticals at the institution level, reflecting the heterogeneous competition between pharmaceutical companies within each hospital. Institution-level pharmaceutical concentration influences the adoption and penetration of new drugs.

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“…1 However, Lee et al (2006), for Taiwan, have found that generic grouping was far more relevant than copayments.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Pharmaceutical Policy Measures: A Structural-Break Approach

Barros

Nunes

2009

SSRN Journal

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Pharmaceutical spending in many other countries has had a steep increase in the last decade. The Portuguese Government has adopted several measures to reduce pharmaceutical expenditure growth, ranging from increased co-payments to price decreases determined administratively.Promotion of generic consumption has also ranked high in political priorities.We assess the overall impact of the several policy measures on total pharmaceutical spending, using monthly data over the period January 1995 -August 2008. Endogenous structural breaks (time-series) methods were employed.Our findings suggest that policy measures aimed at controlling pharmaceutical expenditure have been, in general, unsuccessful. Two breaks were identified. Both coincide with administratively determined price decreases. Measures aimed at increasing competition in the market had no visible effect on the dynamics of Government spending in pharmaceutical products. In particular, the introduction of reference pricing had only a transitory effect of less than one year, with historical growth resuming quickly.The consequence of it is a transfer of financial burden from the Government to the patients, with no apparent effect on the dynamics of pharmaceutical spending. This strongly suggests that pharmaceutical companies have been able to adjust to policy measures, in order to sustain their sales. It remains a challenge for the future to identify firms' strategies that supported continued growth of sales, despite the several policy measures adopted.JEL Numbers: I11, I18

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Impacts of Cost Containment Strategies on Pharmaceutical Expenditures of the National Health Insurance in Taiwan, 1996???2003

Cited by 79 publications

References 13 publications

The impact of repeated cost containment policies on pharmaceutical expenditure: experience in Spain

The impact of repeated cost containment policies on pharmaceutical expenditure: experience in Spain

Pharmaceutical penetration of new drug and pharmaceutical market structure in Taiwan: hospital-level prescription of thiazolidinediones for diabetes

The Impact of Pharmaceutical Policy Measures: A Structural-Break Approach

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