New drugs and the growth of health expenditure: evidence from diabetic patients in Taiwan

Liu, Ya Ming; Hsieh, Chee-Ruey

doi:10.1002/hec.1724

Cited by 12 publications

(13 citation statements)

References 18 publications

(24 reference statements)

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“…Type 2 diabetes is a growing challenge [1] and Oman, a developing country, is experiencing an epidemic [2]. Diabetes is a costly condition imposing great strain on national economies [3]. Prior to 1990, the prevalence of diabetes in Oman was unknown.…”

Section: Introductionmentioning

confidence: 99%

Health Beliefs of People with Type 2 Diabetes in Primary Health Care in Muscat, Oman: A Qualitative Approach

Subhi¹,

Kendall²,

Al-Shafaee³

et al. 2016

Int J Clin Nutr Diet

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Background: With recent affluence, Oman has witnessed a dramatic increase in the number of Omani nationals with type 2 diabetes. Most national studies have focused on quantifying the magnitude of the problem, and issues related to co-morbidity. The purpose of this study was to explore the health beliefs associated with diabetes self-management among adult Omani patients with type 2 diabetes. Methods: This study employed the Health Belief Model (HBM) as the theoretical framework. A structured open-ended interview question guide was developed based on the constructs of the HBM and based on literature regarding various factors associated with diabetes management. The study was conducted in seven conveniently selected Primary Health Care (PHC) centers in the Muscat Governorate. In total 29 patients with type 2 diabetes were invited at convenience, while visiting the centers for regular follow ups, to participate and were interviewed based on written consents. Results: Applying the HBM with this group of patients indicated to six factors as barriers to diabetes self-care: (1) cost of self-monitoring for blood glucose level, (2) social interactions, (3) negative feelings associated with living with the disease, (4) lack of accurate practical and culturally-sensitive health education about diet and exercise, (5) fatalism, and (6) low self-efficacy. Diabetes self-management education was not valued and a large number (19/29) did not actively seek information about diabetes. Conclusion:The findings here point to the urgent need for a culturally appropriate diabetes education program with respected to the health beliefs indicated here.

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Section: Introductionmentioning

confidence: 99%

Health Beliefs of People with Type 2 Diabetes in Primary Health Care in Muscat, Oman: A Qualitative Approach

Subhi¹,

Kendall²,

Al-Shafaee³

et al. 2016

Int J Clin Nutr Diet

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“…Previous research indicates that because of the higher prices and progress of new technology, the adoption of new drugs might increase health expenditures through two channels: treatment substitution and treatment expansion [5]. Liu and Hsieh [17] show that the adoption of new oral hypoglycemic agents, like thiazolidinediones, increases the treatment cost of diabetes patients and the effect of treatment substitution is greater than that of treatment expansion.…”

Section: Resultsmentioning

confidence: 99%

Endogenous technological change in medicine and its impact on healthcare costs: evidence from the pharmaceutical market in Taiwan

2011

Self Cite

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Although the technological change in medicine has been widely recognized as the major driver of rising healthcare costs, there is very little research that directly estimates this effect. This paper uses both a single-equation and a simultaneous equations approach to empirically investigate the interactive relationship between technological innovation and the growth of health expenditure in the context of the pharmaceutical market in Taiwan. Based on observing 182 therapeutic groups between 1997 and 2006, we find evidence to support the argument that technological innovation and health expenditure are simultaneously determined as technological innovation and the growth of health expenditure are endogenous rather than exogenous. Specifically, we find that therapeutic groups associated with higher pharmaceutical expenditure are likely to attract more new products to the market.Meanwhile, therapeutic groups with more new products are associated with higher pharmaceutical expenditures. An important implication of the paper is that the cost containment policy will not only affect the growth of health expenditure, but will also affect the progress of technological innovation in the health sector.

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“…However, drug consumption data presented in DDDs only gave a rough estimate of consumption and not an exact picture of actual use [26]. Second, the study method we used was not sufficient for assessing the impact of introducing new drugs on changes in drug expenditures [27]. Every year, pharmaceutical companies launch newly developed drugs and products while removing many existing drugs from the market.…”

Section: Discussionmentioning

confidence: 99%

Effective policy initiatives to constrain lipid-lowering drug expenditure growth in South Korea

Bae

Park

Lee

et al. 2014

BMC Health Serv Res

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BackgroundThe rapid growth of prescription drug expenditures is a major problem in South Korea. Accordingly, the South Korean government introduced a positive listing system in 2006. They also adopted various price reduction policies. Nevertheless, the total expenditure for lipid-lowering drugs have steadily increased throughout South Korea. The present study explores the factors that have influenced the increased expenditures of lipid-lowering drugs with a particular focus on the effects of statins in this process.MethodsThis paper investigates the National Health Insurance claims data for prescribed lipid-lowering drugs collected between January 1, 2005 and December 31, 2009. We specifically focused on statins and assessed the yearly variation of statin expenditure by calculating the increased rate of paired pharmaceutical expenditures over a 2 year period. Our study classified statins into three categories: new entrants, core medicines and exiting medicines. For core medicines, we further examined influencing factors such as price, amount of drugs consumed by volume, and prescription changes (substitutes for other drug).ResultsStatin expenditure showed an average annual increase of 25.7% between 2005 and 2009. Among the different statins, the expenditure of atorvastatin showed a 36.6% annual increase rate, which was the most dramatic among all statins. Also we divided expenditure for core medicines by the price factor, volume factor, and prescription change. The result showed that annual weighted average prices of individual drug decreased each year, which clearly showed that price influenced statin expenditure in a negative direction. The use of generic drugs containing the same active ingredient as name-brand drugs increased and negatively affected statin expenditure (Generic Mix effect). However, the use of relatively expensive ingredients within statin increase, Ingredient Mix effect contributed to increased statin expenditure (Ingredient Mix effect). In particular, the volume effect was found to be critical for increasing statin expenditure as the amount of statin consumed increased steadily throughout the study period.ConclusionsThe recent rapid increase in statin expenditure can largely be attributed to an increase in consumption volume. In order to check drug expenditures effectively in our current situation, in which chronic diseases remain steadily on the rise, it is necessary to not only have supply-side initiatives such as price reduction, but also demand-side initiatives that could control drug consumption volume, for example: educational programs for rational prescription, generic drug promotional policies, and policies providing prescription targets.

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New drugs and the growth of health expenditure: evidence from diabetic patients in Taiwan

Cited by 12 publications

References 18 publications

Health Beliefs of People with Type 2 Diabetes in Primary Health Care in Muscat, Oman: A Qualitative Approach

Health Beliefs of People with Type 2 Diabetes in Primary Health Care in Muscat, Oman: A Qualitative Approach

Endogenous technological change in medicine and its impact on healthcare costs: evidence from the pharmaceutical market in Taiwan

Effective policy initiatives to constrain lipid-lowering drug expenditure growth in South Korea

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