Smith Cynthia
National Health Statistics Group, Office of the Actuary, Centers for Medicare and Medicaid Services in Baltimore, Maryland, USA.
Health Aff (Millwood). 2004 Jan-Feb;23(1):160-7. doi: 10.1377/hlthaff.23.1.160.
Recent rapid spending growth for retail drugs has largely arisen from increased use of new drugs, rather than from increasing prices of existing drugs. A sizable shift in the payment from consumers to third parties has also contributed to faster growth. Strategies such as negotiating for rebates and using tiered copayments have sought to slow spending growth but simultaneously have complicated the estimation of spending in the National Health Accounts (NHA). NHA estimates show that retail pharmaceuticals' share of health spending is not much different than it was in 1960, although its share of gross domestic product (GDP) has tripled.
近期零售药品支出的快速增长主要源于新药使用的增加,而非现有药品价格的上涨。支付从消费者向第三方的大幅转移也推动了更快的增长。诸如争取回扣和采用分级共付等策略试图减缓支出增长,但同时也使国民健康账户(NHA)中支出的估算变得复杂。NHA估算显示,零售药品在医疗支出中的占比与1960年相比并无太大差异,尽管其在国内生产总值(GDP)中的占比增长了两倍。