de Wolf Peter, Brouwer Werner B F, Rutten Frans F H
Wageningen Business School, Wageningen University, Wageningen, The Netherlands.
Int J Health Plann Manage. 2005 Oct-Dec;20(4):351-74. doi: 10.1002/hpm.819.
In this paper, we describe the Dutch pharmaceutical market, which is heavily regulated by the government. Through the regulation of prices and promoting prudent use, the Dutch government tries to bring down the cost of pharmaceuticals, which increases every year at a higher rate than total health care expenditure. The complex system of regulation, especially aimed at cost containment, is not very effective, particularly with respect to controlling outpatient pharmaceutical expenditure. Moreover, the system has few incentives towards efficiency. Though the market share of generic pharmaceuticals is rapidly growing, pharmaceutical expenditure has not decreased accordingly. The discounts offered by wholesalers of generic products to pharmacists produce private rather than societal gains from generic prescriptions. Dismantling the current regulatory system, boosting competition and efficiency with insurers in a leading role, seems to be the way forward.
在本文中，我们描述了荷兰的药品市场，该市场受到政府的严格监管。通过价格调控和促进合理用药，荷兰政府试图降低药品成本，药品成本每年的增长速度高于医疗保健总支出。复杂的监管体系，尤其是旨在控制成本的体系，效果并不理想，在控制门诊药品支出方面尤为如此。此外，该体系对提高效率的激励措施很少。尽管仿制药的市场份额迅速增长，但药品支出并未相应减少。仿制药批发商给药剂师的折扣带来的是私人收益，而非仿制药处方带来的社会收益。拆除当前的监管体系，以保险公司为主导增强竞争和效率，似乎是前进的方向。
