Newhouse Joseph P, Seiguer Erica, Frank Richard G
Department of Health Care Policy, Harvard Medical School, 180 Longwood Ave., Boston, MA 02115, USA.
Inquiry. 2007 Spring;44(1):15-25. doi: 10.5034/inquiryjrnl_44.1.15.
The Medicare Modernization Act (MMA) prohibited the government from negotiating drug prices, a feature that the act's critics characterize as a giveaway to the drug industry. Instead of the government negotiating to keep prices down, the act relies on competition among drug companies to obtain business from private insurers; yet, competition cannot be effective when there are no close clinical substitutes. In the past few years, the rate of introduction of first-in-class drugs has been low; if this continues, the prohibition on negotiation may be only a minor problem. However, if the prior rate of introduction resumes, the government may find itself with unacceptable expenditure levels.
《医疗保险现代化法案》(MMA)禁止政府对药品价格进行谈判,该法案的批评者称这一特点是对制药行业的让利。该法案并非依靠政府谈判来压低价格,而是依赖制药公司之间的竞争从私人保险公司获取业务;然而,当没有相近的临床替代药物时,竞争就无法有效发挥作用。在过去几年里,一流新药的推出速度一直很低;如果这种情况持续下去,禁止谈判可能只是一个小问题。然而,如果恢复之前的推出速度,政府可能会发现自己面临无法接受的支出水平。