Gouya Ghazaleh, Reichardt Berthold, Bidner Anja, Weissenfels Robert, Wolzt Michael
Universitätsklinik für Klinische Pharmakologie, Medizinische Universität Wien, Wien, Austria.
Wien Klin Wochenschr. 2008;120(3-4):89-95. doi: 10.1007/s00508-007-0890-4.
Rising costs of pharmaceuticals are a challenge to the public health care system. In collaboration with a company health insurance with 3143 members we analysed the economic benefit of reduced prescription fees for generic drugs in a 12-month period.
Within the observation period 1 euro per prescription of a generic drug was reimbursed to the insurants. On the basis of 5 drug classes the prescribed proportion of generic drugs and the change in prescription pattern was computed. The acceptance of the intervention by the insurants was assessed using anonymous questionnaires.
42,219 drug prescriptons for insurants of the health insurance company were registered, with an overall cost of euro 843,954.95. In the observation period there was a 45% increase of the proportion of overall costs spent for generic drugs, from euro 78,325.65 to euro 110,419.90, together with a 38% increase of prescriptions of generic drugs. The expenditures for reimbursements of prescription payments amounted to euro 9,984 (euro 1-74 to insurants). In the 5 selected drug classes the proportion of generic drugs increased from 23% before the observation period to 40%, whereby a cost reduction of euro 2.47 per prescription was achieved. Taking into account an overall increase of prescriptions of the selected drugs, a cost reduction from euro 188,811.45 to euro 173,677.15 was accomplished. This intervention was considered useful by 84% of all insurants.
Financial incentives for insurants by partial reimbursement of prescription charges are effective for increasing the proportion of generic substitutes and for controlling drug costs.
药品成本不断上涨对公共医疗保健系统构成挑战。我们与一家拥有3143名成员的公司医疗保险合作,分析了在12个月内降低仿制药处方费用的经济效益。
在观察期内,每份仿制药处方向参保人报销1欧元。根据5类药物计算仿制药的处方比例和处方模式的变化。通过匿名问卷评估参保人对干预措施的接受程度。
该医疗保险公司的参保人共开出42219份药方,总成本为843954.95欧元。在观察期内,用于仿制药的总费用比例增加了45%,从78325.65欧元增至110419.90欧元,同时仿制药处方增加了38%。处方报销支出为9984欧元(每位参保人1至74欧元)。在选定的5类药物中,仿制药的比例从观察期前的23%增至40%,每张处方成本降低了2.47欧元。考虑到所选药物处方总数的增加,成本从188811.45欧元降至173677.15欧元。84%的参保人认为该干预措施有用。
通过部分报销处方费用对参保人进行经济激励,对于提高仿制药替代比例和控制药品成本是有效的。