Research Centre for Economics and Health (CRES), Department of Economics and Business, Universitat Pompeu Fabra, Ramon Trias Fargas 25-27, 34-08005 Barcelona, Spain.
Eur J Health Econ. 2011 Dec;12(6):563-73. doi: 10.1007/s10198-010-0271-1. Epub 2010 Sep 1.
The growth in expenditure on the financing of pharmaceuticals is a factor that accounts for a large part of the increase in public health spending in most developed countries. In an attempt to kerb this growth, many health authorities, particularly in Europe, have introduced numerous regulatory measures that have affected the market, especially on the supply side. These measures include the system of reference pricing, the reduction of wholesale distributors' and retailers' markups and compulsory reductions of ex-factory prices. We assess the impact of these cost containment measures on expenditure per capita, prescriptions per capita and the average price of pharmaceuticals financed by the public sector in Catalonia (Spain), from 1995 to 2006. We apply an autoregressive integrated moving average (ARIMA) time series model using dummy variables to represent the various cost containment measures implemented. Twelve of the 16 interventions analysed that were intended to contain the overall pharmaceutical expenditure were not effective in reducing it even in the short term, and the four that were effective were not so in the long term, thus amounting to a moderate annual saving.
药品融资支出的增长是大多数发达国家公共卫生支出增加的一个重要因素。为了控制这种增长，许多卫生当局，特别是在欧洲，已经采取了许多监管措施来影响市场，特别是在供应方面。这些措施包括参考定价制度、降低批发商和零售商的加价以及强制降低出厂价格。我们评估了这些成本控制措施对加泰罗尼亚（西班牙）人均支出、人均处方和公共部门资助的药品平均价格的影响，时间跨度为 1995 年至 2006 年。我们应用自回归综合移动平均（ARIMA）时间序列模型，使用虚拟变量来表示实施的各种成本控制措施。在分析的 16 项旨在控制整体药品支出的干预措施中，有 12 项即使在短期内也未能有效降低支出，而 4 项有效的干预措施在长期内也未能有效降低支出，因此仅实现了适度的年度节省。
