Pattanaprateep Oraluck, Pongcharoensuk Petcharat, Suvanakoot Patcharin, Kaojarern Sming
Department ofPharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2010 Oct;93(10):1223-31.
The use of statins at Ramathibodi, a teaching hospital, has been rising rapidly
Determine how price, volume, and drug mix (use of five brands and one generic) affect expenditure.
Dispensing records of the six statins were retrieved from database and analyzed for factors contributing to increased drug expense.
Overall, statins' expenditure rose 35.6% and 6.4% in 2006 and 2007 respectively, mainly from civil servant outpatients who are more likely to be prescribed with brand drugs, even among new patients. In all schemes, volume effect was positive, more people use statins, and each one used a larger quantity of drug in 2007 than in 2005. The price effect was negative. Drug mix effect indicated that there was a shift from higher to lower priced drugs in capitation scheme and from lower to higher priced original drugs in a fee-for-service scheme.
There is a trend of more statins utilization but with a different pattern of drug prescribed between health schemes and possible drug over-prescribed in some patients. However indication for statin use was not studied, which needs to be considered. With high use of original drugs, effective policy initiative to promote generic drug use should be implemented in order to efficiently use the limited health care resources.
在一家教学医院拉玛蒂博迪,他汀类药物的使用量一直在迅速上升。
确定价格、用量和药物组合(使用五个品牌和一种仿制药)如何影响支出。
从数据库中检索六种他汀类药物的配药记录,并分析导致药品费用增加的因素。
总体而言,他汀类药物的支出在2006年和2007年分别增长了35.6%和6.4%,主要来自公务员门诊患者,他们即使在新患者中也更有可能被开品牌药。在所有方案中,用量效应是正向的,更多的人使用他汀类药物,并且2007年每个人使用的药物量比2005年更多。价格效应是负向的。药物组合效应表明,在按人头付费方案中存在从高价药向低价药的转变,而在按服务收费方案中存在从低价原研药向高价原研药的转变。
他汀类药物的使用有增加的趋势,但不同医保方案之间的用药模式不同,并且在一些患者中可能存在药物过度处方的情况。然而,他汀类药物使用的指征未进行研究,这一点需要考虑。由于原研药使用量大,应实施有效的政策举措来促进仿制药的使用,以便有效利用有限的医疗资源。