Egberts Antoine C G, de Boer Anthonius
Universiteit Utrecht, divisie Farmaco-epidemiologie en Klinische Farmacologie, Utrecht, the Netherlands.
Ned Tijdschr Geneeskd. 2010;154(51-52):A3004.
In the Netherlands there are separate pharmaceutical budgets for hospital, nursing home and primary healthcare. This complex method of funding drug use, plus three recent developments, is putting increasing pressure on patient access to adequate pharmacotherapy. The three developments concerned are: the rapidly increasing number of expensive drugs available; the transfer of complex hospital care to primary care; and the transfer of budget responsibility from the government to health insurance companies. The so called 'postcode lottery affair' is just one example of access to expensive drugs (e.g. trastuzumab) depending on the region in which patients live. A reform of the way pharmaceutical budgets are distributed needs urgent reconsideration.
在荷兰，医院、疗养院和初级医疗保健机构有着各自独立的药品预算。这种复杂的药品使用资金筹集方式，再加上最近的三个新情况，正给患者获得充分药物治疗带来越来越大的压力。这三个新情况分别是：可用的昂贵药品数量迅速增加；复杂的医院护理向初级护理的转移；以及预算责任从政府向健康保险公司的转移。所谓的“邮编彩票事件”只是一个例子，说明患者能否获得昂贵药品（如曲妥珠单抗）取决于他们居住的地区。药品预算分配方式的改革亟待重新考虑。
