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安大略省药品通用定价改革的短期影响。

The short-term impact of Ontario's generic pricing reforms.

机构信息

The Centre for Health Services and Policy Research, School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada.

出版信息

PLoS One. 2011;6(7):e23030. doi: 10.1371/journal.pone.0023030. Epub 2011 Jul 28.

Abstract

BACKGROUND

Canadians pay amongst the highest generic drug prices in the world. In July 2010, the province of Ontario enacted a policy that halved reimbursement for generic drugs from the public drug plan, and substantially lowered prices for private purchases. We quantified the impact of this policy on overall generic drug expenditures in the province, and projected the impact in other provinces had they mimicked this pricing change.

METHODS

We used quarterly prescription generic drug dispensing data from the IMS-Brogan CompuScript Audit. We used the price per unit in both the pre- and post-policy period and two economics price indexes to estimate the expenditure reduction in Ontario. Further, we used the post-policy Ontario prices to estimate the potential reduction in other provinces.

RESULTS

We estimate that total expenditure on generic drugs in Ontario during the second half of 2010 was between $181 and $194 million below what would be expected if prices had remained at pre-policy level. Over half of the reduction in spending was due to savings on just 10 generic ingredients. If other provinces had matched Ontario's prices, their expenditures over during the latter half of 2010 would have been $445 million lower.

DISCUSSION

We found that if Ontario's pricing scheme were adopted nationally, overall spending on generic drugs in Canada would drop at least $1.28 billion annually--a 5% decrease in total prescription drug expenditure. Other provinces should seriously consider both changes to their generic drug prices and the use of more competitive bulk purchasing policies.

摘要

背景

加拿大的仿制药价格居全球最高之列。2010 年 7 月,安大略省出台了一项政策,将公共药品计划中仿制药的报销比例降低一半,并大幅降低私人购买仿制药的价格。我们量化了该政策对该省仿制药总支出的影响,并预测了其他省份效仿这一定价变化的影响。

方法

我们使用 IMS-Brogan CompuScript 审计的季度处方仿制药配药数据。我们使用政策前后的单位价格和两个经济价格指数来估计安大略省的支出减少情况。此外,我们使用安大略省的政策后价格来估计其他省份的潜在减少量。

结果

我们估计,2010 年下半年安大略省的仿制药总支出比如果价格保持在政策前水平,预计要低 1.81 亿至 1.94 亿美元。支出减少的一半以上是由于仅 10 种仿制药成分的节省。如果其他省份的价格与安大略省的价格相匹配,那么它们在 2010 年下半年的支出将减少 4.45 亿美元。

讨论

我们发现,如果安大略省的定价方案在全国范围内采用,加拿大的仿制药总支出每年至少将下降 12.8 亿美元——这将使处方药总支出减少 5%。其他省份应认真考虑调整仿制药价格和采用更具竞争力的大宗采购政策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06f5/3145787/41b176d3029e/pone.0023030.g001.jpg

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