Institute of Economics, Academia Sinica, Taipei, Taiwan.
Eur J Health Econ. 2013 Apr;14(2):287-95. doi: 10.1007/s10198-011-0370-7. Epub 2011 Dec 27.
Although the technological change in medicine has been recognized widely as the major driver of rising healthcare costs, there is very little research that estimates this effect directly. This paper uses both a single-equation and a simultaneous equations approach to investigate empirically the interactive relationship between technological innovation and the growth of health expenditure in the context of the pharmaceutical market in Taiwan. Based on observing 182 therapeutic groups between 1997 and 2006, we find evidence to support the argument that technological innovation and health expenditure are determined simultaneously as technological innovation, and that the growth of health expenditure are endogenous rather than exogenous. Specifically, we find that therapeutic groups associated with higher pharmaceutical expenditure are likely to attract more new products to the market. Meanwhile, therapeutic groups with more new products are associated with higher pharmaceutical expenditures. An important implication of the paper is that cost containment policies will affect not only the growth of health expenditure, but also the progress of technological innovation in the health sector.
尽管医学技术变革已被广泛认为是导致医疗保健费用上涨的主要因素，但直接估计这种影响的研究却很少。本文采用单方程和联立方程方法，在台湾药品市场背景下，从实证角度研究技术创新与医疗支出增长之间的互动关系。本文以 1997 年至 2006 年的 182 个治疗组为观察对象，结果表明技术创新和医疗支出是同时决定的，即医疗支出的增长是内生的，而不是外生的。具体而言，我们发现与较高药品支出相关的治疗组更有可能吸引更多新产品进入市场。与此同时，具有更多新产品的治疗组与更高的药品支出相关。本文的一个重要启示是，成本控制政策不仅会影响医疗支出的增长，还会影响卫生部门的技术创新进程。
