Department of Environmental Health Sciences, University Medical Center Freiburg, Germany.
Health Econ Policy Law. 2013 Jan;8(1):7-20. doi: 10.1017/S1744133112000084. Epub 2012 Sep 4.
The aim of the analysis was to determine whether demand in Germany for specific antimicrobial agents is driven by prices that drop considerably when generic substitutes become available. A time-series approach was therefore carried out to explore price elasticities of demand for two different classes of broad-spectrum antimicrobials (fluoroquinolones and cephalosporins) using data on ambulatory antibiotics prescribed on the German statutory health insurance scheme and data on in-hospital antibiotic use in a German teaching hospital. In short, we attempted to explain demand for different antibiotics based on changes in price and hospital-wide morbidity. The data indicate that patent expiration is followed by substantial decreases in the price of antibiotics. In the outpatient sector, all antibiotics included in the analysis showed significant negative own-price elasticities of demand. However, in the hospital settings, significant own-price elasticities were only determined for some antibiotics, although price decreases were stronger than in the outpatient sector. We conclude that price dependence of demand for antimicrobials is present both in the ambulatory and the hospital setting. However, this is especially surprising in the hospital setting because price differences among the antibiotics observed are particularly small compared with the overall cost of hospitalisation.
分析的目的是确定德国对特定抗菌药物的需求是否受到价格的驱动，当仿制药上市时，价格会大幅下降。因此，采用时间序列方法，利用德国法定健康保险计划中规定的门诊抗生素数据和德国教学医院中抗生素使用的住院数据，探讨了两类不同广谱抗菌药物（氟喹诺酮类和头孢菌素类）的需求价格弹性。简而言之，我们试图根据价格变化和医院整体发病率来解释不同抗生素的需求。数据表明，专利到期后，抗生素的价格会大幅下降。在门诊部门，分析中包含的所有抗生素都显示出需求的显著负自价格弹性。然而，在医院环境中，只有一些抗生素的自价格弹性具有统计学意义，尽管价格下降的幅度比门诊部门更大。我们的结论是，抗菌药物需求对价格的依赖既存在于门诊也存在于医院环境中。然而，这在医院环境中尤其令人惊讶，因为与住院总费用相比，观察到的抗生素之间的价格差异特别小。
