Rischatsch Maurus
Department of Economics, University of Zurich, Zurich, Switzerland,
Eur J Health Econ. 2014 Sep;15(7):697-708. doi: 10.1007/s10198-013-0515-y. Epub 2013 Jul 18.
While most countries separate drug prescription and dispensation to ensure independent drug choice, some allow this combination to increase pharmaceutical access in rural areas or to increase the utilization of pharmacist skills. A drawback of this approach is that dispensing physicians or prescribing pharmacists may be incentivized to increase their own profits through the prescription of cost-inefficient drug packages, leading to an increase in pharmaceutical spending. Switzerland constitutes an interesting example of where dispensing and non-dispensing physicians coexist, permitting a comparison of their prescribing behavior. The present study shows that drug margin optimization is possible under the current drug price regulation scheme in Switzerland. Using drug claims data, empirical findings indicate a 5-10% higher margin per dose for dispensing physicians compared to pharmacists. Cost per dose is 3-5% higher when dispensed by physicians instead of pharmacists.
虽然大多数国家将药品处方和配药分开以确保独立的药物选择，但有些国家允许这种结合以增加农村地区的药品可及性或提高药剂师技能的利用率。这种方法的一个缺点是，配药医生或开处方的药剂师可能会受到激励，通过开具有成本效益低下的药品包装处方来增加自己的利润，从而导致药品支出增加。瑞士是一个有趣的例子，配药医生和非配药医生并存，便于比较他们的处方行为。本研究表明，在瑞士现行的药品价格监管方案下，优化药品利润率是可能的。利用药品报销数据，实证结果表明，与药剂师相比，配药医生每剂药品的利润率高出5%-10%。由医生配药时，每剂成本比药剂师配药时高出3%-5%。
