University of Greifswald, Faculty of Law and Economics, Friedrich-Loeffler-Str, 70, D-17489, Greifswald, Germany.
BMC Health Serv Res. 2013 Oct 10;13:407. doi: 10.1186/1472-6963-13-407.
Pharmaceutical products are an important component of expenditure on public health insurance in the Federal Republic of Germany. For years, German policy makers have regulated public pharmacies in order to limit the increase in costs. One reform has followed another, main objective being to increase competition in the pharmacy market. It is generally assumed that an increase in competition would reduce healthcare costs. However, there is a lack of empirical proof of a stronger orientation of German public pharmacies towards competition thus far.
This paper analyses the self-perceptions of owners of German public pharmacies and their orientation towards competition in the pharmacy markets. It is based on a cross-sectional survey (N = 289) and distinguishes between successful and less successful pharmacies, the location of the pharmacies (e.g. West German States and East German States) and the gender of the pharmacy owner. The data are analysed descriptively by survey items and employing bivariate and structural equation modelling.
The analysis reveals that the majority of owners of public pharmacies in Germany do not currently perceive very strong competitive pressure in the market. However, the innovativeness of the pharmacist is confirmed as most relevant for net revenue development and the profit margin. Some differences occur between regions, e.g. public pharmacies in West Germany have a significantly higher profit margin.
This study provides evidence that the German healthcare reforms aimed at increasing the competition between public pharmacies in Germany have not been completely successful. Many owners of public pharmacies disregard instruments of active customer-orientated management (such as customer loyalty or an offensive position and economies of scale), which could give them a competitive advantage. However, it is clear that those pharmacists who strive for systematic and innovative management and adopt an offensive and competitive stance are quite successful. Thus, pharmacists should change their attitude and develop a more professional business model.
药品是德意志联邦共和国公共医疗保险支出的重要组成部分。多年来,德国决策者一直在规范公共药房,以限制成本的增长。一项改革接着另一项改革,主要目标是增加药房市场的竞争。人们普遍认为,竞争的增加将降低医疗保健成本。然而,到目前为止,还缺乏关于德国公共药房对竞争的更强调整性的经验证据。
本文分析了德国公共药房所有者对竞争的自我认知及其对药房市场的竞争定位。它基于横断面调查(N=289),并区分了成功和不太成功的药房、药房的位置(例如,西德州和东德州)以及药房所有者的性别。数据通过调查项目进行描述性分析,并采用双变量和结构方程建模。
分析表明,德国公共药房的大多数所有者目前并未感受到市场上非常强烈的竞争压力。然而,药剂师的创新能力被确认为对净收入发展和利润率最相关。不同地区存在一些差异,例如,西德的公共药房利润率明显更高。
本研究表明,德国旨在增加德国公共药房之间竞争的医疗保健改革并未完全成功。许多公共药房的所有者忽视了积极以客户为导向的管理工具(如客户忠诚度或积极的定位和规模经济),这些工具可以使他们具有竞争优势。然而,很明显,那些努力实现系统和创新管理并采取积极和竞争立场的药剂师非常成功。因此,药剂师应该改变他们的态度,发展更专业的商业模式。