Marđetko Nika, Kos Mitja
Faculty of Pharmacy, University of Ljubljana, Askerceva 7, 1000, Ljubljana, Slovenia.
Int J Clin Pharm. 2016 Oct;38(5):1301-10. doi: 10.1007/s11096-016-0370-x. Epub 2016 Aug 8.
Background The therapeutic reference pricing (TRP) in Slovenia was implemented for proton pump inhibitors in 2013 and for angiotensin-converting enzyme inhibitors and lipid-lowering medicines in 2014. Objective The study aimed to assess patients' knowledge and attitude towards the TRP system. Moreover, the patients' willingness to pay was evaluated for patients who rejected the substitution of a current medicine within a therapeutic class by the reference medicine for which no co-payment is needed. Setting Invitation of patients to participate in a survey and filling in the first part of the questionnaire was run in the community pharmacies in Slovenia. The second part of the questionnaire was filled in at patients' home. Method A representative sample of 676 patients that had been prescribed at least one medicine from the three therapeutic classes was surveyed. The survey was carried out from 15th May to 15th June 2014 in 40 community pharmacies with the help of the pharmacists, who filled in the first part of the questionnaire in the presence of the patients. The second part of the questionnaire was filled in by 475 patients at home and returned by prepaid mail. Main outcome measure Patients' knowledge of and attitude to the TRP system implemented into Slovenian health care practice. Results Most of the statements describing patient' rights and duties within the TRP system were known by approximately 50 % of the patients. Patients were inhomogeneous in their view about the necessity and benefits of the TRP system, most of them regarded it as an unnecessary burden. Among 50.4 % of the patients who were required to copay for their medicine, 46.7 % accepted and 3.7 % rejected co-payment. The average co-payment was € 6.92, while the expressed average willingness to co-pay was € 10.4 per 3 months of therapy. Conclusion Our results indicate that the implementation of the TRP system and potential upgrades represent a significant challenge for the patients.
背景 斯洛文尼亚于2013年对质子泵抑制剂实施了治疗参考定价（TRP），并于2014年对血管紧张素转换酶抑制剂和降脂药物实施了该政策。目的 本研究旨在评估患者对TRP系统的了解和态度。此外，还评估了那些拒绝用治疗类别内无需自付费用的参考药物替代当前药物的患者的支付意愿。地点 在斯洛文尼亚的社区药房邀请患者参与调查并填写问卷的第一部分。问卷的第二部分在患者家中填写。方法 对676名至少从这三个治疗类别中开具过一种药物的患者进行了代表性抽样调查。2014年5月15日至6月15日，在40家社区药房借助药剂师的帮助进行了调查，药剂师在患者在场的情况下填写问卷的第一部分。问卷的第二部分由475名患者在家中填写并通过预付邮资的方式寄回。主要观察指标 患者对斯洛文尼亚医疗保健实践中实施的TRP系统的了解和态度。结果 描述TRP系统内患者权利和义务的大多数陈述约50%的患者知晓。患者对TRP系统的必要性和益处看法不一，大多数人认为这是不必要的负担。在需要为药物自付费用的50.4%的患者中，46.7%接受了自付费用，3.7%拒绝了自付费用。平均自付费用为6.92欧元，而每3个月治疗期表示愿意自付的平均金额为10.4欧元。结论 我们的结果表明，TRP系统的实施及潜在升级对患者来说是一项重大挑战。
