Lin Yu-Shiuan, Jan I-Shiow, Cheng Shou-Hsia
Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan.
National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Pharmacoepidemiol Drug Saf. 2017 Mar;26(3):301-309. doi: 10.1002/pds.4122. Epub 2016 Nov 8.
Generic medications used for chronic diseases are beneficial in containing healthcare costs and improving drug accessibility. However, the effects of generic drugs in acute and severe illness remain controversial. This study aims to investigate treatment costs and outcomes of generic antibiotics prescribed for adults with a urinary tract infection in outpatient settings.
The data source was the Longitudinal Health Insurance Database of Taiwan. We included outpatients aged 20 years and above with a urinary tract infection who required one oral antibiotic for which brand-name and generic products were simultaneously available. Drug cost and overall healthcare expense of the index consultation, healthcare cost during a 42-day follow-up period, and treatment failure rates were the main dependent variables. Data were compared between brand-name and generic users from the entire cohort and a propensity score-matched samples.
Results from the entire cohort and propensity score-matched samples were similar. Daily antibiotic cost was significantly lower among generic users than brand-name users. Significant lower total drug claims of the index consultation only existed in patients receiving the investigated antibiotics, while the drug price between brand-name and generic versions were relatively large (e.g., >50%). The overall healthcare cost of the index consultation, healthcare expenditure during a 42-day follow-up period, and treatment failure rates were similar between the two groups.
Compared with those treated with brand-name antibiotics, outpatients who received generic antibiotics had equivalent treatment outcomes with lower drug costs. Generic antibiotics are effective and worthy of adoption among outpatients with simple infections indicating oral antibiotic treatment. Copyright © 2016 John Wiley & Sons, Ltd.
用于慢性病的仿制药有助于控制医疗成本并提高药物可及性。然而,仿制药在急性和重症疾病中的效果仍存在争议。本研究旨在调查门诊环境中为患有尿路感染的成人开具的仿制药抗生素的治疗成本和治疗结果。
数据来源为台湾纵向健康保险数据库。我们纳入了年龄在20岁及以上、患有尿路感染且需要一种有品牌药和仿制药同时可用的口服抗生素的门诊患者。指标会诊的药物成本和总体医疗费用、42天随访期内的医疗成本以及治疗失败率是主要的因变量。对整个队列以及倾向得分匹配样本中的品牌药使用者和仿制药使用者的数据进行了比较。
整个队列和倾向得分匹配样本的结果相似。仿制药使用者的每日抗生素成本显著低于品牌药使用者。仅在接受所研究抗生素治疗的患者中,指标会诊的总药物报销费用显著较低,而品牌药和仿制药之间的药品价格差异相对较大(例如,>50%)。两组之间指标会诊的总体医疗成本、42天随访期内的医疗支出以及治疗失败率相似。
与接受品牌抗生素治疗的患者相比,接受仿制药抗生素治疗的门诊患者治疗结果相当,但药物成本较低。仿制药抗生素有效,对于表明需要口服抗生素治疗的简单感染门诊患者而言值得采用。版权所有© 2016约翰威立父子有限公司。