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为什么仿制药在希腊未能获得足够的市场份额?实证研究结果与政策建议。

Why do generic drugs fail to achieve an adequate market share in Greece? Empirical findings and policy suggestions.

作者信息

Balasopoulos T, Charonis A, Athanasakis K, Kyriopoulos J, Pavi E

机构信息

National School of Public Health, Department of Health Economics, 196 Alexandras Avenue, 11521, Athens, Greece.

National School of Public Health, Department of Health Economics, 196 Alexandras Avenue, 11521, Athens, Greece.

出版信息

Health Policy. 2017 Mar;121(3):265-272. doi: 10.1016/j.healthpol.2016.12.011. Epub 2017 Jan 9.

Abstract

OBJECTIVES

Since 2010, the memoranda of understanding were implemented in Greece as a measure of fiscal adjustment. Public pharmaceutical expenditure was one of the main focuses of this implementation. Numerous policies, targeted on pharma spending, reduced the pharmaceutical budget by 60.5%. Yet, generics' penetration in Greece remained among the lowest among OECD countries. This study aims to highlight the factors that affect the perceptions of the population on generic drugs and to suggest effective policy measures.

METHODOLOGY

The empirical analysis is based on a national cross-sectional survey that was conducted through a sample of 2003 individuals, representative of the general population. Two ordinal logistic regression models were constructed in order to identify the determinants that affect the respondents' beliefs on the safety and the effectiveness of generic drugs.

FINDINGS

The empirical findings presented a positive and statistically significant correlation with income, bill payment difficulties, safety and effectiveness of drugs, prescription and dispensing preferences and the views toward pharmaceutical companies. Also, age and trust toward medical community have a positive and statistically significant correlation with the perception on the safety of generic drugs. Policy interventions are suggested on the bases of the empirical results on 3 major categories; (a) information campaigns, (b) incentives to doctors and pharmacists and (c) to strengthen the bioequivalence control framework and the dissemination of results.

摘要

目标

自2010年以来,希腊实施了谅解备忘录作为财政调整措施。公共药品支出是该措施实施的主要重点之一。众多针对药品支出的政策使药品预算减少了60.5%。然而,希腊非专利药的渗透率在经合组织国家中仍处于最低水平。本研究旨在突出影响民众对非专利药认知的因素,并提出有效的政策措施。

方法

实证分析基于一项全国性横断面调查,该调查通过对2003名具有总体代表性的个体样本进行。构建了两个有序逻辑回归模型,以确定影响受访者对非专利药安全性和有效性信念的决定因素。

结果

实证结果表明,收入、账单支付困难、药品安全性和有效性、处方和配药偏好以及对制药公司的看法之间存在正相关且具有统计学意义。此外,年龄和对医疗界的信任与对非专利药安全性的认知呈正相关且具有统计学意义。根据实证结果,在三大类基础上提出了政策干预建议;(a)宣传活动,(b)对医生和药剂师的激励措施,以及(c)加强生物等效性控制框架和结果传播。

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