Wu Jing, Yue Ning, Xu Weiwei
School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China.
School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China.
Value Health Reg Issues. 2013 May;2(1):37-42. doi: 10.1016/j.vhri.2013.01.002. Epub 2013 Mar 7.
This study aimed to explore the driving factors of the increasing anti-infective drug expenditures in Tianjin, China, and to provide evidence-based suggestions for policymakers.
Data were extracted from inpatient records in Urban Employee Basic Medical Insurance data of Tianjin, China, from 2003 January to December 2007. Expenditure increase for a basket of 63 constantly used anti-infective drugs was decomposed into three broad categories: price effects, quantity effects, and therapeutic choices. Furthermore, the injection anti-infective drug expenditures from 2006 to 2007 were decomposed into six determinants.
From 2003 January to December 2007, the expenditure for a fixed basket of drugs increased by 9%. The driving factors were therapeutic choices and quantity effects; each increased 48% and 10%, respectively. The relative price decreased by 33% during the study period. After adding new drugs to the formulary in 2005, the rate of increase in drug expenditure was 28% from 2006 to 2007; the driving factors were still therapeutic choice (16.8%) and quantity effects (14.9%).
Therapeutic choice transferring from cheap drugs to expensive ones, rather than the price, was the main driving factor for increasing expenditures. Policymakers need to pay more attention to rationalize physicians' prescribing behavior to control the expenditure.
本研究旨在探讨中国天津抗感染药物支出增加的驱动因素，并为政策制定者提供循证建议。
数据取自中国天津城镇职工基本医疗保险数据2003年1月至2007年12月的住院记录。63种常用抗感染药物的篮子支出增长被分解为三大类：价格效应、数量效应和治疗选择。此外，2006年至2007年的注射用抗感染药物支出被分解为六个决定因素。
2003年1月至2007年12月，一篮子固定药物的支出增长了9%。驱动因素是治疗选择和数量效应；分别增长了48%和10%。研究期间相对价格下降了33%。2005年将新药纳入处方集后，2006年至2007年药物支出增长率为28%；驱动因素仍然是治疗选择（16.8%）和数量效应（14.9%）。
治疗选择从廉价药物转向昂贵药物，而非价格，是支出增加的主要驱动因素。政策制定者需要更加关注使医生的处方行为合理化以控制支出。
