School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
Expert Rev Pharmacoecon Outcomes Res. 2022 Apr;22(3):505-512. doi: 10.1080/14737167.2019.1605292. Epub 2019 Apr 22.
: Previous studies have ignored the bidirectional causality and the heterogeneity of health level. This study explored the bidirectional causality between pharmaceutical expenditure (PE) and total health-care expenditure (Total HCE) considering the health level for effective health investment and national health improvement.: Based on the panel data on PE and Total HCE in 32 OECD countries and China, the Granger causality test was applied. Countries were divided into low- and high-health-level (LH and HH) groups according to their life expectancies.: A 1% increase in the growth rate of per capita PE boosted a 0.11% increase in that of per capita Total HCE of the following year in HH group, whereas no such causality existed in LH group. A 1% increase in the growth rate of per capita Total HCE boosted a 0.46% increase in that of the per capita PE of the following year in LH group, whereas no such causality existed in HH group.: High-health-level countries should continue to increase the health investment by promoting rational PE growth such as expanding insurance coverage for innovative medicine for health improvement. Low-health-level countries should take optimizing policy to increase health investment in pharmaceutical for medicine accessibility and national health.
: 先前的研究忽视了健康水平的双向因果关系和异质性。本研究考虑健康水平，探讨了药品支出 (PE) 和总医疗保健支出 (Total HCE) 之间的双向因果关系，以实现有效的医疗投资和国家健康水平的提高。: 基于 OECD 国家和中国的药品支出和总医疗保健支出的面板数据，应用了格兰杰因果检验。根据预期寿命，将各国分为低健康水平 (LH) 和高健康水平 (HH) 两组。: 在 HH 组中，人均 PE 增长率每增加 1%，下一年人均 Total HCE 增长率将增加 0.11%，而在 LH 组中则不存在这种因果关系。在 LH 组中，人均 Total HCE 增长率每增加 1%，下一年人均 PE 增长率将增加 0.46%，而在 HH 组中则不存在这种因果关系。: 高健康水平国家应继续通过促进合理的 PE 增长来增加卫生投资，例如扩大对创新药物的保险覆盖范围，以促进健康改善。低健康水平国家应采取优化政策，增加药品投资，以提高药物可及性和国家健康水平。
