《印度尼西亚实施医疗保险制度下医药政策对药品采购定价的影响》
The Impact of Pharmaceutical Policies on Medicine Procurement Pricing in Indonesia Under the Implementation of Indonesia's Social Health Insurance System.
机构信息
Faculty of Pharmacy, University of Pancasila, Jl. Srengseng Sawah, Jagakarsa, Jakarta Selatan, Indonesia.
Faculty of Pharmacy, University of Pancasila, Jl. Srengseng Sawah, Jagakarsa, Jakarta Selatan, Indonesia.
出版信息
Value Health Reg Issues. 2020 May;21:1-8. doi: 10.1016/j.vhri.2019.05.005. Epub 2019 Oct 18.
BACKGROUND
Indonesia's social health insurance (Jaminan Kesehatan Nasional, JKN) has been implemented since 2014. To support medicine provision, the government launched policies reform on medicine pricing, procurement and reimbursement; hence, the system might affect medicine prices in the country.
OBJECTIVE
To evaluate the effects of the pharmaceutical policies reforms on medicine procurement prices.
METHODS
This was a pre-post observational study. Medicine price data were collected retrospectively from the 2013 Ministry of Health procurement price list, the 2017 e-catalogue procurement system, and the procurement departments at 2 hospitals in Jakarta and Cilegon (both categorized as region I). The 2013 national procurement price was compared with the 2017 e-catalogue price. The hospitals' procurement prices were collected from the data 3 years before and 3 years under Indonesia's social health insurance JKN (2011-2016), and the data were used to assess the medicine procurement prices in real conditions. The outcome measure was the difference in procurement prices before and under the JKN.
RESULTS
The results showed that the procurement prices of 429 (79.6%) of 539 medicines listed in the 2017 e-catalogue decreased, of which 210 items (39.0%) showed over a 50% decrease. Nevertheless, the procurement prices of 104 items (19.3%) increased, especially those that were still under patent or those with a few brands registered in Indonesia. The procurement prices in public and private hospitals showed a similar trend, that is, a significant decrease. Interestingly, non-e-catalogue medicine prices also decreased quite steeply, although the prices of the branded generic category in the private hospital remained unchanged.
CONCLUSION
The pharmaceutical policies under the JKN implementation had a profound impact on decreasing medicine procurement prices in Indonesia.
背景
印度尼西亚的社会医疗保险（Jaminan Kesehatan Nasional，JKN）自 2014 年开始实施。为了支持药品供应，政府对药品定价、采购和报销政策进行了改革；因此，该制度可能会影响该国的药品价格。
目的
评估药品政策改革对药品采购价格的影响。
方法
这是一项前瞻性观察研究。回顾性收集了 2013 年卫生部采购价格清单、2017 年电子目录采购系统以及雅加达和西冷（均归类为 I 区）2 家医院采购部门的药品价格数据。将 2013 年全国采购价格与 2017 年电子目录价格进行比较。从 JKN 实施前 3 年和实施后 3 年（2011-2016 年）收集 2 家医院的采购价格数据，以评估实际情况下的药品采购价格。结果测量指标是 JKN 前后采购价格的差异。
结果
结果显示，在 2017 年电子目录中列出的 539 种药品中有 429 种（79.6%）的采购价格下降，其中 210 种（39.0%）下降超过 50%。然而，104 种（19.3%）药品的采购价格上升，特别是那些仍在专利期内或在印度尼西亚注册的少数品牌的药品。公立和私立医院的采购价格都呈现出类似的下降趋势。有趣的是，非电子目录药品的价格也大幅下降，尽管私立医院的品牌仿制药价格保持不变。
结论
JKN 实施下的药品政策对降低印度尼西亚的药品采购价格产生了深远的影响。
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