Meher Bikash R, Padhy Biswa M
Assistant Professor, Department of Pharmacology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
Associate Professor, Department of Pharmacology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
Trop Doct. 2020 Apr;50(2):157-159. doi: 10.1177/0049475520903644. Epub 2020 Feb 9.
The concept of indication-specific pricing (ISP) of drugs means that the cost of a drug will vary depending on the reasons for its use. ISP is a novel concept and its beneficial or detrimental effects are unknown. Experience from richer countries suggests that it is fraught with many administrative, ethical and regulatory challenges. It seems, though, that prices of some drugs have been set using this model. The barriers, real and potential, to the implementation of ISP in low- and middle-income countries are discussed. Implementation of ISP is impractical in such environments because of the large impoverished population, low frequency of health insurance, generally poor health infrastructure, lack of regulatory oversight, and the fact that most healthcare expenditure is borne personally.
药品特定适应症定价（ISP）的概念是指药品成本会因其使用原因而异。ISP是一个新概念，其利弊尚不明晰。富裕国家的经验表明，它面临诸多行政、伦理和监管挑战。然而，似乎已有一些药品采用这种模式定价。本文讨论了在低收入和中等收入国家实施ISP的实际和潜在障碍。由于贫困人口众多、医疗保险覆盖率低、卫生基础设施普遍薄弱、缺乏监管以及大多数医疗支出由个人承担，在这种环境下实施ISP是不切实际的。
