Faculty of Business Administration and Economics/CINCH Health Economics Research Center, Universität Duisburg-Essen, Essen, Germany.
Faculty of Business and Economics, University of Basel, Basel, Switzerland.
Value Health. 2022 Jul;25(7):1124-1132. doi: 10.1016/j.jval.2021.12.017. Epub 2022 Feb 24.
We analyze how shortages led to changes in access to and expenditure for pharmaceutical care in the Swiss health system between 2015 and 2020.
We combined cross-sectional and longitudinal data to study medicine shortages by incidence, duration, intensity, and pharmaceutical expenditure. We assessed 4119 markets defined by active ingredient, dosage form, and strength. We classified markets by essential medicine status and other characteristics. We differentiated shortages by the degree to which alternative options are still available. We investigated the first lockdown period of the pandemic, considering also the shortage of COVID-19-specific medicines.
A total of 1964 markets never reported shortages, and 1336 markets reported some shortages; 819 markets reported shortages lasting at least 14 days. Markets with a higher number of manufacturers, a lower co-payment share, and lower prices more frequently reported shortages. We did not find differences by essential medicine status. In 50% of instances, the average price of substitutes available was lower than the price of the product on shortage. The total pharmaceutical expenditure attributed to shortages increased by CHF 17.00 million (€15.63 million) in 2018.
Medicine shortages have substantially reduced access to pharmaceuticals. Switzerland has experienced shortages on a scale similar to that in other countries. Prices of substitutes available at the time of shortages can be higher or lower, indicating an unelastic demand for medicines.
我们分析了 2015 年至 2020 年间瑞士医疗体系中药物短缺如何导致药物获得和药物支出的变化。
我们结合了横断面和纵向数据，通过发生率、持续时间、强度和药物支出来研究药物短缺。我们研究了 4119 个由活性成分、剂型和强度定义的市场。我们根据基本药物状况和其他特征对市场进行分类。我们根据替代方案仍然可用的程度来区分短缺。我们调查了大流行的第一个封锁期，同时也考虑了 COVID-19 特定药物的短缺。
共有 1964 个市场从未报告短缺，1336 个市场报告了一些短缺；819 个市场报告了至少 14 天的短缺。制造商数量较多、共付份额较低、价格较低的市场更频繁地报告短缺。我们没有发现基本药物状况的差异。在 50%的情况下，可用替代品的平均价格低于短缺产品的价格。2018 年，归因于短缺的药品总支出增加了 1700 万瑞士法郎（合 1563 万欧元）。
药物短缺大大降低了药物的可获得性。瑞士经历的短缺规模与其他国家相似。短缺时可用替代品的价格可能更高或更低，这表明对药物的需求无弹性。
