Wu Shu-I, Lee An-Sheng, Chung Ching-Hu
Department of Medicine, Mackay Medical College, Taipei City, Taiwan.
Department of Psychiatry, Mackay Memorial Hospital, Taipei City, Taiwan.
Front Med (Lausanne). 2024 Aug 20;11:1388569. doi: 10.3389/fmed.2024.1388569. eCollection 2024.
The Taiwanese government adopted the National Health Insurance (NHI) system in March 1995. This study aimed to understand the difference in medication costs before (year 2019) and during the COVID-19 pandemic (2020-2021) among different hospitals for treating their patients.
The NHI claims database consisting of claims of prescription drugs for inpatients (IPD) and outpatients (OPD) in Taiwan was used to determine drug expenditure in different hospitals, particularly the top 10 prescription Anatomical Therapeutic Chemical (ATC) categories.
In medical centers, L01X (other antineoplastic agents) showed the highest drug expenditure, followed by L04A (immunosuppressants) and J05A (direct-acting antivirals). The drug expenditure pattern in regional hospitals was similar to that in medical centers, with L01X (other antineoplastic agents) showing the highest drug expenditure. L01X (other antineoplastic agents) also showed the highest drug expenditure in district hospitals, followed by N05A (antipsychotics) and A10B (blood glucose-lowering drugs, excluding insulin). In clinics, A10B (blood glucose-lowering drugs, excluding insulin) showed the highest drug expenditure. The total medication costs in 2021 were lower or similar to those in 2019. The use of systemic use anti-infectives decreased over time in OPDs among all hospita1 levels but increased in IPDs in medical centers and district hospitals. Furthermore, our analysis revealed that the trend in drug expenditure closely mirrored the trend in drug prescription volume for the highest annual sum cost item among the top 10 drug subgroups across different hospital levels.
Our analysis found that annual drug expenditures in 2021 were lower or similar to those in 2019, suggesting that the COVID-19 pandemic has contributed to this reduction in drug expenditure.
台湾地区政府于1995年3月采用了全民健康保险（NHI）系统。本研究旨在了解不同医院在2019年（新冠疫情之前）和新冠疫情期间（2020 - 2021年）治疗患者的用药成本差异。
利用台湾地区全民健康保险理赔数据库，该数据库包含住院患者（IPD）和门诊患者（OPD）的处方药理赔信息，以确定不同医院的药品支出，特别是排名前十的解剖治疗学化学分类（ATC）处方药类别。
在医学中心，L01X（其他抗肿瘤药）的药品支出最高，其次是L04A（免疫抑制剂）和J05A（直接作用抗病毒药）。区域医院的药品支出模式与医学中心相似，L01X（其他抗肿瘤药）的药品支出最高。L01X（其他抗肿瘤药）在地区医院的药品支出也最高，其次是N05A（抗精神病药）和A10B（降糖药，不包括胰岛素）。在诊所，A10B（降糖药，不包括胰岛素）的药品支出最高。2021年的总用药成本低于或与2019年相似。在所有医院级别中，门诊患者全身用抗感染药的使用随时间减少，但在医学中心和地区医院的住院患者中增加。此外，我们的分析表明，不同医院级别中排名前十的药品亚组中年度总成本最高项目的药品支出趋势与药品处方量趋势密切相关。
我们的分析发现，2021年的年度药品支出低于或与2019年相似，这表明新冠疫情促成了药品支出的减少。
