- 學位論文
健保總額制度下原廠藥與學名藥之市場競爭研究－以頭孢子菌素(Cephalosporins)抗生素為例
Market competitive trends between original brand-name drugs and generic drugs in the global budget system of national health insurance ─ take the cephalosporin as an example
摘要
政府政策一向對產業有直接又重大的影響，台灣藥品市場亦然。在中央健保局制定的「醫院總額制度」和「藥價基準、藥價調查、藥價調整」二項政策主導之下，佔抗生素市場首位的頭孢子菌素(Cephalosporins)市場產生很大的變化。 本研究主要是以寰宇藥品資料管理股份有限公司(Intercontinental Medical Statistics company, IMS)提供來自國家衛生研究院即中央健保局資料庫的資料，研究在2003年至2005年全民健康保險總額給付制度實施後，對抗生素整體市場和頭孢子菌素抗生素市場的衝擊，及剖析原廠藥與學名藥之市場競爭情況，並探究其原因。 本研究主要發現如下： 1. 對整體頭孢子菌素而言，第一世代頭孢子菌素因總額制度實施加上藥價調整致使每年銷售量及金額遞減，大受衝擊。反觀第三世代頭孢子菌素的銷售金額與數量整體呈現成長的趨勢，且在頭孢子菌素的市佔率逐年升高。 2. 第一世代頭孢子菌素的原廠藥在總額制度實施後3年，銷售金額與數量逐漸下滑，在2005年時更居於學名藥之後，繼而退出市場。但是，第二世代與第三世代頭孢子菌素原廠藥似乎未受影響，市佔率仍居高不下穩佔市場，讓學名藥望其項背。 3. 然而第二世代與第三世代頭孢子菌素抗生素在藥價調降和細菌耐藥性(Resistance)產生下，醫師改變用藥轉向使用其他廣效型盤尼西林類(Penicillins)、氟奎諾酮類(Fluoroquinolones)，甚至抗菌力更強的碳青黴烯類(Carbapenems)抗生素，使市場有逐漸萎縮的隱憂。 4. 健保總額制度和藥價調整政策對頭孢子菌素抗生素市場造成的衝擊和市場生態的轉變很可能也同樣地發生在其他類別的抗生素上甚至其他健保用藥上；諸如抗高血壓、高血脂、糖尿病等等藥品。對台灣藥品市場的影響與日俱增。
並列摘要
Government policies always have a direct and significant influence on industry, so does to the drug market in Taiwan. “Global budget system” and “Ceiling price, Price-volume survey and Price adjustment”, enacted by Bureau of National Health Insurance(BNHI), dramatically sways the market of cephalosporins. Cephalosporins occupies the largest market share in antibiotics. The data of this study is collected from Intercontinental Medical Statistics company(IMS) providing the database of BNHI from the year of 2003 to 2005. This research investigated the impact of antimicrobial agents and cephalosporins market, it also analyzed the competition between original brand-name drugs and generic drugs after global budget system was executed. The major conclusions are as follows: 1. Total volume and sales of first-generation cephalosporins is decreasing progressively every year because of the administration of global budget system and price adjustment. However, the third-generation cephalosporins has bloomed in total volume and sales. The third-generation cephalosporins’ market share has escalated gradually among all-generation cephalosporins. 2. The implementation of global budget system latter 3 years, total volume and sales of original brand-name first-generation cephalosporins have been dwindling. In the year of 2005 they were even less than generic drugs. Afterwards the original brand-name first-generation cephalosporins were withdrawn from the market. But, the original brand-name second- and third-generation cephalosporins seemed to be uninfluenced by the policy, their market shares remained steadily and were hard to be chased by generic drugs. 3. Under the threats of price adjustment and bacterial resistance to cephalosporins, doctors tend to prescribe broad spectrum penicillins, fluoroquinolones and carbapenems instead of cephalosporins, causing the market gradually shrink. 4. The impact of global budget system and price adjustment on cephalosporins market could also happen to another class of antibiotics and other category of drugs such as antihypertensive, lipid-lowering, hypoglycemia, etc. These policies have more and more influence to the Taiwan pharmaceutical market.