醫師選擇藥品關鍵因素相對權重之研究

The relative weight analysis of key factors in physicians drug selection

林澤民(TSE-MIN LIN)

指導教授 ： 莊世杰

國立中正大學/管理學院/企業管理學系/碩士(2015年)

摘要

摘　　要
台灣目前已經面臨高齡化的人口分布，慢性病人數到103年已經到9,833,310人,跟96年8,074,731人相比，已成長21.7%，但是大部分的慢性病患，舉凡高血壓、高血酯、糖尿病…患者等，大部分均需要長期的藥物控制，以免造成病情惡化。根據衛生福利部中央健康保險署重要財務資訊(104)資料，103年藥費(1,605.3億元)占整體醫療費用 26.1%，既然藥費的費用占整體醫療費用如此高的占比，隨著慢性病病人的增加如何讓慢性病的整體費用不持續的提升，當然控制藥物成本讓成為重要的因素。

健保署表示，經推估去2014年超出額度為82.1億元，2015年應調降藥價82.1億元。基於各藥廠因應健保持續實施藥價調整，造成藥廠整體利潤大受影響，進而延伸研究、行銷、推廣人事費用大幅縮水，因此本研究之研究目的，旨在了解醫師選擇藥品之現況及主要關鍵因素，並應用層級分析法(AHP)之研究程序，進行調查研究與資料分析。本研究結論分述如下：
一、在主要構面中,醫生選擇藥品關鍵因素以【大型實證數據】最為顯著，高於「本身臨床經驗」、「領導者及同儕的推薦」、「業務常規拜訪與提醒」及「產品本身」，所以藥廠在大型試驗研究上所投入的大量資源，終究還是會得到醫師的認同及肯定。

二、在次要構面中,長期的安全性試驗報告，將是醫師在選擇處方時考慮的最重要因素，畢竟藥品本身就是用於治療病人，如果無法提供長期的安全性報告及證據，醫師將如何放心將其使用於病人身上。如果因藥品帶來的傷害高於治療所帶來的利益,此藥品將毫無價值可言。

關鍵字

層級分析法 ； 醫師用藥選擇 ； 大型實證數據

並列摘要

Abstract
Taiwan is currently facing an aging of the population. The numbers of chronic disease patients in 2014 is already at 98,333,100 people, compared to 8,074,731 people in 2007, this number has risen by 21.7%. Most of the patients suffer from: hypertension, high cholesterol, diabetes, etc. Most patients will all need long-term medication control to prevent the diseases from getting worse. According to information from the Ministry of Health and Welfare, in 2014, the cost of drugs accounts for 26.1% of all healthcare costs (NT$:160,530M). Since the cost of drugs accounts for such a big part of the total medical cost, when dealing with the rise of chronic illness patients without an increase in cost, controlling drug costs will be an important factor.
The Healthcare department claims that they estimates that cost will exceed NT$821 million in 2014, and in 2015 they should be able to lower the drug costs down to NT$ 821 million. Because pharmaceutical companies are trying to respond to the constant change in drug price, it is causing major impacts on their profits. Extended research, marketing, and promotion cost has all decreased dramatically. So the purpose of this study is to understanding the physicians’ drugs of choice and the key factors by applying the AHP study program and conduct research and data analysis.

The findings of the study are described below:
1.In the main perspective of the study, the doctors chose key drugs in the large clinical study evidence data that are the most significant, higher than the “self-clinical experience,” “leaders and peers recommendations,” “PSR business visits and reminds,” and “the product itself. ” So if pharmaceutical companies invest a lot of resources in large scale research, they will receive the doctors’ approvals and confirmations in the end.
2.In the secondary perspective of the study, the long-term safety reports will be the most important factor to consider for physicians when choosing a prescription; after all, the drug is chosen to help a patient. If long-term safety reports and evidence cannot be provided, how can physicians feel safe letting their patients consume the drugs? If the harm done by the drugs outweighs the benefits, such drugs will be worthless.

並列關鍵字

AHP ； Physician drug selection ； Bag empirical data

參考文獻

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