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https://ah.lib.nccu.edu.tw/handle/140.119/101065| 題名: | 製藥產業創新核價模式 Innovative Pricing Model in Pharmaceutical Industry |
作者: | 王宥人 | 貢獻者: | 李仁芳 王宥人 |
關鍵詞: | 創新核價模式 風險分攤 價量協議 結果導向給付方案成 效為基礎給付模式 製藥產業 |
日期: | 2011 | 上傳時間: | 1-Sep-2016 | 摘要: | 由於醫療科技的進步以及人口老化造成各國政府對於健康支出越來越高，導致財務上的壓力；很多創新的藥品因為研發成本高或是病人族群太少所以價格高昂。醫療保險也因為財務衝擊過大而無法給付，最後演變成醫療的需要無法被完全滿足。\n\n因此藥品公司採用創新核價模式，透過分擔財務上風險來降低交易成本，近年來更有藥品公司與保險公司或政府簽訂契約，以分擔治療結果上的風險來降低市場進入障礙。\n\n本篇論文嘗試以新制度經濟學交易成本理論，初探製藥產業為了降低市場進入障礙採用創新核價模式的可行性。透過文獻整理、外在環境與兩個個案分析發現，創新核價/給付模式提供政府與藥品公司足夠的誘因，讓雙方願意坐下來協商雙方都可接受的可能性。\n\n因此，創新核價/給付模式確實能有效降低市場進入障礙，提高新藥的可近性。適合採用創新核價模式的產品通常有以下三個共同特點：交易頻率相對較低，單價高或財務衝擊大，有明確的審查依據並能取得客觀可靠的資訊。台灣目前已有產品部份採用創新核價/給付模式。\n\n不確定性是影響交易成本的主要因素，事實上台灣也有越來越多的創新核價/給付模式用來增加市場可近性，除了個案所提的價量協議合約以外，事實上健保局早就將以成效為基礎給付的創新核價/給付模式隱身在給付規定中。未來，創新核價/給付模式除了財務上的風險分攤以外，依實證發展給付（coverage with evidence development, CED）模式或許會成為下一個發展的重點。 | 參考文獻: | 1. Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat, World Population Prospects: The 2008 Revision. http://esa.un.org/unpp, Saturday, September 25, 2010.\n\n2. Bill Mitchell, The US should have universal public health care. http://bilbo.economicoutlook.net/blog/?p=8909 Sunday, Oct 3,2010.\n\n3. WHO (May 2009). "World Health Statistics 2009" http://www.who.int/whosis/whostat/2009/en/index.html, Sunday, Oct 3, 2010\n\n4. Institute for research and information in health economics. OECD Health Data 2010 – Frequently Requested Data. http://www.irdes.fr/EcoSante/DownLoad/OECDHealthData_FrequentlyRequestedData.xls, Monday, Oct 4, 2010.\n\n5. Claus Moldrup No Cure, No Pay. BMJ 2005;330:1262-4.\n6. 全民健康保險藥品論質計酬計畫實施要點(草案）. 全民健康保險藥事小組第8屆第16次會議紀錄附件5. http://www.nhi.gov.tw/webdata/AttachFiles/Attach_15849_2_第8屆第16次會議紀錄(990728).pdf, Saturday, Oct 9, 2010.\n\n7. 全民健康保險藥價基準(民國99年9月24日修正） http://dohlaw.doh.gov.tw/Chi/FLAW/FLAWDAT0202.asp?lsid=FL037963, Feb 12, 2011.\n\n8. Ferris, J. & S. Tang, The New Institutionalism and Public Administration: An Overview. Journal of Public Administration: Research and Theory 1993;3(1):4-10.\n\n9. North, D.C. Economic Performance through Time. American Economic Review 1994;84:359-68\n\n10. Davis, L. and North, D.C. 1971. Institutional Change and American Economic Growth. Cambridge: Cambridge University Press.\n\n11. Williamson, O.E. 1985. The Economic Institutions of Capitalism. New York: The Free Press.\n\n12. Commons, J.R. 1934. Institutional Economics. Madison: University of Wisconsin Press.\n\n13. Williamson, O.E. Transaction-Cost Economics: The Governance of Contractual Relations. Journal of Law and Economics 1979;22:233-61.\n\n14. Coase, R.H. The Nature of the Firm. Economica 1937;4:386-405.\n\n15. Arrow, K.J. 1969, The Organization of Economic Activity: Issues Pertinent to the Choice of Market versus Non-Market Allocation. The Analysis and Evaluation of Puclic Expenditures: The PBB-System, Joint Economic Committee, 91st Cong., 1st sess., Vol. 1. Washington, D.C.: Government Printing Office.\n\n16. Scherer, F.M. 1987. Selling Costs. In Eatwell, J., Milgate, M. and Newman, P.(Eds.) The New Palgrave: A Dictionary of Economics, 4:300-301. London: Macmillan.\n\n17. 吳思華，策略九說—策略思考的本質，二版，台北：臉譜文化1996。\n\n18.Burt, R.S. 1992. Structural Holes: The Social Structure of Competition. Cambridge: Harvard University Press. \n\n19.Miller, J.G. and Vollmann T.E. The Hidden Factory. Harvard Business Review 1985;55(5):142-50.\n\n20. Levi, M. 1988. Of Rule and Revenue. Berkeley: University of California Press.\n\n21. Ouchi, W. G. A Conceptual Framework for the Design of Organizational Control Mechanisms. Management Science 1979;25(9):833-848.\n\n22. Rindfleisch, A. and J. Heide, Transaction Cost Analysis: Past, Present, and Future Applications. Journal of Marketing 1997;61(4):30-54\n\n23. Chiles TH. Mcmackin JF. Integrating Vairable Risk Preferences, Trust and Transaction Cost Economics. The Academy of Management Review 1996;21(1) 73-99.\n\n24. Shelanski, Howard A., and Peter G. Klein, "Empirical Research in Transaction Cost Economics: A Review and Assessment," Journal of Law, Economics and Organization11, no. 2 (October 1995): 335-61. Reprinted in Glenn R. Carroll and David J. Teece, eds., Firms, Markets, and Hierarchies: The Transaction Cost Perspective (New York: Oxford University Press, 1999), pp. 89-118.\n\n25. Klein, B. Self-Enforcing Contacts. Journal of Institutional and Theoretical Economics 1985;141:594-600.\n\n26. Weber, M. 1968. Economy and Society: An Outline of Interpretative Sociology. Edited by Roth G. and Wittich C. Berkeley: University of California Press.\n\n27. Brousseau, E. and Glachant, JM. 2002. The Economics of Contracts: Theories and Applications Cambridge: Cambridge University Press.\n\n28. Jensen, M. C., and Meckling W. H., Theory of the Firm: Managerial Behavior, Agency Costs and Ownership Structure. Journal of Financial Economics 1976;3:305-60.\n\n29. Grossman, Sanford J & Hart, Oliver D, "The Costs and Benefits of Ownership: A Theory of Vertical and Lateral Integration," Journal of Political Economy. 1986;94(4):691-719.\n\n30. Tirole, J., Incomplete Contracts: Where Do We Stand? Econometrica. 1999;67(4):741-781.\n\n31. Hart, O. and Moore, J. Property Rights and the Nature of the Firm. Journal of Political Economy, 1990;98(4):1119-1158.\n\n32. Foss, K. and Foss, NJ. Theoretical isolation in contract theory: suppressing margins and entrepreneurship. Journal of Economic Methodology. 2000;7(3):313-339.\n\n33. Baker, G., Gibbons R. and Murphy KJ., Relational Contracts and the Theory of the Firm, The Quarterly journal of economics, 2002;117(1):39-84.\n\n34. Chen Y.M. Promises, trust, and contracts. Journal of Law Economics and Organization. 2000;16(1):209 232.\n\n35. The Pharmaceutical Price Regulation Scheme 2009. Department of Health and the Association of the British Pharmaceutical Industry, December 2008. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_091825 Monday, May 23, 2011.\n\n36. Alberta Pharmaceutical Strategy Phase Two-Brand Name Drugs (Fact Sheet). Alberta Health and Wellness, October 2009. http://www.health.alberta.ca/documents/Pharma-Strategy-2-Brand-Drugs.pdf Monday, May 23, 2011\n\n37. Guidelines for Deeds of Agreement for the Pharmaceutical Benefits Scheme (Version 1.3). Department of Health and Ageing, 2009. http://www.pbs.gov.au/pbs/pdf-viewer?pdf=%2Findustry%2Flisting%2Felements%2Fdeeds-agreement%2FGuidelines_for_Deeds_of_Agreement.pdf Monday, May 23, 2011.\n\n38. Carlson JJ, Garrison LP, Sullivan SD. Paying for Outcomes: Innovative Coverage and Reimbursement Schemes for Pharmaceuticals. J Manag Care Pharm 2009; 15:683-7.\n\n39. Garber AM, McClellan MB. Satisfaction Guaranteed “Payment by Results” for Biologic Agents. N Engl J Med 2007;357:1575-7.\n\n40. Ehreth J, Williams D. European Pharmaceutical Pricing and Reimbursement conference. Expert Review of Pharmacoeconomics & Outcomes Research 2009;9:37-9\n\n41. Datamonitor Healthcare. Pricing and Reimbursement: Innovative Risk-Sharing Strategies. July, 2009\n\n42. Trueman P, Grainger DL, Downs KE. Coverage with Evidence Development: Applications and Issues. International Journal of Technology Assessment in Health Care 2010;26:79-85.\n\n43. Sullivan SD, Garrison LP, Carlson JJ, et al. Performance-Based Risk-Sharing Reimbursement Agreements for New Medical Products (Executive Summary). In: ISPOR 11th Annual European Congress: Risk-sharing agreements panel. Athens: Pharmaceutical Outcomes Research and Policy Program, University of Washington; 2008.\n\n44. Carlson JJ, Sullivan SD, Garrison LP, Neumann PJ, Veenstra DL. Linking Payment to Health Outcomes: A Taxonomy and Examination of Performance-based Reimbursement Schemes between Healthcare Payers and Manufacturers. Health Policy 2010;96:179-90.\n\n45. Akerlof GA. The Market for "Lemons": Quality Uncertainty and the Market Mechanism. The Quarterly Journal of Economics 1970;84(3):488-500.\n\n46. Rebecca A. Williams et al. The Psychosocial Impact of Macular Degeneration. Arch Ophthalmol. 1998;116:514-520.\n\n47. Brown GC etal. Difference between ophthalmologists` and patients` perceptions of quality of life associated with age-related macular degeneration. Can J Ophthalmol. 2000;35(3):127-33.\n\n48. Philip J. Rosenfeld et al. for the MARINA Study Group. Ranibizumab for Neovascular Age-Related Macular Degeneration. N Engl J Med 2006;355:1419-31.\n\n49. David M. Brown et al. for the ANCHOR Study Group. Ranibizumab versus Verteporfin for Neovascular Age-Related Macular Degeneration. N Engl J Med 2006;355:1432-44.\n\n50. National Institute for Health and Clinical Excellence, NICE technology appraisal guidance 155. Ranibizumab and pegaptanib for the treatment of age-related macular degeneration. Aug 2008. http://www.nice.org.uk/nicemedia/live/12057/41719/41719.pdf\n\n51. National Institute for Health and Clinical Excellence, Audit Support. Ranibizumab and pegaptanib for the treatment of age-related macular degeneration. Sep 2008. http://www.nice.org.uk/nicemedia/live/12057/41926/41926.doc \n\n52. Department of Health and Ageing. About Pharmaceutical Benefits Scheme http://www.pbs.gov.au/info/about-the-pbs \n\n53. Department of Health and Ageing. Sensory organs > Ophthalmologicals > Ocular vascular disorder agents http://www.pbs.gov.au/medicine/item/1382R \n\n54. Canadian Agency for Drugs and Technologies in Health. CEDAC Final Recommendation and Reasons for Recommendation, Ranibizumab. Mar, 2008 http://www.cadth.ca/media/cdr/complete/cdr_complete_Lucentis_March-27-2008.pdf \n\n55. Saskatchewan Health, Appendix A of Exception Drug Status (EDS) Program. http://formulary.drugplan.health.gov.sk.ca/publications/APPENDIX%20A.pdf\n\n56. 全民健康保險藥事小組第8屆第5次會議紀錄http://www.nhi.gov.tw/Resource/webdata/Attach_14079_2_第8屆第5次藥事小組會議紀錄.pdf\n\n57. 全民健康保險藥事小組第8屆第9次會議紀錄http://www.nhi.gov.tw/Resource/webdata/Attach_14890_2_全民健康保險藥事小組第8屆第9次會議記錄0990111.pdf\n\n58. 全民健康保險藥事小組第8屆第13次會議紀錄http://www.nhi.gov.tw/Resource/webdata/Attach_15476_2_全民健康保險藥事小組第8屆第13次會議紀錄.pdf\n\n59. 全民健康保險藥事小組第8屆第17次會議紀錄http://www.nhi.gov.tw/Resource/webdata/Attach_15888_2_全民健康保險藥事小組第8屆第17次會議紀錄.pdf\n\n60. Data refer to the year 2010. World Economic Outlook Database-April 2011, International Monetary Fund. http://www.imf.org/external/pubs/ft/weo/2011/01/weodata/index.aspx Monday, June 13, 2011.\n\n61. OECD. Country Statistical Profiles 2010. OECD Health Data 2010 http://stats.oecd.org/Index.aspx?DatasetCode=CSP2010 Monday, June 13, 2011.\n\n62. Chen SJ, Cheng CY, Peng KL, Li AF, Hsu WM, Liu JH, Chou P. Prevalence and associated risk factors of age-related macular degeneration in an elderly Chinese population in Taiwan: the Shihpai Eye Study. Invest Ophthalmol Vis Sci. 2008;49(7):3126-33.\n\n63. Ferris FL 3rd, Fine SL, Hyman L. Age-related macular degeneration and blindness due to neovascular maculopathy. Arch Ophthalmol. 1984;102(11):1640-2.\n\n64. Arnold JJ, Sarks SH. Age-related macular degeneration. BMJ 2000;321:741-744\n\n65. Zou HD, Zhang X, Xu X, Wang FH, Zhang SJ. Prevalence study of age-related macular degeneration in Caojiadu blocks, Shanghai. Zhonghua Yan Ke Za Zhi. 2005;41(1):15-9.\n\n66. WHO Scientific Group on the Prevention and Management of Osteoporosis (2000 : Geneva, Switzerland) (2003). "Prevention and management of osteoporosis : report of a WHO scientific group" (pdf). http://whqlibdoc.who.int/trs/WHO_TRS_921.pdf. Retrieved 2010-01-26.\n\n67. Yang NP, Deng CY, Chou YJ, et al. Estimated prevalence of osteoporosis from a nationwide health insurance database in Taiwan. Health Policy 2006;75:329-337.\n\n68. 國際骨質疏鬆症基金會International Osteoporosis Foundation http://www.osteofound.org/press_centre/fact_sheet.html\n\n69. Berry SD, Samelson EJ, Hannan MT, et al. Second hip fracture in older men and women. Arch Intern Med. 2007;167(18):1971-1976.\n\n70. Black DM, Delmas PD, Eastell R, et al. Once-yearly Zoledronic acid for treatment of postmenopausal osteoporosis. N Engl J Med 2007:356:1809-22.\n\n71. 全民健康保險藥事小組第8屆第18次會議紀錄http://www.nhi.gov.tw/Resource/webdata/Attach_15997_2_8-18會議紀錄-final.pdf\n\n72. 國民健康局2007年台灣中老年身心社會生活狀況長期追蹤(第六次）調查\n\n73. Black DM, Delmas PD, Eastell R, et al. Once-yearly Zoledronic acid for treatment of postmenopausal osteoporosis. N Engl J Med 2007:356:1809-22.\n\n74. 游慧光(2004)，OECD國家與台灣醫療保健支出成長因素之探討，逢甲大學會計與財稅研究所碩士論文。\n\n75. 陳昭姿，健保新藥管理趨勢，Dec 14, 2010\n\n76. Frank R.G.,“Government Commitment and Regulation of Prescription Drugs” Health Affairs 2003;22(3):46-48.\n\n77. 行政院衛生署中央健康保險局, 全民健康保險藥品給付規定http://www.nhi.gov.tw/Resource/webdata/15321_1_藥品給付規定條文.doc | 描述: | 碩士 國立政治大學 科技管理研究所 94359030 |
資料來源: | http://thesis.lib.nccu.edu.tw/record/#G0094359030 | 資料類型: | thesis |
| Appears in Collections: | 學位論文 |
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