全民健保下藥品供應鏈e化之研究

Abstract

全民健保的實施改變了傳統的藥品通路，使得藥品市場逐漸集中於醫院，而醫療院所為因應總額支付的政策，降低營運成本，因而有逐漸結盟經營的趨勢。為滿足市場導向的藥品供應鏈需求，本研究探討自全民健保1995年實施後，藥品通路的變革對藥品供應鏈所造成的影響，並藉由個案探討以及理論分析，探討藥品供應鏈e化之趨勢，以歸納出一個藥品供應鏈e化可行模式，供政府機關、醫療院所、藥商及物流商在藥品供應鏈之流程中作為參考。\n\n 本研究認為藥品供應鏈應從分散管理改為集中管理，並藉由具有公信力的中央健保局，配合資訊科技協助藥品供應鏈e化，以讓藥品資訊可以有效的流通被利用。透過以以中央健保局為中心的藥品供應鏈模式，可以讓各個產業專業分工的成效更明顯，其具有下列益處：\n一、以量制價統一配銷\n二、降低醫療院所藥品存貨\n三、簡化健保給付流程 \n四、藥品資訊有效利用\n五、幫助醫藥分類落實\n\n 此外，本研究亦針對此模式下之藥品供應鏈提出初步實施規劃如下：\n一、從公立體系醫院興辦\n二、選擇量大且較常使用的健保給付藥品\n三、彈性的配送頻率\n四、資訊流與金流的整合\n五、由中央健保局協助資訊商建立藥品供應鏈e化平台\n\n 透過本研究所提出之藥品供應鏈之e化模式及流程，本研究期望能加速藥品供應鏈集中管理之機制形成，以幫助醫藥產業降低藥品流通的成本並落實醫藥分業。

This paper examines the condition of Taiwanese National Health Insurance (NHI) and brings up the idea of the centralizd management. Since Taiwan put the NHI into practice, Drug Price Black-Hole of the NHI has estimated about 20 billion every year under the fee-for-service payment system (FFS) and pricing drug with brand. Therefore, we collect the papers and some cases to discuss the situation of the Drug Supply Chain in Taiwan. We would like to understand how to descrease the drug cost in purchasing and distributing by this paper.\n\n This paper makes use of Value Chain, Diamond Theory, New Value Curve to analyze the Drug Supply Chain in Taiwan and proposes the model and process to direct the industry how to developing the Drug Supply Chain by certralized management.\n\n The Drug Supply Chain of certralized management can provide some benefit as following:\n1. Purchase jointly to reach economies of scale\n2. Simplify the reporting process\n3. Effectively use the information of the drugs\n4. Utilize the distributed process by jointly delivery\n5. Help the separation profession of pharmacy from medicine to implement\n\n Besides, this paper proposes the initial plan about the Drug Supply Chain of certralized management as following:\n1.Begin with governmental hospitals.\n2. Select large amount of the drugs of NHI. \n3. Provide flexible frequency of distribution. \n4. Intergrate the information flow and cash flow. \n5. Bureau of National Health Insurance (BNHI) supports the Internet Servie provider (ISP) to build the platform of the Drug Supply Chain.\n \n Our main goal is to adapt this kind of model to help NHI overcome financial crisis by jointly purchasing and distributing, simplifying the process of reporting and help the separation profession of pharmacy from medicine.