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題名 拓展心衰竭專利藥普及率之商業策略
Strategic Approached to Expanding the Accessibility and Adoption of Patented Medication for Heart Failure
作者 范姜士彰
Chiang, Allen Fan
貢獻者 吳文傑
Wu, Wen-Chieh
范姜士彰
Allen Fan Chiang
關鍵詞 心衰竭
heart failure
ivabradine
Coralan
patent
life quality
日期 2025
上傳時間 4-Feb-2025 15:36:41 (UTC+8)
摘要 Heart failure is a condition caused by loss of crucial quantity of functional myocardial cells after injury to the heart from various causes. With a 5-year mortality rate ranks fifth among all diseases, heart failure is also a chronic condition that patients must live with but cannot be cured. Thus, the challenge lies in improving life quality for heart failure patients through medical treatment. With intervention of Ivabradine, patients can improve their heart’s ejection fraction and alleviate symptoms that interfere with daily life. Moreover, Ivabradine is currently the only solution to manage hypotension caused by heart failure, a condition that not only causes discomfort but also hinders patients from reaching target medication dose. Therefore, raising awareness of Ivabradine intervention is crucial to optimizing medication and improving life quality for eligible patients. Without a large budget, Servier, the patent owner of Ivabradine in Taiwan, can only conduct limited promotional activities. This thesis will focus on a case study of strategies to achieve a 17% national growth rate for 4 consecutive years, ultimately reaching 50% coverage of eligible patients before patent expires in 2028 with limited budget. More than incremental profits, the underlying goal is to take responsibilities of improving life quality for more patients by optimizing heart failure treatment with Ivabradine.
參考文獻 1. National Health Service (NHS) in England https://www.nhs.uk/conditions/heart-failure/ https://www.nhs.uk/conditions/heart-failure/treatment/ 2. Kemp CD, et al. The pathophysiology of heart failure. Cardiovasc Pathol. 2012 Sep-Oct;21(5):365-71. 3. Vardeny O, et al. Efficacy of sacubitril/valsartan vs. enalapril at lower than target doses in heart failure with reduced ejection fraction: the PARADIGM-HF trial. Eur J Heart Fail 2016;18(10):1228-34. 4. Pharithi RB, et al. Sacubitril-Valsartan in a routine community population: attention to volume status critical to achieving target dose. ESC Heart Fail 2020;7(1):158-66. 5. Kitai T et al. Insufficient reduction in heart rate during hospitalization despite beta-blocker treatment in acute decompensated heart failure: insights from the ASCEND-HF trial. Eur J Heart Fail. 2017 Feb;19(2):241-249. 6. Faris RF, et al. Diuretics for heart failure. Cochrane Database Syst Rev. 2012 Feb 15;(2):CD003838. 7. Bruno N, et al. Mineralocorticoid receptor antagonists for heart failure: a real-life observational study. ESC Heart Fail. 2018 Jun;5(3):267-274. 8. U.S. Food & Drug Administration https://www.fda.gov/drugs/drug-safety-and-availability/fda-revises-labels-sglt2-inhibitors-diabetes-include-warnings-about-too-much-acid-blood-and-serious 9. Parikh RR, et al. Effects of Digoxin in Heart Failure (HF) With Reduced Ejection Fraction (EF). Cureus. 2022 Mar 2;14(3):e22778. 10. Tse S, Mazzola N. Ivabradine (Corlanor) for Heart Failure: The First Selective and Specific If Inhibitor. P T. 2015 Dec;40(12):810-4. 11. Murphy SP et al. Heart Failure With Reduced Ejection Fraction: A Review. JAMA. 2020 Aug 4;324(5):488-504. 12. Borlaug BA et al. Heart failure with preserved ejection fraction: pathophysiology, diagnosis, and treatment. Eur Heart J. 2011 Mar;32(6):670-9. 13.UpToDate.https://www.uptodate.com/contents/treatment-and-prognosis-of-heart-failure-with-preserved-ejection-fraction/print 14. Swedberg K et al. Ivabradine and outcomes in chronic heart failure (SHIFT): a randomised placebo-controlled study. Lancet. 2010 Sep 11;376(9744):875-85. 15. Swedberg K et al. Rationale and design of a randomized, double-blind, placebo-controlled outcome trial of ivabradine in chronic heart failure: the Systolic Heart Failure Treatment with the I(f) Inhibitor Ivabradine Trial (SHIFT). Eur J Heart Fail. 2010 Jan;12(1):75-81. 16. 2023 Consensus of Taiwan Society of Cardiology on the Pharmacological Treatment of Chronic Heart Failure. Acta Cardiol Sin. 2023 May;39(3):361-390. 17. Heart rate at baseline influences the effect of ivabradine on cardiovascular outcomes in chronic heart failure: analysis from the SHIFT study. Clin Res Cardiol. 2013 Jan;102(1):11-22. 18. The Characteristics and Outcomes of Patients with Heart Failure and Reduced Ejection Fraction: The Eligibility of Novel Heart Failure Medications. Acta Cardiol Sin. 2021 Jul;37(4):394-403. 19. TSOC-HFrEF Registry: A Registry of Hospitalized Patients with Decompensated Systolic Heart Failure: Description of Population and Management. Acta Cardiol Sin. 2016 Jul;32(4):400-11. 20. Fox K et al. Resting heart rate in cardiovascular disease. J Am Coll Cardiol. 2007 Aug 28;50(9):823-30. 21. Thorup L et al. Ivabradine: Current and Future Treatment of Heart Failure. Basic Clin Pharmacol Toxicol. 2017 Aug;121(2):89-97. 22. McDonagh TA et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021 Sep 21;42(36):3599-3726. 23. University of Oxford, Centre for Evidence-Based Medicine https://www.cebm.ox.ac.uk/resources/levels-of-evidence 24. Kansal AR et al. Cost-Effectiveness of Ivabradine for Heart Failure in the United States. J Am Heart Assoc. 2016 May 6;5(5):e003221. 25. Heidenreich PA et al. Economic Issues in Heart Failure in the United States. J Card Fail. 2022 Mar;28(3):453-466. 26. Levine, H.J. (1997) Rest Heart Rate and Life Expectancy. Journal of the American College of Cardiology, 30, 1104-1106. 27. Diaz, et al. Heart Rate Working Group. Resting heart rate in cardiovascular disease. J Am Coll Cardiol. 2007;50(9):823-830. 28. Borer JS et al. Effect of ivabradine on recurrent hospitalization for worsening heart failure in patients with chronic systolic heart failure: the SHIFT Study. Eur Heart J Online, 27 August 2012 29. Fong MC et al. The Characteristics and Outcomes of Patients with Heart Failure and Reduced Ejection Fraction: The Eligibility of Novel Heart Failure Medications. Acta Cardiol Sin. 2021 Jul;37(4):394-403. 30. Wang CC et al. TSOC-HFrEF Registry: A Registry of Hospitalized Patients with Decompensated Systolic Heart Failure: Description of Population and Management. Acta Cardiol Sin. 2016 Jul;32(4):400-11. 31. Böhm M et al. Heart rate at baseline influences the effect of ivabradine on cardiovascular outcomes in chronic heart failure: analysis from the SHIFT study. Clin Res Cardiol. 2013 Jan;102(1):11-22. 32. National Health Institute – Health Technology Assessment from Taiwan Center for Drug Evaluation https://www.nhi.gov.tw/ch/dl-11875-717e9c20986c419dbdb36346b2360fea-1.pdf?utm_source=chatgpt.com
描述 碩士
國立政治大學
國際經營管理英語碩士學位學程(IMBA)
109933010
資料來源 http://thesis.lib.nccu.edu.tw/record/#G0109933010
資料類型 thesis
dc.contributor.advisor 吳文傑zh_TW
dc.contributor.advisor Wu, Wen-Chiehen_US
dc.contributor.author (Authors) 范姜士彰zh_TW
dc.contributor.author (Authors) Allen Fan Chiangen_US
dc.creator (作者) 范姜士彰zh_TW
dc.creator (作者) Chiang, Allen Fanen_US
dc.date (日期) 2025en_US
dc.date.accessioned 4-Feb-2025 15:36:41 (UTC+8)-
dc.date.available 4-Feb-2025 15:36:41 (UTC+8)-
dc.date.issued (上傳時間) 4-Feb-2025 15:36:41 (UTC+8)-
dc.identifier (Other Identifiers) G0109933010en_US
dc.identifier.uri (URI) https://nccur.lib.nccu.edu.tw/handle/140.119/155425-
dc.description (描述) 碩士zh_TW
dc.description (描述) 國立政治大學zh_TW
dc.description (描述) 國際經營管理英語碩士學位學程(IMBA)zh_TW
dc.description (描述) 109933010zh_TW
dc.description.abstract (摘要) Heart failure is a condition caused by loss of crucial quantity of functional myocardial cells after injury to the heart from various causes. With a 5-year mortality rate ranks fifth among all diseases, heart failure is also a chronic condition that patients must live with but cannot be cured. Thus, the challenge lies in improving life quality for heart failure patients through medical treatment. With intervention of Ivabradine, patients can improve their heart’s ejection fraction and alleviate symptoms that interfere with daily life. Moreover, Ivabradine is currently the only solution to manage hypotension caused by heart failure, a condition that not only causes discomfort but also hinders patients from reaching target medication dose. Therefore, raising awareness of Ivabradine intervention is crucial to optimizing medication and improving life quality for eligible patients. Without a large budget, Servier, the patent owner of Ivabradine in Taiwan, can only conduct limited promotional activities. This thesis will focus on a case study of strategies to achieve a 17% national growth rate for 4 consecutive years, ultimately reaching 50% coverage of eligible patients before patent expires in 2028 with limited budget. More than incremental profits, the underlying goal is to take responsibilities of improving life quality for more patients by optimizing heart failure treatment with Ivabradine.en_US
dc.description.tableofcontents 1. Introduction 1 1.1. Research Background 1 1.2. Research Motivation 1 1.3. Research Objective 3 2. About Heart Failure 6 2.1. What is Heart Failure 6 2.2. Classification, Diagnosis and Symptoms 6 3. Pharmacological Treatments for Heart Failure 10 3.1. Diuretics 10 3.2. Mineralocorticoid Receptor Antagonists (MRAs) 10 3.3. Vasodilators 11 3.3.1. Angiotensin Converting Enzyme Inhibitor (ACEi) 11 3.3.2. Angiotensin Receptor Blocker (ARB) 11 3.3.3. Angiotensin Receptor – Neprilysin Inhibitor (ARNi) 11 3.4. Sodium Glucose Cotransporter 2 Inhibitor (SGLT2i) 12 3.5. β-blockers 12 3.6. Heart Rate Modulators 12 3.6.1. Digoxin 12 3.6.2. DigoxinFunny Current Inhibitor – Invabradine 12 4. Pharmaceutical Industry, Patents of Medicine and Current Major Players of Heart Failure Medications 16 4.1. Pharmaceutical Industry and Patents of Medicines: An Overview 16 4.2. Current Major Players of Heart Failure Medications 18 5. The Role of Ivabradine in Heart Failure Treatment 24 5.1. Current Problems on Heart Failure Treatment and Purpose of Ivabradine Intervention 24 5.2. Role of Ivabradine from Therapeutic Guideline to Reimbursement of National Health Insurance 28 6. Market Analysis of Heart Failure and Ivabradine 30 6.1. Economic Issues and Cost of Heart Failure Care 30 6.2. From Clinical Treatment to Market Analysis 33 6.3. History and Current Market of Ivabradine in Taiwan 35 6.4. Potential Market Before Patent Expiration 35 6.5. Barriers to Overcome for Sharp Leap of Ivabradine Coverage 36 7. Methods to Increase Coverage of Ivabradine for Eligible Heart Failure Patients 47 7.1. Raise the Awareness of Heart Rate to Healthcare Professionals and Heart Failure Patients 47 7.2. Launch Innovative Campaigns or Events for Promotion at Regional an Territorial Scale 49 7.3. Cooperation with Associations of Cardiologists and Patients 51 7.4. Introduce or Support Systematic Care for Heart Failure Patients 52 8. Conclusion 54 Reference 57zh_TW
dc.source.uri (資料來源) http://thesis.lib.nccu.edu.tw/record/#G0109933010en_US
dc.subject (關鍵詞) 心衰竭zh_TW
dc.subject (關鍵詞) heart failureen_US
dc.subject (關鍵詞) ivabradineen_US
dc.subject (關鍵詞) Coralanen_US
dc.subject (關鍵詞) patenten_US
dc.subject (關鍵詞) life qualityen_US
dc.title (題名) 拓展心衰竭專利藥普及率之商業策略zh_TW
dc.title (題名) Strategic Approached to Expanding the Accessibility and Adoption of Patented Medication for Heart Failureen_US
dc.type (資料類型) thesisen_US
dc.relation.reference (參考文獻) 1. National Health Service (NHS) in England https://www.nhs.uk/conditions/heart-failure/ https://www.nhs.uk/conditions/heart-failure/treatment/ 2. Kemp CD, et al. The pathophysiology of heart failure. Cardiovasc Pathol. 2012 Sep-Oct;21(5):365-71. 3. Vardeny O, et al. Efficacy of sacubitril/valsartan vs. enalapril at lower than target doses in heart failure with reduced ejection fraction: the PARADIGM-HF trial. Eur J Heart Fail 2016;18(10):1228-34. 4. Pharithi RB, et al. Sacubitril-Valsartan in a routine community population: attention to volume status critical to achieving target dose. ESC Heart Fail 2020;7(1):158-66. 5. Kitai T et al. Insufficient reduction in heart rate during hospitalization despite beta-blocker treatment in acute decompensated heart failure: insights from the ASCEND-HF trial. Eur J Heart Fail. 2017 Feb;19(2):241-249. 6. Faris RF, et al. Diuretics for heart failure. Cochrane Database Syst Rev. 2012 Feb 15;(2):CD003838. 7. Bruno N, et al. Mineralocorticoid receptor antagonists for heart failure: a real-life observational study. ESC Heart Fail. 2018 Jun;5(3):267-274. 8. U.S. Food & Drug Administration https://www.fda.gov/drugs/drug-safety-and-availability/fda-revises-labels-sglt2-inhibitors-diabetes-include-warnings-about-too-much-acid-blood-and-serious 9. Parikh RR, et al. Effects of Digoxin in Heart Failure (HF) With Reduced Ejection Fraction (EF). Cureus. 2022 Mar 2;14(3):e22778. 10. Tse S, Mazzola N. Ivabradine (Corlanor) for Heart Failure: The First Selective and Specific If Inhibitor. P T. 2015 Dec;40(12):810-4. 11. Murphy SP et al. Heart Failure With Reduced Ejection Fraction: A Review. JAMA. 2020 Aug 4;324(5):488-504. 12. Borlaug BA et al. Heart failure with preserved ejection fraction: pathophysiology, diagnosis, and treatment. Eur Heart J. 2011 Mar;32(6):670-9. 13.UpToDate.https://www.uptodate.com/contents/treatment-and-prognosis-of-heart-failure-with-preserved-ejection-fraction/print 14. Swedberg K et al. Ivabradine and outcomes in chronic heart failure (SHIFT): a randomised placebo-controlled study. Lancet. 2010 Sep 11;376(9744):875-85. 15. Swedberg K et al. Rationale and design of a randomized, double-blind, placebo-controlled outcome trial of ivabradine in chronic heart failure: the Systolic Heart Failure Treatment with the I(f) Inhibitor Ivabradine Trial (SHIFT). Eur J Heart Fail. 2010 Jan;12(1):75-81. 16. 2023 Consensus of Taiwan Society of Cardiology on the Pharmacological Treatment of Chronic Heart Failure. Acta Cardiol Sin. 2023 May;39(3):361-390. 17. Heart rate at baseline influences the effect of ivabradine on cardiovascular outcomes in chronic heart failure: analysis from the SHIFT study. Clin Res Cardiol. 2013 Jan;102(1):11-22. 18. The Characteristics and Outcomes of Patients with Heart Failure and Reduced Ejection Fraction: The Eligibility of Novel Heart Failure Medications. Acta Cardiol Sin. 2021 Jul;37(4):394-403. 19. TSOC-HFrEF Registry: A Registry of Hospitalized Patients with Decompensated Systolic Heart Failure: Description of Population and Management. Acta Cardiol Sin. 2016 Jul;32(4):400-11. 20. Fox K et al. Resting heart rate in cardiovascular disease. J Am Coll Cardiol. 2007 Aug 28;50(9):823-30. 21. Thorup L et al. Ivabradine: Current and Future Treatment of Heart Failure. Basic Clin Pharmacol Toxicol. 2017 Aug;121(2):89-97. 22. McDonagh TA et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021 Sep 21;42(36):3599-3726. 23. University of Oxford, Centre for Evidence-Based Medicine https://www.cebm.ox.ac.uk/resources/levels-of-evidence 24. Kansal AR et al. Cost-Effectiveness of Ivabradine for Heart Failure in the United States. J Am Heart Assoc. 2016 May 6;5(5):e003221. 25. Heidenreich PA et al. Economic Issues in Heart Failure in the United States. J Card Fail. 2022 Mar;28(3):453-466. 26. Levine, H.J. (1997) Rest Heart Rate and Life Expectancy. Journal of the American College of Cardiology, 30, 1104-1106. 27. Diaz, et al. Heart Rate Working Group. Resting heart rate in cardiovascular disease. J Am Coll Cardiol. 2007;50(9):823-830. 28. Borer JS et al. Effect of ivabradine on recurrent hospitalization for worsening heart failure in patients with chronic systolic heart failure: the SHIFT Study. Eur Heart J Online, 27 August 2012 29. Fong MC et al. The Characteristics and Outcomes of Patients with Heart Failure and Reduced Ejection Fraction: The Eligibility of Novel Heart Failure Medications. Acta Cardiol Sin. 2021 Jul;37(4):394-403. 30. Wang CC et al. TSOC-HFrEF Registry: A Registry of Hospitalized Patients with Decompensated Systolic Heart Failure: Description of Population and Management. Acta Cardiol Sin. 2016 Jul;32(4):400-11. 31. Böhm M et al. Heart rate at baseline influences the effect of ivabradine on cardiovascular outcomes in chronic heart failure: analysis from the SHIFT study. Clin Res Cardiol. 2013 Jan;102(1):11-22. 32. National Health Institute – Health Technology Assessment from Taiwan Center for Drug Evaluation https://www.nhi.gov.tw/ch/dl-11875-717e9c20986c419dbdb36346b2360fea-1.pdf?utm_source=chatgpt.comzh_TW