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市場調查報告書
2006年第4季的藥價、償付、處方最新動向
Pharmaceutical Pricing, Reimbursement, and Prescribing News in the Fourth Quarter of 2006
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本報告已在2011年12月21日停止出版。
藥品市場中既有藥價及償付制度的實施與調整在2006年第4季當中成為一個主要課題。在美國Medicare Part D的處方藥補助制度將要邁入第2年，在歐洲技術評價標準的制定工作正在進行當中，各國政府也被迫加緊腳步研擬費用抑制策略。
專門於醫療產業相關廣泛調查的美國市調公司 Decision Resources Inc. （總公司：麻薩諸塞州），針對2006年第4季的藥價、償付、處方最新動向進行調查分析，並系統整理調查結果後出版報告書 "Pharmaceutical Pricing, Reimbursement, and Prescribing News in the Fourth Quarter of 2006" 。
本報告書內容包括：2006年第4季美國、歐洲（法國、德國、義大利、西班牙、英國）及日本藥價、償付、處方環境、費用抑制方案、未來發展預測等。共計22頁的內容綱要摘記如下：
實施概要
序章
美國
- 議會選舉的影響
- Medical part D的變更
- Medicaid改革
- 受到威脅的平均批發價格對策
EU
法國
德國
- 藥品投資金額的停滯
- 新的醫療改革案
- 每天的醫療費用限制
- 免去患者自負額的眾多產品
- 2007年的參考價格調整
義大利
西班牙
英國
- 國家醫療服務（National Healthcare Service）中NICE的角色明確化
- NICE拒絕之與藥物取得相關的裁決
日本
未來發展趨勢
圖表
Abstract
Introduction:
Implementation and refinement of existing pricing and reimbursement
initiatives throughout the major pharmaceutical markets continued to be a
major theme in the fourth quarter of 2006. In the United States, preparations
continued for the second year of the Medicare Part D prescription drug
benefit. In Europe, while the European Union took action to promote common
standards for health technology assessment, individual governments continued
to pursue independent national cost-containment strategies. And in Japan,
implementation of revised price premiums earlier in the year has benefited
manufacturers of useful and innovative drugs.
Get the Answers You Need to Shape Your Strategy:
- In the United States, the midterm Congressional elections dominated the
news. What implications will this change of power have on U.S. health care
policy? How will the pharmaceutical and biotechnology industries respond to
this new political landscape?
- The German government has proposed significant health care reforms. How
will these reforms affect health insurance, physician reimbursement,
hospitals, and the pharmaceutical market? What new freedoms and what new
constraints will result?
- Governments in the major pharmaceutical markets continue to refine
regulations on drug pricing and reimbursement. How will these refinements
affect the pharmaceutical markets in these countries? Will certain drug
classes in certain countries actually benefit from these reforms?
- The steady expansion of reference pricing across Europe exemplifies
governments' tendency to imitate each other, while they simultaneously pursue
their disparate national strategies for containing health care costs. In
such a climate, is there any hope for harmonized reimbursement standards?
Scope:
- Fourth quarter news in 2006: major events in the pharmaceutical
pricing, reimbursement, and prescribing environment in the United States,
Europe (France, Germany, Italy, Spain, and the United Kingdom), and Japan.
- Cost-containment programs: measures that health care payers are
using to curb their drug expenditures and to improve patient access to
medications.
- Outlook: our assessment of the implications of these events for the
pharmaceutical industry in the major markets under study.
Mentioned in This Spectrum Report:
Organizations:
- Agence Francaise de Sécurité
- Sanitaire des Produits de Santé (AFSSAPS; French Agency for the
Safety of Health Products)
- Allgemeine Ortskrankenkassen (Local General Health Insurance Funds)
- Biotechnology Industry Organization (BIO)
- Bundesfachverband der Arzneimittelhersteller(BAH; Federal Association of
Pharmaceutical Manufacturers)
- Bundesverband der Betriebskrankenkassen (BKK;Federal Association of
Occupational Health Insurance Funds)
- Bundesvereinigung Deutscher Apothekerverbande(ABDA; Federal Union of
German Pharmacists' Associations)
- Centers for Medicare and Medicaid Services (CMS)
- Chuikyo (Central Social Insurance Medical Council)
- Department of Veterans Affairs (VA)
- European Network for Health Technology Assessment (HTA)
- Farmaindustria Gemeinsamer Bundesausschus der Ärzte,Zahnärzte,
Krankenhäuser und Krankenkassen(GBA; Joint Federal Committee of
Physicians, Dentists, Hospitals, and Health Insurance Funds)
- Gesetzliche Krankenversicherung (GKV; statutory health insurance)
- Haute Autorité de Santé (HAS; National Health Authority)
- High-Level Group on Innovation and the Provision of Medicines (G10
Medicines Group)
- High-Level Pharmaceutical Forum
- House Energy and Commerce Committee' s Subcommittee on Health
- Institut
für Qualität und Wirtschaftlichkeit im Gesundheitswesen (IQWiG;
Institute for Quality and Economy in the Health Care System)
- Kassenärztliche Bundesvereinigung (KBV; Federal Union of Health
Insurance Fund Physicians)
- National Health Service (NHS)
- National Institute for Health and Clinical Excellence (NICE)
- Osservatorio Nazionale sull' Impiego dei Medicinali (OsMed; National
Observatory on Pharmaceutical Spending)
- Servizio Sanitario Nazionale (SSN; National Health Service)
- Sistema Nacional de Salud (SNS; National Health System)
Companies:
- EnvisionRx Plus
- Express Scripts
- First Databank
- Health Net
- Humana
- Ipsen
- Longs Drug Stores
- McKesson
- Medi-Span
- Merck KGaA
- NewQuest Health Solutions
- NMHC Systems
- Roche
- Thomson' s Red Book
- Torchmark
Table of Contents
- Executive Summary
- Strategic Considerations
- Stakeholder Implications
- Introduction
- United States
- Impact of Congressional Elections
- Changes to Medicare Part D
- Medicaid Reform
- Average Wholesale Price Measure Under Threat
- European Union
- European Cooperation on Health Technology Assessment
- France
- New Wave of Reimbursement Cuts
- Impact of Government' s Medical Control Strategy
- Germany
- Slowdown in Pharmaceutical Spending
- Proposed New Health Care Reforms
- Daily Cost-of-Therapy Limits
- Many Products Exempted from Copayments
- Reference Price Adjustments for 2007
- Italy
- Price Cuts Slow Sales Growth
- Spain
- Industry Requests Price Increase
- New Reference Pricing System Authorized
- United Kingdom
- Clarifi cation of NICE' s Role in the National Health Service
- Courts Rule on Access to Drugs Rejected by NICE
- Japan
- Reform of the Pricing and Reimbursement System Deferred
- Higher Price Premiums for Innovation
- Outlook and Implications for the Pharmaceutical Industry
Tables:
- 1: Key Features of Standard Medicare Part D Drug Benefit, 2006 and 2007
- 2: German Daily Cost-of-Therapy Limits, 2007
Figures:
- 1: Percentage of Stand-Alone Prescription Drug Plans Charging Various
Monthly Premiums,2006 and 2007
- 2: Percentage of Medicare Advantage Plans Charging Various Monthly Drug
Premiums,2006 and 2007
- 3: Percentage of Stand-Alone Prescription Drug Plans Levying Various Drug
Deductibles,2006 and 2007
- 4: Percentage of Medicare Advantage Plans Levying Various Drug
Deductibles, 2006 and 2007
- 5: Percentage of Stand-Alone Prescription Drug Plans Offering Various
Levels of Drug Coverage in the Coverage Gap, 2006 and 2007
- 6: Percentage of Medicare Advantage Plans Offering Various Levels of Drug
Coverage in the Coverage Gap, 2006 and 2007
- 7: Monthly Pharmaceutical Expenditures of Germany' s Statutory Health
Insurance System, January 2003-October 2006
- 8: Infl uences on Pharmaceutical Expenditures in Germany' s Statutory
Health Insurance System, April-October 2006
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