结构变化的医药市场中的竞争:一些卫生经济考虑

Klaus Von Grebmer
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摘要

卫生保健的经济分析必然包括药物治疗作为健康的一个生产因素。最近的研究表明,在现有的保健生产要素中,最大的生产力提高来自药物治疗方面的技术进步。未来生产力的提高将受到药品市场组织方式的影响。实证研究结果表明,短期成本控制措施不利于充分的跨期分配,越来越多的国家不同意研究成本的国际分配。药品定价机制是分配财政资源的一种手段。然而,以成本为导向的定价对于研究型公司并不完全可行,因为它们无法将很大一部分成本分配给单个产品。然而,研究认为,在专利存续期间,研究型公司之间的异质性竞争和专利到期后非研究型公司之间的同质竞争保护了患者免受剥削。经验数据表明,这两种竞争的共存在过去取得了相当令人满意的效果。集中于药品价格的成本控制措施的趋势与该行业目前的阶段相结合,可能产生一种长期有害于社会的影响。卫生经济学家的贡献应该导致一种政策,在这种政策中,短期和政治上适当的成本削减不占主导地位,而是导致长期的卫生技术和经济生产。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Competition in a structurally changing pharmaceutical market: Some health economic considerations

Economic analysis of health care necessarily includes pharmaceutical therapy as one production factor of health. Recent research shows that within the available production factors for health the highest productivity increases have come from technological advances in drug therapy. Future productivity increases will be influenced by the way in which pharmaceutical markets are organised. Empirical findings show that short-term cost containment measures act against an adequate intertemporal allocation and increasingly more nations disagree with the international allocation of research costs.

The mechanism of pricing of pharmaceuticals is available as a means to allocate financial resources. However, cost-orientated pricing is not wholly practical for research-based companies where a high proportion of costs cannot be allocated to individual products. However, it is argued that heterogeneous competition between research-based companies during the patent life-time and homogeneous competition of non-research-based companies after patent expiration protect the patient from exploitation. Empirical data indicate that the coexistence of both types of competition has worked quite satisfactorily in the past.

The combination of the tendency of cost-containment measures to concentrate on drug prices and the present phase of the industry may have an effect which, in the long run, works to the detriment of society. The contribution of health economists should lead to a policy in which short-term and politically opportune cost cuttings do not dominate but one which results in long-run technical and economic production of health.

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