| Abstract: | 隨著2010年健保局論病計酬給付制度逐步導入診斷關聯群，相同成分但不同廠牌的藥品對於同一疾病的整個療程，健保藥費支出之間是否存在差異性？本研究由全民健保資料庫中1997~2000年出生的三到六歲學齡前兒童，凡是以中耳炎 ICD-CM-9診斷碼門診健保申報者為母群體。篩選第一次使用原廠、進口學名藥或台灣製造之任一廠牌的學名藥抗生素Amoxicillin-clavulanate為治療藥物，學齡前兒童共分三個群組。本研究探討服藥後180天內，具有相同中耳炎ICD-CM-9診斷碼上述群組之所有藥費支出與就診開藥天數的差異性。 本研究篩選149位學齡前兒童使用Amoxicillin-clavulanate 藥品，以t檢定顯現群體與群體之間的藥費支出平均數的差異。結果顯示追蹤半年療程後，平均藥費以原廠藥 Group 1支出最高，台廠學名藥Group 3 次之，進口學名藥Group 2支出最低。有關就診開藥天數， Group 1最長，Group 3次之，Group 2最短。 無論是進口學名藥或台製學名藥，半年整體療程平均每位病患藥費支出均較原廠藥低。台灣在診斷關係群全面施行後,醫療院所藥品選擇的最佳策略是採用進口學名藥並在強化台製學名藥品質達到穩定與一致性後加以使用，可同時兼顧療效與節約藥費。
In 2010,the National Health Insurance(NHI) has led case-based payment into the Diagnosis Related Groups(DRG). How many differences does drug costs have if this policy ,the same ingredients but different brands of drugs for the same disease, the entire course of treatment, gradually carry out？The application to the NHI Database has been drawn in the 2003 sample and archive, we've choosen born in 1997-2000 preschool children from age 3 to age 6, all with otitis media ICD-CM-9 diagnosis codes reported by outpatient service health insurance for population. Screening preschool children for the first time to use the brand drugs , import generic drugs or Taiwan-made generic drugs of Amoxicillin-clavulanate forthe treatment of antibiotic drugs, it is divided into three groups.Taking otitis media within 180 days of patients with the same Diagnostic codes are ICD-CM-9, we performed a retrospective analysis of all prescription drug costs and days of treatment, to compare the relevant usage. By using independent samples t test of statistica analysis, we compare to 149 screened preschool children with Amoxicillin-Clavulanate groups, pharmaceutical groups and the average expenditure on drugs between the different, According to the studies show the average drug costs each patient as treatment for six months is brand drugs group1 spending the hightest outcome, the second is Taiwan- made generic drugs group3 and the lowest costs is from the import of generic drugs group2. The average number of days on prescription, group 1 is longest, group 3, followed by, group 2 shortest. Either imported or Taiwan-made generic drugs, the overall course of six months, the average expenditure on drugs per patient are lower than those of the brand drugs. The best selection strategy of drug for medical institutions is the use of drugs imported generic drugs and in enhancing the quality of Taiwan-made generic drugs to be used after the stability and consistency in Taiwan after implementation of comprehensive DRG.Taking into acoount the effect and can save medical expenses. |
