Background

Previous studies have shown that financial strategies are beneficial for improving the appropriate use of antibiotics within a limited period of time. Long-term effects have rarely been explored.

Methods

This study evaluated the changes in expenditure and prescription patterns of antibacterial agents under the global budget (GB) program and drug price adjustment of a National Health Insurance scheme. Two structural methods, i.e., the Laspeyres method and Fisher’s Ideal Index decomposition method, were used to illustrate the impacts of price, volume and drug change.

Results

During the first 5 years of the GB program (i.e., 2001-2006), the expenses of antibacterial agents increased by 54.1%, while the volume decreased by 11-21.3%. Therapeutic choice was the predominant cause of expense growth. In the second and third 5-year periods (i.e., 2006-2011 and 2011-2016), the driving force of therapeutic choice gradually decreased. The antibacterial expense remained stable with a slight increase in prescription volume. Periodic price adjustment contributed steadily to cost containment, by 21.9 to 39.9%.

Conclusion

The GB program led to a remarkable increase in antibacterial expenses, which was mainly attributed to therapeutic choice, especially in the early stage. Periodic price adjustment, in contrast, provided steady benefits to pharmaceutical budget control without a noticeable increase in drug volume.

中文翻译：

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全球预算计划和定期价格调整对抗菌药物的长期影响：2001年至2016年全国分解分析

背景

先前的研究表明，财务策略有利于在有限的时间内提高抗生素的适当使用。长期影响很少被探讨。

方法

本研究评估了全球预算（GB）计划和国民健康保险计划药品价格调整下抗菌药物支出和处方模式的变化。采用Laspeyres法和Fisher理想指数分解法两种结构方法来说明价格、数量和药品变化的影响。

结果

在国标计划实施的前5年（即2001-2006年），抗菌药物的费用增加了54.1%，而数量则减少了11-21.3%。治疗选择是费用增长的主要原因。在第二个和第三个5年期间（即2006-2011年和2011-2016年），治疗选择的驱动力逐渐下降。抗菌药物费用保持稳定，处方量略有增加。定期价格调整对成本控制的贡献稳定，增幅为21.9%至39.9%。

结论

GB计划导致抗菌费用显着增加，这主要归因于治疗选择，尤其是在早期阶段。相比之下，定期价格调整为药品预算控制带来了稳定的好处，而药品数量没有明显增加。