Abstract
While most drug policy researches paid attention to the financial impact of expensive drugs, the market situation of low-priced drugs in a country was seldom analyzed. We used the nationally representative claims datasets to explore the status within the National Health Insurance (NHI) in Taiwan. In 2007, a total of 12,443 distinct drug items had been prescribed 853,250,147 times with total expenditure of 105,216,950,198 new Taiwan dollars (NTD). Among them, 7,366 oral drug items accounted for 701,353,383 prescribed items and 68,133,988,960 NTD. Besides, 2,887 items (39.2% of oral drug items) belonged to cheap drugs with the unit price ≤1 NTD (about 0.03 of US dollar). While the top one item among all oral drugs had already a market share of 5.0%, 30 items 30.3% and 107 items 50.0%, the cheap drugs with aggregate 332,893,462 prescribed items (47.5% of all prescribed oral drug items) only accounted for 2,750,725,433 NTD (4.0% of expenditure for oral drugs and 2.6% of total drug expenditure). The drug market of Taiwan's NHI was abundant in cheap drugs. The unreasonably low prices of drugs might not guarantee the quality of pharmaceutical care and the sustainability of a healthy pharmaceutical industry in the long run.
Highlights
The growth of drug expenditure is a global issue
Among all the oral pills, nearly onefourth of drug items are with a unit price between 0.5 and 1 new Taiwan dollars (NTD) and totally 38.0% of drug items are cheaper than 1 NTD (Table 1)
7,366 oral drug items accounted for 701,353,383 prescribed items (82.2% of total prescribed items) and 68,133,988,960 NTD (64.8% of total drug expenditure)
Summary
The growth of drug expenditure is a global issue. Many governments have endeavored to control the drug expenditure in order to enhance the availability and affordability of drugs. While most people pay attention to expensive drugs with the intention of cost control, a special phenomenon within the pharmaceutical sector of the NHI in Taiwan deserves careful study; the market is abundant in low-priced drug items. These drugs, mostly belonging to generics, might be the legacy of pharmaceutical regulations in earlier days of Taiwan. The one-sided policy of setting low prices without persistent and extensive quality control might be detrimental to both the health of beneficiaries and the future of the pharmaceutical industry in Taiwan. A retrospective study is needed to observe the situation of low-priced drugs within the NHI before further discussions and measures can be undertaken
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