突破品牌:一项关于日本药房-医院-患者关系和仿制药使用的观察性研究
Ayame Fujimoto1, Rong Fu2, Haruko Noguchi3
1Waseda Institute of Social and Human Capital Studies, Tokyo, Japan.
BMJ open
|May 21, 2025
概括
药房与医生和患者的关系对日本的仿制药 (GE) 使用有重大影响. 更强大的医院-药房联系促进了GE的使用,而患者-药房联系则取决于上下文,为更广泛的GE采用提供了政策信息.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 制药政策 制药政策
- 医疗保健管理的管理
背景情况:
- 通用药物 (GE) 的使用对于医疗保健成本控制和可访问性至关重要.
- 了解利益相关者关系对GE处方模式的影响对于优化医疗保健系统至关重要.
- 日本独特的医疗保健结构需要检查医生,药剂师和患者关于使用GE的互动.
研究的目的:
- 调查医生,药剂师和患者之间的关系与日本医疗保健系统内的仿制药 (GE) 使用之间的关联.
- 量化医院药房和患者药房处方度对GE发行率的影响.
- 为制定促进转基因利用的政策提供基于证据的见解.
主要方法:
- 一项观察性研究利用了从2015年4月到2021年3月的纵向医疗索赔数据.
- 分析了来自日本各地的药店的数据,这些药店为全国医疗保险协会的受益人提供服务.
- 包括69,395家药房,导致322,097家药房年度观察,以确定分发的GE的数量份额.
主要成果:
- 更高的医院处方度始终与增加的GE使用有关 (1.12.3个百分点高).
- 患者处方度与GE使用总体呈现积极关联,但在医院度低的地区呈现负面关联.
- 药房规模和城市化程度改变了这些关系,较小的药房显示出更强的医院集中效应,较大/较小的城市药房显示出更强的患者集中效应.
结论:
- 药房与利益相关者的关系,特别是医院与药房的联系,在日本显著影响着仿制药的使用.
- 患者和药店之间的关系显示出了上下文的有效性,突出了对量身定制的政策方法的需求.
- 通过度率来衡量这些关系,为了解药物发行决策和为有效的GE推广政策提供信息提供了一种新的方法.
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