在意大利推广仿制药的严厉法规与软弱法规
Aarushi Dhingra1, Gianluca Fiorentini2, Ayman Fouda3
1Department of Economics, University of Bologna, Bologna, Italy. aarushi.aarushi@unibo.it.
概括
意大利推广仿制药的法规取得了适度的成功,强制性法律比推更有效. 诸如全科医生竞争和专家互动等因素影响了通用处方率.
科学领域:
- 卫生政策
- 制药经济学
- 公共卫生
背景情况:
- 优化多机构关系对于有效的医疗保健政策至关重要.
- 一般药物和品牌药物之间的处方选择对医疗保健成本和患者的结果产生重大影响.
- 之前促进仿制药使用的干预措施取得了不同结果.
研究的目的:
- 评估意大利法规对全科医生 (GPs) 处方行为对仿制药和品牌药物的影响.
- 评估软 (建议) 与强制性 (强制性) 法律对仿制药的不同影响.
- 探索影响通用处方率异质性的因素.
主要方法:
- 使用时间框架中的回归不连续性和事件研究分析.
- 在意大利的埃米利亚-罗曼尼亚,使用的季度行政数据与全科医生的数据联系在一起.
- 在2012年实施两项不同的立法干预之前和之后分析了处方数据.
主要成果:
- 实施的政策在影响处方选择方面表现出有效性,尽管通用药物处方的总体增加很小.
- 与建议相比,强制性法律 (严格法律) 在推动转向通用处方方面发挥了更重要的作用.
- 在一般医生之间竞争较少,与专家互动较强的地区, 一般药物处方较高.
结论:
- 监管干预可以影响医生的处方行为,但它们对通用药物的吸收的影响可能是适度的.
- 条例的严格性 (强制性或推性) 是它们有效性的关键决定因素.
- 医疗保健系统的特点,如医生竞争和跨学科合作,可能会抑制旨在促进仿制药使用的政策的成功.
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