| dc.description.abstract | Since its inception in 1997, Taiwan′s National Health Insurance (NHI) policy has benefited the populace by not only catering to economically disadvantaged individuals but also by promoting widespread access to healthcare services, leading to a gradual increase in the average life expectancy of citizens. However, this expansion of coverage has also resulted in significant financial deficits for the NHI system. In response to these challenges, the National Health Insurance Administration (NHIA) under the Ministry of Health and Welfare has gradually adjusted the drug prices and implemented medication insurance payment mechanism covered by the NHI scheme to mitigate the financial burden on the system.
Therefore, this study aims to examine the factors influencing the reimbursement of antimicrobial agents under the NHI scheme over the years. It seeks to analyze the determinants of NHI drug reimbursement using hedonic price analysis. The research methodology involves establishing virtual variables based on the types of drugs listed in the NHIA′s announcements of reimbursable drug items from 2017 to 2022. Ordinary Least Squares (OLS) regression analysis is then employed to construct a price reimbursement model and analyze the significant factors affecting the overall reimbursement of antimicrobial agents, comparing them to control groups and identifying differences. Moreover, this research attempts to analyze the impact of NHI drug prices on the usage of antimicrobial agents across different drug categories. It establishes a demand analysis model using two-stage least squares methods (2SLS) to investigate the reasons for changes in both variables.
Therefore, this study aims to examine the factors influencing the factor of reimbursement for antimicrobial agents under the NHI over the years. It seeks to analyze the determinants of reimbursement factor for these medications. The research methodology involves establishing dummy variables based on the types of medications listed in the NHIA′s announcements of reimbursable drug items from 2016 to 2022. Ordinary Least Squares (OLS) regression analysis is then employed to identify significant factors affecting the overall reimbursement of antimicrobial agents. Moreover, the study investigates the reasons for compared to the control group and identifies any differences therein.
According to the empirical results of the price reimbursement model, annual usage exhibits a significant negative correlation. Regarding indications, antineoplastic drugs and immunosuppressants have the highest impact on drug reimbursement, followed by medications for the digestive system and metabolism, medications for the genitourinary system and hormonal-related medications, and systemic anti-infective agents, which show significant positive correlations. Conversely, anthelmintic drugs, medications for hemorrhoids, and hormonal medications exhibit significant negative correlations. Generic drugs, first-line medications, single-ingredient medications, and oral medications also show significant positive correlations, whereas injectable medications show significant negative correlations.
In the demand analysis model, among different drug categories, the demand elasticity for antineoplastic drugs, immunosuppressants, systemic anti-infective agents, and second-line medications is less than 1, while other medications do not exhibit this pattern. Injectable medications, on the other hand, show positive demand elasticity due to drug shortages and lack of alternatives, indicating that the uniqueness and urgency of medication usage can indeed influence demand elasticity. | en_US |