On the control of drug economics in drug costs in the role of the

        Abstract How to control the rising cost of medicines has now become an urgent need to solve the problem. PharmacoEconomic study to address this issue provides a new tool. In this paper, the definition of drug Economics, Research methods, implementation steps and the role were introduced.
        KEY WORDS PharmacoEconomics Drug Cost Control
        In recent years, China's medical expenses of 30% annual rate, far beyond the gross domestic product growth rate of about 10%, which has seriously affected China's Economic development and people's living standards. How to control the rapid growth of medical expenses have become a primary concern and we need to address the problem. Drug costs are an important part of medical expenses, medical costs in the whole occupies a large proportion of medical costs that affect the rapid growth of the main factors. At present the hospital's business in China, 50% of revenue comes from drugs, and therefore the focus of Health care costs under control is one of how to control the rapid growth of drug costs.
        Control the rapid growth of drug costs, the key is to clarify the reasons for rising drug costs, then solve the problem. Drug costs caused by the rapid growth of many factors, but summed up no more than two aspects: First, rational factors that uncontrollable factors, such as population growth and aging, disease spectrum changes, chronic diseases increased, the residents to increase Health awareness, drug costs increased and so on; 2 it is unreasonable to factors such as price management is flawed, medical compensation mechanisms are inadequate to drugs to support medical care, medication management lax, the current Health care system is plagued by problems and improper use of medicines and so on.
        Drug cost control from the providers of medical services that the hospital paid side, the demand side so that the patient start with a focus on as much as possible to meet the medical needs of the people on the basis of controlling the rising cost of some unreasonable factors, the core is a reasonable use of limited Health resources to ensure equity in Health services and special needs of.
        In controlling drug costs at home and abroad has taken a number of practical ways, such as drug use evaluation [1], drug price controls, risk-sharing contracts [2], to develop the basic medical directories and health insurance agent directory, the implementation of 'total control, structural adjustment ', the reform of urban workers and the health care system that is cost-sharing [3], as well as the professional moral education. Of these methods to control the rising cost of medicines is indeed played a key role, but there are also some shortcomings. First, it more consideration to the price of drugs at the expense of cost-effectiveness of drugs, so its short-term rise in controlling drug costs, while drug costs may bring the long-term rise; 2 is its provision of medical services and demand side the control side with a certain amount of forced, did not give full play to their initiative. The Economic evaluation of drugs can compensate for this defect, it from the drug cost and treatment of two point of view, a comprehensive evaluation of drug therapy cost-effectiveness.
        1, Pharmacoeconomics.
        (A) Definition: Pharmacoeconomics (pharmacoeconom ics) is the drug therapy on health-care system and the human society to pay the cost and have an effect description and analysis. Specifically, application of modern economics, economics of drug Research tools, combined with epidemiology, decision science, biostatistics and other multi-disciplinary Research, comprehensive analysis of different drug treatment programs, drug treatment programs and other programs, such as surgery treatment and different medical or social service projects, such as social pensions and family care costs, benefits or effects and effectiveness, evaluate the economic value of the difference. Pharmacoeconomics services include the health care system for all participants: government administrative departments, units of health care providers, health insurers, doctors and patients. Pharmacoeconomics now has developed into an emerging interdisciplinary by a growing number of Researchers attention.
        (B) Research Methods: The pharmacoeconomic research methods are mainly four kinds: Cost-minimization analysis (co stm in im izat ion analysis, CMA), cost-effectiveness analysis (co st effect iveness analysis, CEA), cost-utility analysis (co st ut ility analysis, CUA) and cost-benefit analysis (co st benef it analysis, CBA).
        1. Minimum Cost Analysis: Cost-minimization analysis is exactly the same effects in clinical cases, compared to what medication, including other medical intervention program cost is minimized. It first must prove that two or more of the drug treatment program the results of no significant difference, and then analyzed to identify those who minimize the cost. Because it required the clinical treatment of drug effects, including efficacy, side effects, duration, exactly the same scope of application than its predecessor.
        (Reposted elsewherein the free papers download ht tp:?? W ww 1hi1381net) 2. Cost-effectiveness analysis: cost-effectiveness analysis is a more complete form of a comprehensive economic evaluation to compare differences in health outcomes and cost differences, the results of the unit Health effect of increasing the cost of the value of the cost-effectiveness ratio indicated. Its characteristics are not treatment outcomes expressed in monetary units, while the use of clinical indicators, such as: to save the number of patients, the extended years of life, the cure rate and so on. The ratio of cost-effectiveness analysis indicated that two kinds of commonly used methods: (1) cost and effect of the ratio law: the cost and effectiveness ratio, that is, each produces an effect of the costs. (2) additional costs and the additional effect of the ratio law: is, if given an extra cost, is able to generate additional effects, cost-effectiveness analysis, while limited by its effect units, can not be a comparison between the different clinical effects, but the results easily for clinical medical personnel and public acceptance is a common means of drug economics. [Free Paper Download Center hi138.com]
        3. Cost-utility analysis: Cost-utility analysis is the development of cost-effectiveness, and cost-effectiveness have many similarities. To some extent, both measured in monetary costs, and measuring results are also using clinical indicators as a measure of parameters of the final outcome. The difference is cost - effectiveness as a purely biological indicators, such as prolonging life time, weight gain, reducing the number of such blood pressure. In contrast, cost-utility analysis of the results were closely related to the quality, noting the requirements of the patient quality of life using utility function change, that is commonly used unit is the quality-adjusted life years (qualityadju sted life years, QAL Y), rather than health outcomes change. Drug treatment can be of different measures of the disease compared to the drug in recent years by the respected economic research methods. However, different diseases affect different aspects of life of patients, generic quality of life indicators do not reflect the special nature of the disease, therefore, the research community for the pharmacoeconomic cost-utility analysis of the reasonableness of the still controversial.
        4. Cost-benefit analysis: Cost-benefit analysis is a cost and outcome of currency units are measured economic analysis. And cost-effectiveness analysis is the result of different monetary forms, and it not only has the advantages of an intuitive easy to understand, but also universal, not only can compare the different drugs of the same disease, the treatment efficiency, but also for different diseases between treatments comparison, even the treatment of diseases and other public investment projects, such as public investment in education more suitable for comprehensive health and public investment decisions. However, many in the short-term clinical effects of changes, such as prevalence, mortality, disability status is difficult to measure in monetary units, the long-term effects of data with little or very comprehensive, and economists outside the clinical medical staff and the public it is difficult to accept the currency is measured in units of the life, health, monetary value. Therefore, the cost-effectiveness analysis in health economics and pharmacoeconomics research, the application of far less than the cost-effectiveness analysis.
        (C) the implementation of the steps: Pharmacoeconomic analysis of the implementation of the required 10 steps to complete: (1) a clear pharmacoeconomic research problems; (2) the establishment of research point of view; (3) the establishment of treatment programs and results; (4 ) Select the appropriate pharmacoeconomic method; (5) the results of monetary value; (6) The distinction between resources; (7) to establish the results of the probability of the event; (8) decision analysis; (9) conduct a cost-sensitive or by cash or the amount of cost analysis; (10) outcome.
        Must be clear of drugs economics research problems and research perspectives.
        Pharmacoeconomic point of view may come from the community, paid side, institutions, departments, patients, any or a combination of all of these parties. Second, we must distinguish between treatment programs and their associated positively or negatively consequences. The drug of choice economics analysis methods of its treatment outcomes expressed in monetary value. Drug acquisition costs and medical costs and clinical results is included in the cost of being directly related to, but also from literature or historical records, but also it can be built on the basis of reasonable assumptions.
        Second, economic studies of drugs in controlling the role of rising drug costs.
        Pharmacoeconomics not only focus on the cost of drug treatment, but also concerned about the outcome of drug treatment and thus in controlling drug costs has a strong scientific and acceptability. The role of pharmacoeconomics through the following aspects to manifest.
        (A) to guide development of new drugs production: our policy is a socialist market economy, in a market economy, demand for commodities depends on the value and quality of goods. Although drugs, as a special commodity, but it still has the characteristics of general merchandise, their needs depends on the drugs the same value and quality (effects). Cost-effectiveness of drugs (effective) the greater the greater the demand. Therefore, manufacturers who develop and produce drugs, we must develop and produce a cost of as much as possible - with good effects drugs, and thus obtain the required profit. Drug manufacturers in accordance with the results of pharmacoeconomic studies to decide whether or produce certain drugs or drug prices in complying with the principles developed under the premise of the appropriate lower the price of drugs in order to enhance cost-effectiveness of drugs.
        (B) for the development of national basic medical insurance, reimbursement of medical drugs Range: At present, China's 'National Essential Drugs List' are mainly based on clinical need to consider, namely, the safety and effectiveness of drugs, economic factors, the price factor to consider a more less. The drug list applies to all people, mainly to guide and standardize the behavior of clinical medicine. The scope of the basic Medicare drug medical drug selection based on write-off 'National Essential Drugs List' as the basis of the formation. Medication verification has taken into consideration the scope of clinical needs, but also to consider economic and other factors. Economic factors, mainly refers to the treatment of drug prices, it does not take into account the course of drug treatment of other costs, such as inspection laboratory services, hospitalization fees; it does not consider the drug cost - effectiveness ratio or cost-benefit ratio, and thus there is a certain amount of defects. Currently overseas such as Australia and Canada in determining the scope of drug claims, in addition to required manufacturers to provide drugs for safety and efficacy data, also requires manufacturers to provide the drug and domestic treatment of the same disease, the most commonly used drug or the appropriate non-pharmacological treatments compare and contrast objects, as the results of drug economics, the National Steering Committee will refer to the results of pharmacoeconomics to make a decision whether to grant reimbursement.
        (C) to help develop the hospital medicine hospital directory, regulate medical drugs:
        At present many of our provinces and municipalities in order to control rapidly rising medical costs, the introduction of 'total control, structural adjustment' policy. The basic idea is to increase the value of the medical staff services, reducing hospital drug revenues, so that the growth rate of control of drug expenses in a certain range. The implementation of this policy on the use of medicines at the hospital put forward new demands. It requires the hospital as much as possible the use of good efficacy, low prices of drugs, that is, a good cost-effectiveness of drugs would be a good cost-effectiveness of drugs into the hospitals, drug directories, so that the growth rate of control of drug costs within the limits prescribed in the policy. Pharmacoeconomics research findings will help hospitals to better drugs are cost-effective drugs chosen for inclusion in the hospital directory. At the same time, the hospital can regulate the formulation of drug directory doctors drug acts to prevent improper use of medicines.
        (D) to determine the scope of application of drugs: Any drugs are not a panacea, have a certain scope of application. Suffering from certain diseases and effective drug for one group to another group is not necessarily effective, its cost-effectiveness is also low. For example, cholesterol-lowering drug for the treatment of a certain risk factors for hypercholesterolemia patients, is recognized as a good cost-effective treatment measures, but for pure hypercholesterolemia patients, then the cost-ineffective. Ruoqiang cholesterol-lowering drug for the treatment of a number of risk factors is not simple hypercholesterolemia patients, are not only not reduce medical costs, on the contrary will lead to rising medical costs. Pharmacoeconomics is the study of specific populations of disease-specific cost-effectiveness of drug treatment, so its highly targeted purpose clearer.
        (E) to help the patient the right choice of drugs: With economic development and people's living standard and cultural qualities and health care system reform, the patient's sense of self-care will be gradually increased, the special nature of the medical service market will thus change not purely medical services, supply-side market, in particular, pharmaceutical services, more and more patients will be to go to the medical store selection and purchase of medicines. Therefore, the patient information needs relating to drugs will increase, particularly in the price of medicines, effects and cost-effectiveness.
        Patients want a better cost-effective drugs, pharmaceutical economics to meet the needs of patients in this regard.
        Pharmacoeconomics from many different medicines to control the cost of the rapid rise in economic studies of drugs in our country to carry out a very important practical significance, must be given drugs to control drug costs economics in the role in place. At present, China's pharmaceutical economics has just begun, many people do not on their understanding, little is known about the state in the formulation of 'the scope of public health drug claims' not fully consider the economic characteristics of pharmaceutical drugs. So from now on we must vigorously carry out advocacy and research in pharmaceutical economics work, and countries such as Australia and Canada will be included in the economics of drug provisions, give full play to the role of pharmacoeconomics.
        References:
        1 Cha Chung Ling a study of a pharmaceutical drug utilization Journal of Epidemiology, 1996, 2: 112.
        2 ZHENG Peng-controlled health care plan a United States drug policy a foreign medical management of a hospital volumes, 199,414: 165.
        3 Yu Shi Guang a medical insurance system for workers in China introduced the reform of a Chinese pharmacy, 1997, 1:3. [Free Paper Download Center]