藥業經營者面對二代健保實施的因應措施

• Main Author: 陳光冠
• Language: 中文
• Published: 國立政治大學
• Subjects: 二代健保; 台灣藥業經營領導者; 環境變革; 藥價政策; 藥價調查; 藥品支付目標; 2G NHI; Taiwan pharmaceutical leaders; change management; pharmaceutical benefit scheme; price volume survey; drug expenditure target
• Online Access: http://thesis.lib.nccu.edu.tw/cgi-bin/cdrfb3/gsweb.cgi?o=dstdcdr&i=sid=%22G0097932023%22.

全民健康保險自1995年三月實施，提昇國人健康及疾病治療水準，有其正面的貢獻，但也影響了醫療相關的從業者甚巨。藥品的費用占率約全部健保費用的百分之二十五，是除了醫事服務相關費用之外，占率最高的費用。健康保險局，收支潛在的赤字在健保實施次年後已浮現，隨即採用多種藥費及藥價控管措施。新藥核價過低、過程耗時；已上市的藥品，除每兩年健保局的藥價調查後的全面性調降，和不定時的異常品項調查外，尚需面臨客戶端再次降價的要求。對於藥業營運已有顯著的負面影響。 再者現行的健保制度，保證醫療院所藥品的申報一律為健保給付價，無論其以多低的價格採購，中間的價差利潤皆歸之所有，俗稱藥價黑洞，外界難以了解其對醫療體系的運作的重要性，一味的譴責之！事實上於現行總額給付實施之下，可彌補醫療院所健保給付不足所造成的營運困難，使民眾得以持績享受價平質佳的醫療照護。然負面影響為無法提昇病患痊癒效率，也對醫事人員專業的養成，及産業的發展伏下隱憂。健保制度沿於現有的法源，法源不改，扭曲的現象續存，最終的受害者為全體民眾。 二代健保法於2011年元月立法院三讀通過。產業環境的遊戲規則勢必改變。經由訪談，二十家不同類型的藥品供應廠商的經營領導者，於新的健保法實施之際的應變措施，且其合計市占率已超過整體藥品市場的41 %。由深度訪談中，可了解不同類型的廠商，對新制度的看法及其因應措拖的異同，再佐以近代管理學的概念檢視對照不同的領導風格，推估其和產業的特性及未來發展生存之道的關連性，或許可提供予産業長遠發展的建議。 歸納本研究的重要結論為：台灣藥業環境變動是漸進的，易被輕忽影響度；且從事藥業廠商者眾不易形成共識，很難共同努力改善環境不利的變動；依靠新産品的開發取得，是藥業重要成長的策略。於經營者的研究結論：發現大多數的領導者的强項為執行力及銷售力，這可能和産品生命週期長，進入門檻高有關；但因之不利改變慣例，跳脱舒適圈，將公司導向更兼具靈活彈性又與環境更符合的營運模式。未來成長的契機在於領導者洞悉未來的趨勢；藥業營造有利趨勢，在於跳脱近親繁殖，取法於外。 === National Health Insurance has been launched on March, 1995. It has been recognized as the safeguard to the improvement for all country’s residents. The financial burden of BNHI has struggled to balance its books from early on. Drug costs contributed about 25% of NHI healthcare spending, therefore is controlled mainly through pricing and reimbursement policy, particularly the regular rounds of price cut. The current system allows health providers gain profit from drug purchasing under negotiations with pharmaceutical companies which subsidizes the insufficient reimbursement for other service to patients. All these system hamper the healthcare industry sound growth. Without healthcare reform cannot correct the system toward healthier operation. Winder reform in the shape of 2G NHI Act was finally passed by the Legislative Yuan in January 2011. The future NHI scheme will change in many areas. In order to understand the counter actions from pharmaceutical industry, the study is designed to interview 20 leaders in Rx companies which included different types such as MNC, domestic and agencies. The overall revenue from the 20 companies shared over 41% in Taiwan pharmaceutical industry. The study will compare and analyze the difference from each company’s actions toward the future change, from results to use modern business scholarship theory checking any particular similarity within the industry. The main findings of the study are 1) The change of environment is easily been neglected for moving slowly and gradually, 2) To shape environment toward the positive side is difficult since hard to have consensus within industry, 3) Introduction of new products is the main growth strategy, 4) The most strength leadership capability from the interviewees is the execution, and the possible explanations are longer products life cycle plus higher entry barriers from new competitors. The downside of this type of leadership is hard to flexibly move fast in developing new business model to match the environment evolution. In-depth understanding trend of leaders will be the key of future success. The industry might learn from other industries to shape the environment more effectively.