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首页> 外文期刊>Frontiers in Public Health >Drug Utilization and Drug Pricing in the Private Primary Healthcare System in Malaysia: An Employer Price Control Mechanism
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Drug Utilization and Drug Pricing in the Private Primary Healthcare System in Malaysia: An Employer Price Control Mechanism

机译：马来西亚私募初级医疗系统中的药物利用和药物定价：雇主价格控制机制

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Uncontrolled drug pricing in the private healthcare system in Malaysia leads to high drug prices; however, its impact on employee drug utilization and employer reimbursement coverage is unclear. This study examined patterns of drug pricing and drug utilization among employees covered by employer medical insurance. A drug price control mechanism was also devised for the employer to ensure fair benefits to all parties without compromising the quality of patient care. This retrospective study was conducted among International Islamic University Malaysia (IIUM) community members who sought outpatient treatment at the IIUM panel of health clinics serviced by general practitioners from January 2016 to September 2019. Prescription data (drug type, dose, quantity, duration, price, and manufacturer), patient characteristics (age, sex, and diagnosis) and total charges were extracted from the claims database of PMCare, the insurance company managing IIUM medical claims. Patterns of commonly prescribed drugs, drug pricing, profit margins, and total charges per clinic visit were evaluated. Descriptive statistics were used, and all analyses were performed using Stata v15.1. There were a total of 161,146 prescriptions for 10,150 patients in the IIUM community during the study period (48.85% women, mean ± standard deviation; age: 26.33 ± 17.63 years). The most commonly prescribed drug was paracetamol (25.3%), followed by chlorpheniramine (9.46%), cetirizine (7.3%), diphenhydramine (6.13%), loratadine (4.57%), and diclofenac (4.36%). Generic paracetamol (500 mg), which serves as a prime example for details on drug pricing, is commonly charged between Ringgit Malaysia (RM) 5 and 10 for 10 tablets with a profit between 2,400 and 4,900% according to the average cost price of RM 0.20 per 10 tablets. Most patients were charged within the approved coverage limit of RM 45 per clinic visit, with only 2.41% of patients being charged with costs that exceeded this limit. Uncontrolled drug pricing in the private healthcare system in Malaysia indicates that drug prices differ greatly across private healthcare providers most of the prices were charged with high profit margins. Employers may consider a multilayer capping system to prevent inappropriate drug pricing, which will inevitably benefit patients clinically and economically and provide greater patient access to better drug treatment.
机译：马来西亚私人医疗保健系统中不受控制的药品定价导致药品价格高;然而，它对员工药物利用和雇主报销报告的影响尚不清楚。本研究检测了雇主医疗保险所涵盖的员工的药物定价和药物利用模式。还为雇主制定了药品价格控制机制，以确保所有缔约方的公平利益，而不会影响患者护理的质量。这项回顾性研究是在国际伊斯兰大学马来西亚（IIUM）社区成员之间进行的，在2016年1月至2019年1月的全科医生的卫生诊所寻求门诊治疗。处方数据（药物类型，剂量，数量，持续时间，价格和制造商），患者特征（年龄，性别和诊断）和总费用从索赔数据库中提取，保险公司管理IIUM医疗索赔。评估了普通规定的药物，药品定价，利润率和每诊所访问的总费用的模式。使用描述性统计数据，使用STATA V15.1进行所有分析。在研究期间，IIUM社区中10,150名患者共有161,146名处方（妇女48.85％，平均值±标准差;年龄：26.33±17.63岁）。最常见的药物是扑热氨基醇（25.3％），其次是氯苯那甲酰列（9.46％），十六羟嗪（6.3％），二合一羟基胺（6.13％），氯酰胺（4.57％）和双氯氟乙烯（4.36％）。作为药物定价细节的通用扑热酰胺（500mg），它通常在Ringgit Malaysia（RM）5和10之间充电，10片剂，其利润率为2,400和4,900％，根据RM的平均成本价格每10片0.20。大多数患者在每位诊所访问的批准覆盖范围内被指控，只有2.41％的患者被指控超过此限制。在马来西亚的私人医疗保健系统中不受控制的药物定价表明，私人医疗保健提供商的药品价格大部分都被收取高利润利润率。雇主可以考虑多层封装系统，以防止不适当的药物定价，这将在临床上和经济上不可避免地使患者受益，并提供更好的患者获得更好的药物治疗。

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