A Discussion on NHI Pharmaceutical Price Gap in Taiwan

Presenter: Juei-Hua Lee, NHI Supervisory Committee

Abstract

Objectives: In NHI pharmaceutical reimbursement there exists the issue of price gap. Hospitals or other providers gain profit margin between the reimbursement price and the acquisition price. Methodology: The study has examinated the types and causes of prices gap, influences on the medical market and the public by carrying out literature review. It also reviewed the legality, denotation of price gap and what the reasonable gap is. Result:Our results indicated :(1) executing reimbursement prices generated prices gap; (2) pharmaceutical price gap is not illegal; (3) the price gap will affect the medical rights of people; (4) reasonable prices gap will be benefitial to the healthcare-provider, pharmacist, consumer and NHI sector. Conclusions: According to our research findings, we suggest: (1) lower the R-Zone value in patent and under review drugs; (2) implement the flexible Price Volume Surveys and the standardized procedure; (3) lower the ratio of pricing between generic and original drugs; (4) serious penalties are in place for intentionally fraudulent data reporting and implement the claw-back mechanisms; (5) implement the Separation of Dispensing from Prescribing completely and release the chronic disease prescriptions.