Pharmaceutical Economics and Policy

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出版者:Oxford University Press
作者:Stuart O. Schweitzer
出品人:
页数:352
译者:
出版时间:2006-10-1
价格:GBP 51.00
装帧:Hardcover
isbn号码:9780195300956
丛书系列:
图书标签:
  • 医药经济学
  • Pharmaceutical Economics
  • Health Economics
  • Pharmaceutical Policy
  • Healthcare Policy
  • Drug Pricing
  • Reimbursement
  • Market Access
  • Value Assessment
  • Cost-Effectiveness Analysis
  • Health Outcomes Research
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具体描述

Book Description

The pharmaceutical industry is praised as a world leader in high technology innovation and the creator of products that increase both longevity and quality of life for people throughout the world. At the same time, the industry is also criticized for its marketing and pricing practices and for its apparent anticompetitive responses to generic competition. Even its research and development priorities are criticized as being too closely driven by the goal of maximizing shareholder value, rather than the health of the public. Unfortunately, many of the critics of the industry fail to understand the complexities of the industry and its role in the nations healthcare system. This book uses the tools of economic analysis to explore the conflicting priorities and aims of the pharmaceutical industry, from both an American and worldwide perspective. This is the second edition of a uniquely comprehensive and balanced discussion of pharmaceutical policy issues. All the chapters of the former edition have been fully re-written and extensively updated. In addition, the book includes six new chapters on emerging topics such as the broadened role of FDA regulations and the increasing diversity of the industry. An entire chapter is devoted to the biotechnology industry and one to alternative medicines, often called "nutraceuticals." Another new chapter discusses segments of the industry that specialize in particular activities including generic drugs and drug delivery systems. The recent controversial expansion of Medicare to cover outpatient drugs is discussed in depth. The introduction is also updated to address the volatile pace of pharmaceutical innovation and how the pharmaceutical industry has responded to the emergence of managed care.

Book Info

Univ. of California, Los Angeles. Analysis of the pharmaceutical industry with suggestions for regulatory approaches that will serve the industry and its customers. --This text refers to the Hardcover edition.

7 of 7 people found the following review helpful:

Regrettably, out of date..., March 7, 2004

By Dr. van der Linden (Williamstown, NJ) - See all my reviews

This review is from: Pharmaceutical Economics and Policy (Hardcover)

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...since its publication in 1997, for during the interval we've had (among other developments):

(1) The Food and Drug Administration Modernization Act (FDAMA '97),

(2) The promulgation of the Pharmaceutical Research and Manufacturers of America (PhRMA) Code on Interactions with Healthcare Professionals (2002), and

(3) The federal Department of Health and Human Services (DHHS) formally weighing in with their final "anti-kickback" guidance from the Office of their Inspector General (OIG), incidentally shutting the door between pharmaceuticals marketing and the drug manufacturers' "support" of continuing medical education (CME) on April 28, 2003.

(4) New concerns regarding drug safety issues (both pre- and post-marketing) have been raised by way of the COX-2 NSAID crisis, particularly by Merck's defalcations in the suppression of adverse events data in the 2000 publication of their VIGOR trial results (see Waxman's editorial in *The New England Journal of Medicine*, June 23, 2005;352[25]:2576-2578), and have invoked structural and procedural changes in the FDA's Office of New Drugs (OND) the end of which is not yet in sight.

(5) Medicare Part "D" has gone into effect, with NICE long-term implications for future impact upon the pharmaceutical industry in these United States.

Things have *changed,* folks. There's ten years' worth of critically important regulatory and pharmacoeconomic changes that neither the author nor the rest of the industry could have taken into consideration back when the galleys of this book were returned to the publisher. To the best of my knowledge, there is still no other source of information on the subject as ambitious (and as competently written) as is Dr. Schweitzer's work. Both author and publisher must certainly be aware of the fact that there is a need (and a definite market) for a new edition.

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14 of 14 people found the following review helpful:

most comprehensive book on the Pharmaceutical market, August 26, 2000

By P. Caetano "pcaetano" (Maineville, OH United States) - See all my reviews

This review is from: Pharmaceutical Economics and Policy (Hardcover)

I believe the book is useful for everyone in The Pharmaceutical Industry. It will be useful for reps, higher management, physicians, technicians, scientists, product and regulatory affairs managers and just about anyone who wants to "think outside the box" of their specific role within the industry. Despite its broad range the book is succinct, never vague, and contains a plethora of useful information. I came across this book without never having heard about the author and with the sole purpose of finding specific economic data. I found that and much more. What an astonishing surprise the book was. The book presents the most comprehensive and intelligently condensed information about the overall pharmaceutical market forces, that I saw recently. specific to the industry. For instance, the short Chapter (2) on marketing Pharmaceuticals offers more important data and contextual information than most books entirely dedicated to Pharmaceutical marketing. In a little more than 20 pages the author manages to provide useful information about sales forces management and economic analysis, including joint marketing, along with definitions about all types of promotional materials and relevant organizations for promotion of Pharmaceuticals, including Continuing Medical Education and the FDA's Division of Marketing. In the even shorter chapter on pricing, the author starts by cleverly laying out the fundamentals of supply and demand for Pharmaceuticals and goes on to quantitatively and contextually explain the worldwide differences. Overall the book has information just about any Pharmaceutical market topic; from all of the non-life sciences issues associated with pre-clinical development of drugs to the structure and future trends of the industry. All this information is easy to find because the book is simply organized in internal analysis (the industry) versus external analysis (consumer, market, public and private influential institutions). I'm truly impressed with the depth and range of knowledge displayed in this book, so much so that if I wasn't working for The Pharmaceutical Industry already I would approach Professor Schweitzer for a postdoctoral research. Comment | Permalink | Was this review helpful to you? (Report this)

9 of 10 people found the following review helpful:

Review of Pharmaceutical Economics and Policy, April 24, 2000

By A Customer

This review is from: Pharmaceutical Economics and Policy (Hardcover)

I commend the author's attempt to provide a comprehensive review of pharmaceutical economics and policy in less than three hundred pages. This book is an interesting read and is accessible to those of us who are not economists. However, I would not recommend this book to others due to the facts that (1) the author is inconsistent in referencing the literature and (2) he often fails to present alternative interpretations of the empirical evidence. For example, the author uses evidence of price discrimination to demonstrate the "importance of consumer demand" in the pricing of pharmaceuticals and, by extension, the presence of competition in the pharmaceutical market (pgs. 103-105). However, he fails to point out that price discrimination by pharmaceutical companies reduces consumer surplus, a direct benefit of competitive markets. In addition, the book contains many typos that may prove distracting to some readers. Comment | Permalink | Was this review helpful to you? (Report this)

医药经济学与政策研究前沿:跨学科视角下的深度探索 本书导论:全球健康体系的演进与挑战 在二十一世纪,全球公共卫生体系正面临着前所未有的复杂性与挑战。人口老龄化加速、慢性病负担加剧、医疗技术飞速发展以及资源分配不均等问题,使得医疗体系的可持续性受到严峻考验。本书汇集了来自经济学、公共卫生、政治科学和管理学领域的顶尖学者,旨在提供一个跨学科、多维度的分析框架,深入剖析影响当代医疗体系的关键驱动力与政策选择。我们关注的焦点不仅在于衡量医疗支出的效率与公平性,更在于理解政策制定、市场结构与患者行为之间的复杂互动关系。 第一部分:医药经济学基础与计量方法 本部分聚焦于医药经济学的核心理论框架与前沿的计量经济学应用。我们摒弃了传统的、孤立的成本效益分析视角,转而探讨在信息不对称和外部性普遍存在的医疗市场中,如何构建更具现实意义的经济模型。 第一章:医疗需求、供给与市场失灵的再审视 本章系统梳理了健康经济学中关于医疗需求(包括弹性、保险效应与收入效应)的经典理论,并引入了行为经济学(Behavioral Economics)的最新见解。我们探讨了“非理性”的患者决策如何影响医疗服务的消费模式,以及医疗技术进步如何重塑供给侧的生产函数。重点分析了医疗市场中典型的市场失灵(Market Failure)案例,如逆向选择(Adverse Selection)与道德风险(Moral Hazard)在药品研发和医疗服务提供中的具体表现形式及其政策含义。 第二章:药物研发经济学与激励机制设计 新药研发是支撑现代医学进步的核心动力,但其高风险、高投入和高不确定性的特性使其成为一个独特的经济领域。本章深入剖析了专利保护、政府补贴(如研发税收抵免和“优先审评券”)对研发激励的综合影响。我们通过对不同创新模式(如靶点发现、临床试验外包)的成本结构分析,提出了优化研发投资组合的量化模型。此外,本章还探讨了孤儿药(Orphan Drugs)和抗生素研发等特殊领域中,市场激励失灵的克服路径。 第三章:经济评价前沿:从成本效益到价值感知 传统的健康经济评价(HEE)方法,如成本效益分析(CEA)和成本效用分析(CUA),在评估复杂疾病和长期干预措施时面临局限。本章着重介绍了如何整合患者报告结局(PROs)和生活质量指标(QALYs)的局限性,并引入了“基于价值的医疗”(Value-Based Healthcare)的经济学基础。我们详细阐述了概率敏感性分析(PSA)在处理临床不确定性中的应用,并讨论了如何构建能够捕捉长期健康轨迹和代际公平性的动态模型。 第二部分:医疗支付体系与资源配置的博弈 医疗支付方是资源分配的关键决策者。本部分将重点分析不同支付模式(如多付者、单一支付者、混合模式)下,激励机制如何被扭曲或优化,并探讨了如何设计能有效控制成本、同时确保质量的支付改革方案。 第四章:支付方策略与服务提供者的反应 本章详细对比了基于服务量(Fee-for-Service, FFS)、基于病例组合(Diagnosis-Related Groups, DRG/DIP)以及按人头付费(Capitation)等不同支付方式的经济学效应。我们运用博弈论分析了支付方与医疗机构之间的价格谈判策略,以及支付模式的转变(如从FFS到基于价值的支付)对医疗机构的投资决策(如设备采购、人员配置)产生的连锁反应。 第五章:医疗保险市场结构与公平性 在本章中,我们超越了简单的风险调整模型,探讨了商业健康保险市场中的竞争结构、市场集中度对保费水平和承保范围的影响。通过对不同司法管辖区(如美国、欧洲)的经验数据分析,我们量化了保险范围的扩大(如强制性参保)对医疗服务可及性(Access)和公平性(Equity)的净效应。重点讨论了如何利用风险池划分和共付比例设计,在控制道德风险和实现社会公平之间找到平衡点。 第六章:药物可及性与价格管制:全球经验比较 药品价格是各国医疗支出增长的主要驱动力之一。本章详细考察了从直接价格管制(如参考定价、集中采购)到间接激励(如谈判权力)等一系列政策工具的经济学后果。我们通过比较不同国家(如加拿大、澳大利亚、日本和新兴市场)的经验数据,评估了价格下调政策对药物创新供给的长期冲击,并分析了集中采购(Volume-Based Procurement)对全球制药供应链的结构性影响。 第三部分:健康政策的治理、效率与政治经济学 医疗政策的实施往往受到政治考量、治理结构和制度惯性的深刻影响。本部分关注政策制定的过程、不同利益相关者的权力博弈以及跨部门协作的挑战。 第七章:卫生技术评估(HTA)的治理与效能 卫生技术评估(HTA)机构在决策链中的作用日益凸显。本章探讨了HTA机构的独立性、透明度和科学严谨性如何影响其政策采纳率。我们对比了不同国家HTA机构(如NICE, ICER, IQWiG)的评估流程与标准,并分析了制药行业游说活动对评估结果的潜在影响。核心议题在于,如何将科学证据转化为具有政治可行性的、资源分配的决策。 第八章:卫生人力资源的市场失衡与政策干预 医生、护士及其他卫生专业人员是医疗服务的核心供给要素。本章分析了卫生人力资源配置中的市场失衡现象,如地理分布不均、专业选择偏好等。我们运用劳动经济学模型,评估了收入预期、工作条件和专业声誉对医学生专业选择的决定性影响。此外,本章还探讨了远程医疗和任务转移(Task Shifting)政策在缓解基层医疗服务短缺中的经济学潜力与实施障碍。 第九章:健康不平等与政策干预的经济学评估 健康不平等(Health Inequality)不仅是社会公平问题,也是潜在的经济效率损失。本章将健康结果(如预期寿命、患病率)作为内生变量,研究了收入差距、教育水平和社会决定因素(Social Determinants of Health, SDOH)对健康产出的贡献。我们详细评估了旨在缩小不平等的公共政策(如针对贫困社区的定向投资、社会福利计划)的成本效益,并提出了在资源有限条件下优先干预的经济学排序原则。 结论:面向可持续未来的政策取向 本书最后总结了当前医药经济学与政策研究的共同发现,强调了数据科学、因果推断方法在理解复杂医疗系统中的不可替代性。我们认为,未来的健康政策改革必须建立在对激励机制的深刻理解之上,致力于构建一个既能有效激励创新,又能保障全民可及性和公平性的可持续医疗体系。本书旨在为政策制定者、研究人员和行业领导者提供一把理解和重塑全球健康经济蓝图的钥匙。

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2011-06-02读毕,初学者应该读可以开阔眼界,另外可以用之学习写作

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