Pharmaceutical penetration of new drug and pharmaceutical market structure in Taiwan: hospital-level prescription of thiazolidinediones for diabetes.
This study used Taiwan's National Health Insurance claim database (years 2000-2005) to examine how thiazolidinediones (TZD), a new class of drugs for diabetes, penetrated into Taiwan's hospitals, and its association with the concentration of all diabetes drugs at the hospital level. We collected 72 monthly summaries of diabetes prescriptions from all hospitals in Taiwan. Hospital-level pharmaceutical concentration was measured by penetration of TZD, defined as monthly market share of TZD in each hospital. Concentration of diabetes drugs was measured by Herfindahl-Hirschman indices. We found a negative association (coefficient = -0.3610) between TZD penetration and concentration of diabetes drug but a positive association between penetration of TZD and the volume of prescribed diabetes drugs (coefficient = 0.4088). In conclusion, hospital characteristics and volume of services determined the concentration of pharmaceuticals at the institution level, reflecting the heterogeneous competition between pharmaceutical companies within each hospital. Institution-level pharmaceutical concentration influences the adoption and penetration of new drugs.
Tsai
Yi-Wen
YW
Institute of Population Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan, Miaoli 350, Taiwan.
Wen
Yu-Wen
YW
Huang
Weng-Foung
WF
Kuo
Ken N
KN
Chen
Pei-Fen
PF
Shih
Hsin-Wei
HW
Lee
Yue-Chune
YC
D016208:Databases, Factual; D003920:Diabetes Mellitus / Q000188:drug therapy*; D004345:Drug Industry; D004465:Economic Competition; D006761:Hospitals / Q000145:classification / Q000706:statistics & numerical data*; D006801:Humans; D008389:Marketing of Health Services; D009313:National Health Programs / Q000706:statistics & numerical data; D004364:Pharmaceutical Preparations / Q000191:economics; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D013624:Taiwan; D045162:Thiazolidinediones / Q000191:economics* / Q000627:therapeutic use
D004364:Pharmaceutical Preparations; D045162:Thiazolidinediones