醫院換藥潮 VIP才能用原廠藥

[oldlarge]

http://udn.com/NEWS/HEALTH/HEA1/8575076.shtml

【聯合晚報╱記者黃玉芳/台北報導】
2014.03.27 03:05 pm

抗生素「克痢黴素」現缺藥危機

調整藥價已經產生「副作用」，讓嚴重感染病患使用的抗生素「克痢黴素」恐缺藥？有藥師表示，藥廠反映因健保核價低，購買製造藥物的原料不敷成本，面臨缺藥。另外也有藥廠私下表示，醫院已出現換藥潮，某些私立醫院坦言，雖有進原廠藥，但數量不多，「VIP」患者才有機會用原廠藥。

健保調整藥價控制支出，但每次調整藥價，都讓藥廠叫苦，認為台灣藥價偏低，連老藥也不敷成本。去年以來，陸續有抗生素盤尼西林長效劑型、化療藥物解毒劑葉酸鈣等發生缺藥，最後都專案進口應急

台灣臨床藥學會理事長王春玉說，最近便宜、好用的後線抗生素Colistin注射劑也傳出缺藥，原因是藥廠反映，台灣採購製藥原料的用量不大，難以跟原料藥業者議價，又因為健保給付價低，藥廠不可能增加成本購買原料藥生產。

王春玉說，其他用來替代的抗生素價格高，且很可能有抗藥性問題。為了解決缺藥，有時醫院會採購不同劑量的藥品替代，但藥師需要分裝，等於增加藥師的負擔。

藥廠怨 原廠藥半退出私立大醫院

也有藥廠私下抱怨，許多原廠藥幾乎「半退出」私立大醫院，雖然醫院還是有進原廠藥，但數量不多，且醫師開藥會以國產、學名藥為主，只有「VIP」級病人才有機會使用原廠藥。

健保署醫審及藥材組長施如亮說，會持續密切注意是否有缺藥情形，對於爭議較大的三同政策，施如亮說，包括長庚等醫院，早就以同成分藥品作為競標的條件，意謂醫院也認同此作法且是可行的。

[min]

醫院只是將本求利，何時認同健保署的作法？

[a4610]

http://udn.com/NEWS/HEALTH/HEA1/8575076.shtml

【聯合晚報╱記者黃玉芳/台北報導】
2014.03.27 03:05 pm

抗生素「克痢黴素」現缺藥危機

調整藥價已經產生「副作用」，讓嚴重感染病患使用的抗生素「克痢黴素」恐缺藥？有藥師表示，藥廠反映因健保核價低，購買製造藥物的原料不敷成本，面臨缺藥。另外也有藥廠私下表示，醫院已出現換藥潮，某些私立醫院坦言，雖有進原廠藥，但數量不多，「VIP」患者才有機會用原廠藥。

健保調整藥價控制支出，但每次調整藥價，都讓藥廠叫苦，認為台灣藥價偏低，連老藥也不敷成本。去年以來，陸續有抗生素盤尼西林長效劑型、化療藥物解毒劑葉酸鈣等發生缺藥，最後都專案進口應急

台灣臨床藥學會理事長王春玉說，最近便宜、好用的後線抗生素Colistin注射劑也傳出缺藥，原因是藥廠反映，台灣採購製藥原料的用量不大，難以跟原料藥業者議價，又因為健保給付價低，藥廠不可能增加成本購買原料藥生產。

王春玉說，其他用來替代的抗生素價格高，且很可能有抗藥性問題。為了解決缺藥，有時醫院會採購不同劑量的藥品替代，但藥師需要分裝，等於增加藥師的負擔。

藥廠怨 原廠藥半退出私立大醫院

也有藥廠私下抱怨，許多原廠藥幾乎「半退出」私立大醫院，雖然醫院還是有進原廠藥，但數量不多，且醫師開藥會以國產、學名藥為主，只有「VIP」級病人才有機會使用原廠藥。

健保署醫審及藥材組長施如亮說，會持續密切注意是否有缺藥情形，對於爭議較大的三同政策，施如亮說，包括長庚等醫院，早就以同成分藥品作為競標的條件，意謂醫院也認同此作法且是可行的。

(挖鼻孔) (挖鼻孔)

[李誠民]

台灣健保品質倒退到比勞保時代還爛的 時代,; ....只有VIP使用,那不是只有長庚, 新光, 亞東等財團才可以使用!!!....還有台大 榮總等大醫學中心(照顧政治人物為主)

[李誠民]

早就是了!!!抗癌藥只能用兩個療程(?!).....,不是台大 榮總這些教授搞得嗎?!.....美國是貧 富都享有法案(Act)保障; 所以缺藥是普遍的---生理食鹽注射液缺貨!!!

[李誠民]

早就是了!!!抗癌藥只能用兩個療程(?!).....,不是台大 榮總這些教授搞得嗎?!.....美國是貧 富都享有法案(Act)保障; 所以缺藥是普遍的---生理食鹽注射液缺貨!!!

讓我想起台大嚴燦星教授,有學者風範!!!

[hjh]

標題表面上很殺
但其實沒什麼
VIP 可能另有贊助 或者有什麼特權可以威脅醫療機構的
比如是什麼偽善團體的盟主之類的
那當然醫療機構必須乖乖的賠本服務
這是被迫的
能不賠本，誰要賠本？

[mowball]

共產主義當然只有特權才有好貨 (打小人)

[sunday]

既然認定原廠,台廠藥效一樣
何必在乎誰用原廠藥,誰用台廠藥呢

[李誠民]

“VIP 可能另有贊助 或者有什麼特權可以威脅醫療機構的
比如是什麼偽善團體的盟主之類的”…王貴芬事件, 就是好例子!!!

沒有長庚縱容地方的政治勢力(還只是鄉代表!!!...台塑也太摟了吧!!!);;u有了醫院暴力法(?)有解決問題嗎?!...只是幫台X (長庚)解套而已!!!!......它現在是賺長庚生技的錢, 不需要中國大陸幫忙嗎?!

[smallant]

既然認定原廠,台廠藥效一樣
何必在乎誰用原廠藥,誰用台廠藥呢

超級大正解
(爽) (爽) (爽)

[現代仁醫]

不過再來的注射用20cc生理食鹽水也要調整售價從3-4元漲到10元以上，
相信會有很多院所會拿大包的N/S分抽來 稀釋藥物，
品質有提升嗎！

[cwhung]

付陽春麵的錢
本來就只能吃陽春麵

有啥好哭夭的 (挖鼻孔)

[kwojohn]

既然認定原廠,台廠藥效一樣
何必在乎誰用原廠藥,誰用台廠藥呢

超級大正解
(爽) (爽) (爽)

[gucci37]

付陽春麵的錢
本來就只能吃陽春麵

有啥好哭夭的 (挖鼻孔)

+1

[Sawa]

好笑， VIP 也買不到藥好嗎
院方換藥沒進就沒進了.
要說真的VIP買的到藥，大概要很大的VIP，例如藥廠老闆，醫院董事長
然後拿到藥大概都是自費的。

[gary]

樓上說對了

[jesuischinoise]

抗癌藥只能用兩個療程(?!)

真的嗎?
不是該打就打? (咦)

[newshine]

換藥潮應該是指健保署吧
(挖鼻孔) (挖鼻孔) (挖鼻孔)

敵不動
我不動

此乃大原則是也

[施肇榮]

早就是了!!!抗癌藥只能用兩個療程(?!).....,不是台大 榮總這些教授搞得嗎?!.....美國是貧 富都享有法案(Act)保障; 所以缺藥是普遍的---生理食鹽注射液缺貨!!!

讓我想起台大嚴燦星教授,有學者風範!!!

美國是貧 富都享有法案(Act)保障~~

美國的醫療結果費用超過是由醫師負責嗎??

年度藥費總額超過，先扣除醫療勞務給付，以點值來做調整嗎??

[hjh]

樓上第二行的 美 是不是應該改成 我
(咦)

[Einstein]

健保署認為原廠藥和學名藥同品質，所以價錢一樣，難怪原廠藥要退出台灣市場，下面這些學名藥和原廠藥在健健保署的認定是同品質歐！ (爽) (爽) (爽)

督保盟：違規藥品沒下架 健保還給付
衛福部食藥署月初公布33項藥品擅自變更賦形劑未通報，須重做生體相等性試驗(BE)，包括知名藥廠五洲、南光等皆被點名，衛福部則宣布這些藥品需要先下架。不過，民間監督健保聯盟今(30)天質疑，食藥署發給健保署、衛生局的公文仍寫明這33項藥品「安全無虞」，卻沒要求下架，甚至還維持健保給付，根本是在護航藥廠。

由於違規的11家藥廠中，有9家是通過食藥署PIC/S GMP認證的藥廠，督保盟即批評，這些認證反而是「藥」命保證。督保盟召集人黃淑英指出，違規的33項藥品很多是降血壓藥、心血管用藥，食藥署應該立刻重做BE，確認變更賦形劑到底會不會影響吸收，並清查全部獲得PIC/S GMP認證的藥廠。

督保盟發言人滕西華說，這些違規藥廠大多獲得優良認證，而且通過品質認證的藥品，還可以獲得較高的健保給付，加上其中27項藥品已上市約15年，食藥署每5年換藥證，卻沒盡好把關責任，這些大廠何來「優良」、「品質」可言。

對此，食藥署科長祁若鳳回應，12月已陸續要求需重做BE藥效試驗的藥品下架，今天下午就可以確認下架名單，無法做BE的藥品必須撤銷藥證或回歸原處方生產。她指出，這些違規藥品並無嚴重違規到需要取消認證，大多屬未經核准擅自變更賦形劑，依《藥事法》可罰3到15萬元。

[李誠民]

謝謝施肇榮醫師,您是全聯會理事!!!...提供醫些藥品專利權(Patent)與國際貿易的觀念---現在是講區域經濟(自歐盟成立以來, 30 多年了); WTO(World Trade Organization )是美國霸權主義下的產物!!!.....請參考!!!...

The production of generic drugs in India
BMJ 2011; 342 doi: http://dx.doi.org/10.1136/bmj.d1694 (Published 22 March 2011)
Cite this as: BMJ 2011;342:d1694

The European Union is negotiating a trade agreement with India, the consequences of which will be serious for billions of people living in developing countries. Government officials in India are focused on economic growth and are keen to complete a trade deal with the EU. In exchange for market access in other areas of the economy, the EU wants India, a country with very low per capita incomes, to embrace tough new rules on ownership and enforcement of intellectual property for medical inventions.
The EU is now the world’s largest economy; its gross domestic product (GDP) was estimated at more than $16.4 trillion (£10.2 trillion; €11.8 trillion) in 2009—about 28% of the entire world’s GDP


Bayer challenges India’s first compulsory licence for generic version of cancer drug
BMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e6015 (Published 6 September 2012)
Cite this as: BMJ 2012;345:e6015

An Indian court is to issue a landmark judgment in the coming weeks after German drug company Bayer appealed a decision to over-rule its patent on the cancer drug sorafenib (marketed as Nexavar) so that a local producer could make a much cheaper version.
India’s patent controller issued a compulsory licence in March to local company Natco, which has since made the kidney and liver cancer drug sorafenib tosylate for $175 (£110; €139) per month, 97% less than the cost of sorafenib.
……Natco is paying a 6% royalty on sales to Bayer…..

But new patent laws, introduced at the request of the World Trade Organisation, mean that many of the latest drugs for HIV and other life threatening diseases are now patented and cheaper versions cannot be made.
Medical aid agency Médecins Sans Frontières (MSF), which buys 80% of the HIV drugs it uses worldwide from Indian companies and treats 170 000 HIV patients, hopes that Bayer will lose this case, or drop it, and more compulsory licences will be issued in future.

Meanwhile, Swiss drug company, Novartis, is currently pursuing a patent in India for its leukaemia drug, imatinib mesylate, known as Glivec.1 Campaigners say the drug should not be patented because it is just a new formulation of existing medicines. If the patent is granted, they warn, many more patents could be given for similar new formulations, further diminishing India’s ability to produce generics. India’s Supreme Court is due to rule on 11 September on the case.


Novartis challenges India’s drug patent laws in Supreme Court
BMJ 2012; 344 doi: http://dx.doi.org/10.1136/bmj.e1279 (Published 21 February 2012)
Cite this as: BMJ 2012;344:e1279
The interpretation of India’s drug patent laws is being challenged in the country’s Supreme Court by the drug company Novartis. Campaigners say that if the challenge is successful it will restrict access of developing countries to generic drugs.
Novartis is seeking a new patent for the anticancer drug imatinib mesilate (which it markets as Glivec) in a case that will begin in the court on 28 February.


India remains on US trade “priority watch list” for failing to uphold international drug company patents
BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f2949 (Published 8 May 2013)
Cite this as: BMJ 2013;346:f2949
The US government has said that it is seriously concerned about recent rulings in India on drug patenting that have favoured the country’s generics industry over international drug companies.
In its annual report on intellectual property protection by trading partners, the Office of the US Trade Representative has kept India on its “priority watch list,” citing recent decisions by Indian courts to deny international companies exclusive rights over anticancer drugs that they had developed. The report also said that India had made limited progress in 2012 in improving its weak legal framework on intellectual property rights and the enforcement system………
………
Médecins Sans Frontières, the international medical aid agency, said in a statement, “The US Trade Representative’s decision to place India on its annual trade ‘watch list’ is a bully tactic being used to punish the country for taking steps to ensure access to affordable, lifesaving medicines and to prevent other developing countries from following similar strategies.”
However, the trade body the Pharmaceutical Research and Manufacturers of America complained that the US government had not launched an “out of cycle review,” which could have accelerated the process of engagement to resolve the issues.
It said, “Over the past year the government of India has issued several IP [intellectual property] decisions that have disproportionately impacted US biopharmaceutical companies and a number of other innovative sectors. The IP regime in India has been structured and applied in ways that prop up local industries to the detriment of US jobs and the world’s patients.”......

有人口就有消費市場,國家(區域)人口愈多,在貿易談判時,就主導發言權(所以有最強的歐盟? 蘇俄? 東南亞國協--+1, +2, .....+10 最強大!!!)......太累了!!! 再說吧!!!藥學系的基本是藥廠代表(Saleman); 因為他們經濟學常識比醫師好太多了!!!.....全聯會理事長有政治與經濟觀嗎?!

[施肇榮]

謝謝施肇榮醫師,您是全聯會理事!!!...提供醫些藥品專利權(Patent)與國際貿易的觀念---現在是講區域經濟(自歐盟成立以來, 30 多年了); WTO(World Trade Organization )是美國霸權主義下的產物!!!.....請參考!!!...

The production of generic drugs in India
BMJ 2011; 342 doi: http://dx.doi.org/10.1136/bmj.d1694 (Published 22 March 2011)
Cite this as: BMJ 2011;342:d1694

The European Union is negotiating a trade agreement with India, the consequences of which will be serious for billions of people living in developing countries. Government officials in India are focused on economic growth and are keen to complete a trade deal with the EU. In exchange for market access in other areas of the economy, the EU wants India, a country with very low per capita incomes, to embrace tough new rules on ownership and enforcement of intellectual property for medical inventions.
The EU is now the world’s largest economy; its gross domestic product (GDP) was estimated at more than $16.4 trillion (£10.2 trillion; €11.8 trillion) in 2009—about 28% of the entire world’s GDP


Bayer challenges India’s first compulsory licence for generic version of cancer drug
BMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e6015 (Published 6 September 2012)
Cite this as: BMJ 2012;345:e6015

An Indian court is to issue a landmark judgment in the coming weeks after German drug company Bayer appealed a decision to over-rule its patent on the cancer drug sorafenib (marketed as Nexavar) so that a local producer could make a much cheaper version.
India’s patent controller issued a compulsory licence in March to local company Natco, which has since made the kidney and liver cancer drug sorafenib tosylate for $175 (£110; €139) per month, 97% less than the cost of sorafenib.
……Natco is paying a 6% royalty on sales to Bayer…..

But new patent laws, introduced at the request of the World Trade Organisation, mean that many of the latest drugs for HIV and other life threatening diseases are now patented and cheaper versions cannot be made.
Medical aid agency Médecins Sans Frontières (MSF), which buys 80% of the HIV drugs it uses worldwide from Indian companies and treats 170 000 HIV patients, hopes that Bayer will lose this case, or drop it, and more compulsory licences will be issued in future.

Meanwhile, Swiss drug company, Novartis, is currently pursuing a patent in India for its leukaemia drug, imatinib mesylate, known as Glivec.1 Campaigners say the drug should not be patented because it is just a new formulation of existing medicines. If the patent is granted, they warn, many more patents could be given for similar new formulations, further diminishing India’s ability to produce generics. India’s Supreme Court is due to rule on 11 September on the case.


Novartis challenges India’s drug patent laws in Supreme Court
BMJ 2012; 344 doi: http://dx.doi.org/10.1136/bmj.e1279 (Published 21 February 2012)
Cite this as: BMJ 2012;344:e1279
The interpretation of India’s drug patent laws is being challenged in the country’s Supreme Court by the drug company Novartis. Campaigners say that if the challenge is successful it will restrict access of developing countries to generic drugs.
Novartis is seeking a new patent for the anticancer drug imatinib mesilate (which it markets as Glivec) in a case that will begin in the court on 28 February.


India remains on US trade “priority watch list” for failing to uphold international drug company patents
BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f2949 (Published 8 May 2013)
Cite this as: BMJ 2013;346:f2949
The US government has said that it is seriously concerned about recent rulings in India on drug patenting that have favoured the country’s generics industry over international drug companies.
In its annual report on intellectual property protection by trading partners, the Office of the US Trade Representative has kept India on its “priority watch list,” citing recent decisions by Indian courts to deny international companies exclusive rights over anticancer drugs that they had developed. The report also said that India had made limited progress in 2012 in improving its weak legal framework on intellectual property rights and the enforcement system………
………
Médecins Sans Frontières, the international medical aid agency, said in a statement, “The US Trade Representative’s decision to place India on its annual trade ‘watch list’ is a bully tactic being used to punish the country for taking steps to ensure access to affordable, lifesaving medicines and to prevent other developing countries from following similar strategies.”
However, the trade body the Pharmaceutical Research and Manufacturers of America complained that the US government had not launched an “out of cycle review,” which could have accelerated the process of engagement to resolve the issues.
It said, “Over the past year the government of India has issued several IP [intellectual property] decisions that have disproportionately impacted US biopharmaceutical companies and a number of other innovative sectors. The IP regime in India has been structured and applied in ways that prop up local industries to the detriment of US jobs and the world’s patients.”......

有人口就有消費市場,國家(區域)人口愈多,在貿易談判時,就主導發言權(所以有最強的歐盟? 蘇俄? 東南亞國協--+1, +2, .....+10 最強大!!!)......太累了!!! 再說吧!!!藥學系的基本是藥廠代表(Saleman); 因為他們經濟學常識比醫師好太多了!!!.....全聯會理事長有政治與經濟觀嗎?!

全聯會理事長有政治與經濟觀嗎?!

全聯會許多的醫院教授理事，有沒有政治與經濟觀我不知道

但，我是絕對沒有

我只在意法律制定上，對我方合不合理

[hitachi]

不用談「原廠」、「台廠」
以furosemide，有名的Lasix來說
早早就換台廠學名藥了
就算如此
平平是台廠
還是可以「愈換愈沒效」

沒有最cost down
只有更cost down

小弟等著看「消毒用的棉支只剩鼻屎大」……
(原本拇指大)

說真的，我沒差…

[李誠民]

"全聯會許多的醫院教授理事，有沒有政治與經濟觀我不知道

但，我是絕對沒有"........????
政治學與經濟學是很廣泛的 學問!!!如果醫師(尤其理事 理事長)沒有政治與經濟觀(常識!!!);; 就只好被江教授,各所謂學者...等支流玩弄!!!....如何保障病人(Patient)的權益嗎?!...您想當Blumbler了嗎?!

[施肇榮]

"全聯會許多的醫院教授理事，有沒有政治與經濟觀我不知道

但，我是絕對沒有"........????
政治學與經濟學是很廣泛的 學問!!!如果醫師(尤其理事 理事長)沒有政治與經濟觀(常識!!!);; 就只好被江教授,各所謂學者...等支流玩弄!!!....如何保障病人(Patient)的權益嗎?!...您想當Blumbler了嗎?!

知之為知之～～

事情的完成是需要團隊
讀幾篇文章自稱專家的半桶水一堆實在太多
造成現今的亂象

無法觀全貌時
就要虛心的說不知道
當稱職的小螺絲即可

ps.網路上遣詞用字請小心，千萬不要人身攻擊