Drug price control has little effect on controlling drug cost growth

The original intention of drug price control is to control drug cost Many European countries have implemented drug price control in order to reduce drug expenses These drug price control measures include freezing price, cost pricing, profit pricing and reference pricing of foreign drug prices However, the practice of developed countries and the empirical research on the effect of drug price control show that: drug price control can not effectively control the increase of drug costs, and guiding doctors and patients to use drugs reasonably is the key to control the increase of drug costs France, Japan and Canada all provide plenty of examples in this regard Due to strict drug price control, the average drug price in France is the lowest in Europe However, due to high drug consumption, the drug cost accounts for 17% of the medical cost, which is far higher than the level of 10% in the UK and 12.4% in the United States, where the drug is freely priced The practice of drug price control in Japan also proves this point The drug price control measures implemented in Japan from 1980 to 1993 resulted in the increase of prescriptions and the price of new drugs, resulting in an increase of 59% in the overall drug cost In the same way, Canada has adopted strict control policies on drug prices, but there is no effective measures to guide doctors to use drugs reasonably, resulting in the rapid growth of drug costs In fact, we can understand why drug price control policy can not effectively control the increase of drug cost by decomposing the factors that affect drug cost Drug cost is equal to the sum of drug price multiplied by quantity, so the increase of drug cost can be divided into three items: the increase of drug price; the increase of drug use quantity; the increase of drug cost caused by the change of drug variety combination The so-called change of drug variety combination refers to the substitution of high price drugs (often new drugs) for low price drugs (often traditional generic drugs) A large number of literatures analyzing the reasons for the increase of drug costs show that the main reasons for the increase of drug costs are the increase of drug use and the change of drug varieties, not the increase of drug prices For example, according to the analysis of the data of prescription drugs in the United States, from 1994 to 2000, the average annual growth rate of drug costs in the United States was 12.9%, of which only 2.7% was due to the rise of drug prices, and the remaining 10.2% was due to the increase of drug use and the change of drug varieties Another analysis of the reasons for the increase of drug costs in Italy shows that in 2001, the drug costs in Italy increased by 13.5% compared with 2000, of which the growth rate from drug use was 9.5%, the growth rate from the change of drug varieties was 4.8%, and the drug prices fell by 1% during this period From 1992 to 2000, the average annual growth rate of drug cost in the UK was 8.7%, while during this period, the average annual decline of drug price was 1.8%, the annual growth rate of drug use was 4.9%, and the change of drug mix accounted for 5.4% The annual report of Canada in 2002 pointed out that the growth rate of patent drug cost in 2002 was 13.9% compared with that in 2001, while the price of patent drugs actually decreased by 1.2% in 2002, and the use of patent drugs increased by 15.5% According to the above data, the price of controlled drugs is not an effective measure to control the drug cost The increase of drug cost mainly comes from the increase of drug use and the change of drug variety combination China's drug price control practice once again confirms this conclusion: in the past decade, the national development and Reform Commission has taken more than 20 drug price reduction actions covering thousands of drugs, which did not reach the policy intention of controlling drug costs, but led to the negative effect of squeezing the cheap generic drugs with reliable efficacy out of the drug market, and also spawned a large number of so-called innovative drugs with inflated prices In general, the growth rate of drug cost in countries with more drug price control measures (such as France, Spain and Japan) is not lower than those with less drug price control measures (such as Switzerland, the United Kingdom and the United States) Moreover, drug price control policies not only fail to control drug costs, but also distort the resource allocation of the pharmaceutical industry and the production and operation behavior of pharmaceutical enterprises.