scholarly journals Effects of Volume-Price Contracts on Pharmaceutical Prices: A Retrospective Comparative Study of Public Hospitals in Hubei of China

2021 ◽  
Vol 12 ◽  
Author(s):  
Zhuoxian Li ◽  
Chaojie Liu ◽  
Keyuan Zuo ◽  
Junjie Liu ◽  
Yuqing Tang

Background: Pharmaceutical expenditure has been increasing worldwide. Many countries have attempted to contain the increase through collective bargaining, including in China. In 2015, the Chinese government introduced a new policy to empower regional governments to reduce pharmaceutical prices through its existing tendering system which enables a lower price for products with higher procurement volumes. Xiangyang municipality in Hubei province took a lead in piloting this initiative.Objectives: This study aimed to evaluate the effects of the volume-price contract initiative on pharmaceutical price procured by the public hospitals in Xiangyang.Methods: A retrospective comparative design was adopted. The price of cardiovascular medicines (349 products under 164 International Nonproprietary Names) procured by the public hospitals in Xiangyang was compared with those procured in Yichang municipality in Hubei. A total of 15,921 procurement records over the period from January 2017 to December 2018 were examined (Xiangyang started the volume-price contract initiative in January 2018). Generalized linear regression models with a difference-in-differences approach which could reflect the differences between the two cities between January 2018 and December 2018 were established to test the effects of the volume-price contract initiative on pharmaceutical prices.Results: On average, the procurement price for cardiovascular medicines adjusted by defined daily dosage in Xiangyang dropped by 41.51%, compared with a 0.22% decrease in Yichang. The difference-in-differences results showed that the volume-price contract initiative resulted in a 36.24% drop (p = 0.006) in the price (30.23% for the original brands, p = 0.008), in addition to the therapeutic competition effect (31.61% reduction in the price, p = 0.002). The top 100 domestic suppliers were highly responsive to the initiative (82.80% drop in the price, p = 0.001).Conclusion: The volume-price contract initiative has the potential to bring down the price of pharmaceutical supplies. Higher responses from the domestic suppliers are evident.

2019 ◽  
pp. 109-123
Author(s):  
I. E. Limonov ◽  
M. V. Nesena

The purpose of this study is to evaluate the impact of public investment programs on the socio-economic development of territories. As a case, the federal target programs for the development of regions and investment programs of the financial development institution — Vnesheconombank, designed to solve the problems of regional development are considered. The impact of the public interventions were evaluated by the “difference in differences” method using Bayesian modeling. The results of the evaluation suggest the positive impact of federal target programs on the total factor productivity of regions and on innovation; and that regional investment programs of Vnesheconombank are improving the export activity. All of the investments considered are likely to have contributed to the reduction of unemployment, but their implementation has been accompanied by an increase in social inequality.


Author(s):  
Zifeng Liang

Facing climate risks has become a common problem for mankind and a topic of great importance for the Chinese government. To thoroughly implement the overall requirements for the construction of an ecological civilization and effectively improve the capacity of cities to adapt to climate change, China launched the pilot construction of “Climate Resilient Cities” in 2017. In this paper, 16 prefecture level cities in Anhui Province of China were selected as the research objects, and the multi-level grey system evaluation method was used to measure the climate resilience of these regions. We used the difference in differences method to evaluate the effect of the pilot policy of “Climate Resilient Cities.” The pilot policies of the “Climate Resilient Cities” showed a significant contribution to the regional climate resilience, and, after isolating the impact of other factors on the regional climate resilience, the pilot policies of the “Climate Resilient Cities” increased the climate resilience of the pilot cities by four percentage points. The pilot policies of the “Climate Resilient Cities” had a significant contribution to the urban infrastructure development and ecological space optimization, as well as non-significant impacts to the urban water security, emergency management capacity-building, and science and technology innovation initiatives.


Author(s):  
Stuart O. Schweitzer ◽  
Z. John Lu

This chapter provides a detailed examination of pharmaceutical pricing strategies in the United States. It points out that pharmaceutical expenditure as a share of total healthcare spending has historically been quite low in comparison to that of hospitalization and physician services. It identifies several common measures of pharmaceutical prices, and highlights the difference in conclusions reached based on different measures. It offers a critical review of several models used to explain pharmaceutical price behavior, which are grouped into three major categories: market structure models, R&D cost-based models, and product quality or value based models. The chapter concludes that prices of brand-name drugs in the United States are largely driven by product quality attributes, not cost of R&D. Lastly, the chapter examines the impact of generic entry on price.


Author(s):  
Zhensheng Chen ◽  
Xueli Chen ◽  
Xiaoqing Gan ◽  
Kaixuan Bai ◽  
Tomas Baležentis ◽  
...  

Many countries are facing the increasing cost of healthcare services and the low efficiency of public hospitals. These issues are also evident in China. This paper offers a comprehensive assessment of the efficiency of public hospitals operating in China’s 31 regions. The impact of the third round of reform of the health system in 2009 is assessed based on the three-stage data envelopment analysis procedure. The time period from 2011 to 2018 is covered in this study. Due to different functions performed by the public hospitals and other ones, the number of patients with infectious diseases is incorporated as an output variable reflecting the social function. The outpatient visits and inpatient visits are considered to reflect the outputs related to the private functions. The results imply an increase in the mean efficiency of public hospitals from 0.927 to 0.981 after taking the impact of environmental variables and statistic noise into account. These results indicate that the efficiency of public hospitals is dependent in the operational environment. There are 11 regions whose hospitals operate on the efficiency frontier during the whole period covered. Therefore, the Chinese government should reasonably design and apply the regulatory tools to improve the efficiency of public hospitals.


2018 ◽  
Vol 2 (3) ◽  
pp. 111
Author(s):  
Aswindar Adhi Gumilang ◽  
Tri Pitara Mahanggoro ◽  
Qurrotul Aini

The public demand for health service professionalism and transparent financial management made some Puskesmas in Semarang regency changed the status of public health center to BLUD. The implementation of Puskesmas BLUD and non-BLUD requires resources that it can work well in order to meet the expectations of the community. The aim of this study is to know the difference of work motivation and job satisfaction of employees in Puskesmas BLUD and non-BLUD. Method of this research is a comparative descriptive with a quantitative approach. The object of this research are work motivation and job satisfaction of employees in Puskesmas BLUD and non-BLUD Semarang regency. This Research showed that Sig value. (P-value) work motivation variable was 0.019 smaller than α value (0.05). It showed that there was a difference of work motivation of employees in Puskemas BLUD and non-BLUD. Sig value (P-value) variable of job satisfaction was 0.020 smaller than α value (0.05). It showed that there was a difference of job satisfaction of BLUD and non-BLUD. The average of non-BLUD employees motivation were 76.59 smaller than the average of BLUD employees were 78.25. The average of job satisfaction of BLUD employees were 129.20 bigger than the average of non-BLUD employee were 124.26. Job satisfaction of employees in Puskesmas BLUD was higher than non-BLUD employees.


MedienJournal ◽  
2017 ◽  
Vol 30 (2-3) ◽  
pp. 37
Author(s):  
Li Xiguang

The commercialization of meclia in China has cultivated a new journalism business model characterized with scandalization, sensationalization, exaggeration, oversimplification, highly opinionated news stories, one-sidedly reporting, fabrication and hate reporting, which have clone more harm than good to the public affairs. Today the Chinese journalists are more prey to the manipu/ation of the emotions of the audiences than being a faithful messenger for the public. Une/er such a media environment, in case of news events, particularly, during crisis, it is not the media being scared by the government. but the media itself is scaring the government into silence. The Chinese news media have grown so negative and so cynica/ that it has produced growing popular clistrust of the government and the government officials. Entering a freer but fearful commercially mediated society, the Chinese government is totally tmprepared in engaging the Chinese press effectively and has lost its ability for setting public agenda and shaping public opinions. 


Author(s):  
Azhari Amri

Film Unyil puppet comes not just part of the entertainment world that can be enjoyed by people from the side of the story, music, and dialogue. However, there is more value in it which is a manifestation of the creator that can be absorbed into the charge for the benefit of educating the children of Indonesia to the public at large. The Unyil puppet created by the father of Drs. Suyadi is one of the works that are now widely known by the whole people of Indonesia. The process of creating a puppet Unyil done with simple materials and formation of character especially adapted to the realities of the existing rural region. Through this process, this research leads to the design process is fundamentally educational puppet inspired by the creation of Si Unyil puppet. The difference is the inspiring character created in this study is on the characters that exist in urban life, especially the city of Jakarta. Thus the results of this study are the pattern of how to shape the design of products through the creation of the puppet with the approach of urban culture.


2001 ◽  
Vol 15 (4) ◽  
pp. 345-358 ◽  
Author(s):  
John E. McEnroe ◽  
Stanley C. Martens

The auditing “expectation gap” refers to the difference between (1) what the public and other financial statement users perceive auditors' responsibilities to be and (2) what auditors believe their responsibilities entail. The notion of this divergence receives much attention in the accounting literature (i.e., Commission on Auditors' Responsibilities 1978; Guy and Sullivan 1988; AICPA 1993; U.S. Government Accounting Office 1996). Although prior empirical studies encompass certain expectations associated with a range of audit services, these papers often involve the opinions of bankers as the primary user group employed in the research (Nair and Rittenberg 1987; Lowe and Pany 1995). In contrast, this study extends the prior research by directly comparing audit partners' and investors' perceptions of auditors' responsibilities involving various dimensions of the attest function. We conducted the study to determine if an expectation gap currently exists and we find that it does; investors have higher expectations for various facets and/or assurances of the audit than do auditors. Our findings serve as evidence that the accounting profession should engage in appropriate measures to reduce this expectation gap.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kate McBride ◽  
Daniel Steffens ◽  
Christina Stanislaus ◽  
Michael Solomon ◽  
Teresa Anderson ◽  
...  

Abstract Background A barrier to the uptake of robotic-assisted surgery (RAS) continues to be the perceived high costs. A lack of detailed costing information has made it difficult for public hospitals in particular to determine whether use of the technology is justified. This study aims to provide a detailed description of the patient episode costs and the contribution of RAS specific costs for multiple specialties in the public sector. Methods A retrospective descriptive costing review of all RAS cases undertaken at a large public tertiary referral hospital in Sydney, Australia from August 2016 to December 2018 was completed. This included RAS cases within benign gynaecology, cardiothoracic, colorectal and urology, with the total costs described utilizing various inpatient costing data, and RAS specific implementation, maintenance and consumable costs. Results Of 211 RAS patients, substantial variation was found between specialties with the overall median cost per patient being $19,269 (Interquartile range (IQR): $15,445 to $32,199). The RAS specific costs were $8828 (46%) made up of fixed costs including $4691 (24%) implementation and $2290 (12%) maintenance, both of which are volume dependent; and $1848 (10%) RAS consumable costs. This was in the context of 37% robotic theatre utilisation. Conclusions There is considerable variation across surgical specialties for the cost of RAS. It is important to highlight the different cost components and drivers associated with a RAS program including its dependence on volume and how it fits within funding systems in the public sector.


Antibiotics ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 606
Author(s):  
Fauna Herawati ◽  
Rika Yulia ◽  
Bustanul Arifin ◽  
Ikhwan Frasetyo ◽  
Setiasih ◽  
...  

The inappropriate use or misuse of antibiotics, particularly by outpatients, increases antibiotic resistance. A lack of public knowledge about “Responsible use of antibiotics” and “How to obtain antibiotics” is a major cause of this. This study aimed to assess the effectiveness of an educational video about antibiotics and antibiotic use to increase outpatients’ knowledge shown in two public hospitals in East Java, Indonesia. A quasi-experimental research setting was used with a one-group pre-test—post-test design, carried out from November 2018 to January 2019. The study population consisted of outpatients to whom antibiotics were prescribed. Participants were selected using a purposive sampling technique; 98 outpatients at MZ General Hospital in the S regency and 96 at SG General Hospital in the L regency were included. A questionnaire was used to measure the respondents’ knowledge, and consisted of five domains, i.e., the definition of infections and antibiotics, obtaining the antibiotics, directions for use, storage instructions, and antibiotic resistance. The knowledge test score was the total score of the Guttman scale (a dichotomous “yes” or “no” answer). To determine the significance of the difference in knowledge before and after providing the educational video and in the knowledge score between hospitals, the (paired) Student’s t-test was applied. The educational videos significantly improved outpatients’ knowledge, which increased by 41% in MZ General Hospital, and by 42% in SG General Hospital. It was concluded that an educational video provides a useful method to improve the knowledge of the outpatients regarding antibiotics.


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