第 二 篇 經 營 成 效 與 品 質 提 升
Chapter 2 Achievements &Quality Assurance Initiatives
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合理調整藥價
現行藥品之支付係由醫事機構依藥物
給付項目及支付標準向健保署申報藥費，此
制度設計有利於導引藥價下降。由於醫事
機構有議價誘因，透過市場競爭機制，以
較健保支付價為低之價格購買藥品，健保
署再透過定期藥價調查，取得實際交易價
格，據以調降藥價基準合理調整藥品價格。
若健保署依照醫療院所購買價格支付藥品，
醫療院所因此缺乏議價的誘因，藥品購買
價格無從下降，反而不利於健保財務。
Keeping Drug Prices Down
Under the current system for reimbursing drug expenses,
medical institutions ask for reimbursement from the NHIA
according to designated prices for each medication covered by
the NHI program. The system is designed to help push drug
prices down because it gives medical institutions the incentive
to negotiate drug prices with pharmaceutical companies that
are lower than the amount they are reimbursed by the NHIA.
The NHIAregularly surveys market prices for drugs, and once
it verifies that the price for a drug in the marketplace has fallen,
it adjusts the amount it reimburses for that drug accordingly.
If the NHIA were to simply reimburse health care providers
based on the actual prices they pay for drugs, the providers
would have no incentive to bargain with pharmaceutical
companies. Prices would be less likely to fall, and the NHI
system’s finances would suffer.