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Naslov:VPLIV DOPLAČIL ZA ZDRAVILA, KI SO FINANCIRANA S STRANI ZDRAVSTVENE ZAVAROVALNICE, NA ODLOČANJE ZDRAVNIKA, FARMACEVTA IN BOLNIKA KOT SOODLOČEVALCEV V PROCESU IZBIRE ZDRAVILA
Avtorji:ID Gril, Leon (Avtor)
ID Mumel, Damijan (Mentor) Več o mentorju... Novo okno
Datoteke:.pdf MAG_Gril_Leon_2015.pdf (2,54 MB)
MD5: 04D0EB40729F0F03CA6EC32B95A3B7EB
 
Jezik:Slovenski jezik
Vrsta gradiva:Magistrsko delo
Tipologija:2.09 - Magistrsko delo
Organizacija:EPF - Ekonomsko-poslovna fakulteta
Opis:V nalogi smo raziskovali mehanizme nakupnega procesa zdravil na recept in z njim povezane dejavnike, ki vplivajo na odločitev. Še posebej nas je zanimal vpliv doplačila za zdravila na recept, ki so financirana iz javnih sredstev. V številnih državah v Evropi in širše se uveljavlja princip deljenja stroška za zdravila med javnimi sistemi (država, zavarovalnice) in bolnikom, kot uporabnikom zdravila. Najprej gre za motiv omejevanja izdatkov za zdravila iz javnih blagajn, ki imajo po celem svetu trend naraščanja, hkrati pa želijo upravljavci zdravstvene politike bolnika z delnim sofinanciranjem »iz žepa« za zdravljenje z zdravili pripraviti do bolj racionalnega in odgovornega jemanja terapije. Učinki, ki jih prinaša takšno deljenje stroškov in posledično doplačevanje bolnikov pa so lahko tudi negativni. Iz številnih objav jasno izhaja, da dodatna obremenitev bolnika z doplačilom pomeni manjšo porabo zdravil v državi, kjer se ukrep sprejme. Vprašanje, na katerega še ni jasnega odgovora pa je, ali takšno zmanjšanje v uporabi zdravil pomeni ukinjanje potrebne terapije, ki bo imelo za posledico nove zaplete zdravljenja, ki jih mora financirati ta isti zdravstveni sistem. Torej dilema, ali so ti ukrepi stroškovno učinkoviti in ali vplivajo na zdravje ljudi. Ker je pri zdravilih na recept odločevalec o terapiji praviloma zdravnik kot predpisovalec in delno farmacevt kot svetovalec, nas je v nalogi zanimalo, kako dejstvo, da je zdravilo bolniku potrebno doplačati, vpliva na predpisovanje oziroma svetovanje obeh soodločevalcev v tej shemi nakupnih vlog. Zdravniki in farmacevti upoštevajo dejstvo, da bo bolnik moral zdravilo doplačevati, ko predpisujejo oziroma svetujejo izbor zdravila. Pri tem sta najpomembnejša dejavnika bolnikov socialni položaj in zavzetost bolnika za zdravljenje. Zelo je odvisno od tega, kako dolgo bo trajalo zdravljenje (ali bo akutna ali kronična terapija) in dejstva, ali je bolnik z zdravilom že seznanjen in ga pozna, ker ga je jemal v preteklosti, ali je to zanj nova terapija. Pri Akutni terapiji zdravniki menijo, da doplačilo ni tako pomembni dejavnik in upoštevajo bolj druge dejavnike pri odločanju. Pri kronični terapiji zdravniki upoštevajo dejstvo, da bo bolnik moral terapijo doplačevati vse življenje in pogosteje predlagajo izbor, ki ga ni potrebno doplačati. Farmacevti imajo pri svetovalni vlogi v takšnih scenarijih nekoliko drugačno stališče. Pri akutni terapiji prej predlagajo menjavo terapije na alternativo, ki je ni potrebno doplačevati. Pri kroničnem zdravljenju pa so bolj zadržani in redkeje predlagajo spremembo predpisane terapije. Še posebej to velja za bolnike, ki že imajo ustaljeno terapijo, ki jo poznajo. Bolniki so v Sloveniji po mnenju zdravnikov in farmacevtov, ki jim glede smiselnosti doplačevanja svetujejo vsak dan, pripravljeni doplačati za akutno zdravljenje približno 5 EUR za mesečno terapijo, pri kronični terapiji pa med 1 in 2 EUR za mesečno zdravljenje. Doplačilo je torej pomembni dejavnik v nakupnem procesu zdravila na recept. Ker poleg bolnikove privolitve na odločitev pomembno vplivata pred vsem zdravnik in farmacevt mora cenovna strategija izdelkov v farmacevtskem podjetju zelo upoštevati tudi stališče omenjenih vplivnežev v prodajnem procesu.
Ključne besede:doplačilo, zdravila na recept, proces odločanja, deljenje stroškov
Kraj izida:Maribor
Založnik:[L. Gril]
Leto izida:2015
PID:20.500.12556/DKUM-55190 Novo okno
UDK:658.8
COBISS.SI-ID:12160028 Novo okno
NUK URN:URN:SI:UM:DK:QRXFL4C0
Datum objave v DKUM:25.11.2015
Število ogledov:1395
Število prenosov:176
Metapodatki:XML DC-XML DC-RDF
Področja:EPF
:
GRIL, Leon, 2015, VPLIV DOPLAČIL ZA ZDRAVILA, KI SO FINANCIRANA S STRANI ZDRAVSTVENE ZAVAROVALNICE, NA ODLOČANJE ZDRAVNIKA, FARMACEVTA IN BOLNIKA KOT SOODLOČEVALCEV V PROCESU IZBIRE ZDRAVILA [na spletu]. Magistrsko delo. Maribor : L. Gril. [Dostopano 21 januar 2025]. Pridobljeno s: https://dk.um.si/IzpisGradiva.php?lang=slv&id=55190
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Sekundarni jezik

Jezik:Angleški jezik
Naslov:The Impact of Co-payment on Prescribing Reimbursed Medicines with Regard to Physicians, Pharmacists and Patients as Decision-makers
Opis:In this assignment, the author investigates the prescription medicine buying process and factors influencing decisions made by consumers and decision-makers. The author primarily analyses the impact of co-payment on prescribing of and giving advice about reimbursed prescription medicines. Several kinds of cost-sharing principles between patients, who are also consumers, and public reimbursement systems (e.g. the government, insurance companies, etc.) are being introduced not only in the European countries, but also in certain other countries in the world. The basic reason for this is to limit medicine-related costs that have been on an upward trend. At the same time, governments and health system coordinators aim to make the use and prescribing of medicines more rational and responsible by charging a patient for the treatment with “out-of-the-pocket money”. However, such cost-sharing practices may also have certain negative long-term consequences. According to the published data, it is very clear that charging a patient with co-payment for reimbursed medicines reduces the use of medicines in the country that adopts any such measure. It remains an open question whether the decrease in utilisation of prescription medicines also means that a certain number of patients requiring treatment reduces or forgoes a therapy, which would most certainly result in disease-related complications. These in turn would have to be managed and financed by the same public health system. Therefore a dilemma arises, whether co-payment schemes are actually cost efficient and benefit public health in any way. Physicians prescribe medicines to patients and function as the principal decision-makers. Pharmacists function as advisors and they usually recommend prescription medicines to patients upon the purchase. The author investigated the impact of co-payment for prescription medicines on physicians’ prescribing decisions and pharmacists’ recommendations for the treatment, and consequently on the purchasing role scheme. When prescribing a medicine or giving advice, physicians and pharmacists also consider if the medicine would have to be co-paid by the patient. The most important factors in decision making are the patient's social status and general compliance of the patient. There are two very important decision-making parameters related to co-payment. The first one is the duration of a therapy (an acute or chronic treatment). The second one is how familiar the patient is with a medicine: has he already been taking a certain medicine, or is the therapy newly initiated. When making acute therapy decisions, physicians are not influenced in particular by the patient’s co-payment. They primarily consider other usual prescribing factors instead. However, when making a decision about a chronic treatment, co-payment plays an important role in a physician’s decision-making process, because the patient will have to co-pay for the treatment for the entire life, or at least for a long time. In this case, they are more likely to opt for a co-payment free alternative. As advisors, pharmacists share a different point of view. They are more likely to propose switching to a co-payment free alterative for an acute treatment, but are much more conservative when a chronic treatment is in question. They rarely offer a co-payment free alternative to a chronic patient, especially if the patient already knows the prescribed brand or has been taking it. Physicians and pharmacists discuss daily with patients the level of acceptable co-payment for a treatment. They believe that patients in Slovenia are prepared to co-pay for reimbursed medications up to €5 per month for an acute treatment and between €2–3 EUR per month for a chronic treatment. Co-payment vitally influences the purchasing process of prescription medicines. In addition to the patients’ agreement, physicians and pharmacists act as important opinion leaders or even decision makers for the final decision. The author therefore believes that pharmaceutical companies should closely consider their opinion and behaviour when defining price strategy of reimbursed medicines on the market.
Ključne besede:copayment, prescription medicines, decision making process, cost sharing


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