34 KB479 KB28 KB192920262012Bojnec, ŠtefanKajdiž, Romanaletnik:81številka:9str. 618-625COBISSID:1024467540ISSN:1318-0347URN:URN:NBN:SI:doc-EYXJH2IVslSlovensko zdravniško društvoZdravniški vestnikcene zdravildoločanje cen medsebojno zamenljivih zdravil z najvišjo priznano vrednostjoeksterne referenčne ceneexternal reference priceinternal reference pricesinterne referenčne cenekritje cen zdravilprice regulation for medicinal productsprices of medicinal productsreference pricing mutually interchangeable medicinal products with maximum attributed valueregulacija cen zdravilreimbursement of expenses for medicinal productsSloveniaSloveniajSlovenijaAli regulacija in kritje cen zdravil vplivata na javne izdatke za zdravila?| Do the price regulation and reimbursement affect public expenditures for medicinal products?|Background: Slovenia aims to regulate and reimburse prices of medicinal products in order to manage and reduce public expenditure for medicinal products. Two levels of reference prices (R) are used: external R with a regulated maximum price and internal R with a maximum attributed value, defined by reference pricing for interchangeable medicinal products. The Health Insurance Institute of Slovenia covers expenses for their prescribed use and negotiates prices. The objective of our article was to confirm the basic thesis that the price regulation system and reimbursement have caused the decline in the regulated and reimbursed wholesale prices for medicinal products. Consequently, the decline in prices might contribute to a reduction of public expenditures for medicinal products. Methods: The research covered 760 regulated and reimbursed wholesale prices for both groups of medicinal products prescribed on an outpatient prescription and financed by public expenditures. The Laspeyres index and Wilcoxon signed ranks test are used to estimate the impact of wholesale price regulation system and reimbursement on the trends in nominal and real wholesale prices of medicinal products in the period 2003-2010. Results: The main thesis that the nominal and real wholesaleprices of medicinal products declined during the years 2003-2010, wasconfirmed by the Laspeyres index. The Wilcoxon signed ranks test further confirmed the existence of statistically significant differences in the wholesale prices of medicinal products (p < 0.05). With 5 % significance level, we can conclude that the regulated and reimbursed nominal and real wholesale prices of medicinal products have declined during the analysed years. The regulated and reimbursed nominal and real wholesale prices of generic medicinal products have declined more than the prices of original medicinal productsIzhodi eaČ Z regulacijo in s kritjem cen zdravil posku amo v Sloveniji obvladovati in zmanj evati javne izdatke za zdravila. Obstajata dve vrsti referenenih cen (R)Č eksterne cene z najvi jo dovoljeno ceno in interne cene znajvi jo priznano vrednostjo. Zavod za zdravstveno zavarovanje Slovenije krije njihovo predpisano rabo in se za vse cene tudi pogaja. V elanku smo eleli potrditi osnovno tezo, da se regulirane veleprodajne cene zdravil zaradiregulacije cen in kritja zdravil zni ujejo in verjetno vplivajo na obvladovanje in zmanj evanje javnih izdatkov za zdravila. MetodeČ V raziskavo smo zajeli 760 reguliranih veleprodajnih cen iz obeh skupin zdravil, tj. predpisanih ambulantno na recept in zdravil, financiranih iz javnih sredstev. Za oceno vpliva regulacije veleprodajnih cen in kritja zdravil na nominalno inrealno gibanje veleprodajnih cen zdravil v letih 2003-2010 smo uporabili Laspeyresov indeks in Wilcoxonov test predznaeenih rangov. RezultatiČ Z Laspeyresovim indeksom smo potrdili zni evanje reguliranih in kritih nominalnih in realnih sprememb ravni veleprodajnih cen zdravil v letih 2003-2010, kar smo potrdili tudi s statistieno pomembnimi razlikami z Wilcoxonovim testom predznaeenih rangov (sig < 0,05). Zato smo pri stopnji tveganja Ž = 0,05 sprejeli sklep, da so se regulirane in krite nominalne in realne veleprodajne cene zdravil v proueevanem obdobju zni evale. Regulirane in krite veleprodajne nominalne in realne cene generienih zdravil se zni ujejobolj kot cene originalnih zdravil. ZakljuekiČ V prispevku ugotavljamo, daso se proueevane regulirane in krite veleprodajne cene zdravil v letih 2003-2010 zni evale. Regulacija in kritje veleprodajnih cen zdravil bi ob ueinkoviti porabi in ponudbi zdravil lahko pozitivno vplivalo na obvladovanje in zmanj evanje javnih izdatkov za zdravila. V elanku nismo obravnavali bolni nienih zdravilTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaSlovensko zdravniško društvo