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Titolo:
Changes in drug economy in Israel's health maintenace organizations in thewake of the National Health Insurance Law
Autore:
Sax, P;
Indirizzi:
Ben Gurion Univ Negev, Fac Hlth Sci, Beer Sheva, Israel Ben Gurion Univ Negev Beer Sheva Israel ac Hlth Sci, Beer Sheva, Israel
Titolo Testata:
ISRAEL MEDICAL ASSOCIATION JOURNAL
fascicolo: 8, volume: 3, anno: 2001,
pagine: 605 - 609
SICI:
1565-1088(200108)3:8<605:CIDEII>2.0.ZU;2-W
Fonte:
ISI
Lingua:
ENG
Keywords:
drug policy; drug economics; drug utilization; health maintenance organizations; national health insurance; reimbursement policy; co-payments;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
12
Recensione:
Indirizzi per estratti:
Indirizzo: Sax, P POB 4654, IL-91045 Jerusalem, Israel POB 4654 Jerusalem Israel IL-91045 54, IL-91045 Jerusalem, Israel
Citazione:
P. Sax, "Changes in drug economy in Israel's health maintenace organizations in thewake of the National Health Insurance Law", ISR MED ASS, 3(8), 2001, pp. 605-609

Abstract

Background: It is not clear to what extent the drug economy in Israel's health maintenance organizations is responsive to major healthcare reforms. Objective: To provide information on how drug expenditures, revenues, net costs and drug utilization have changed in the wake of the 1995 National Health Insurance Law in Israel. Methods: This study compares trends in aggregate sick fund expenditures, revenues (patient co-payment) and net costs (expenditures less revenues) in Israel's four health maintenance organizations for the 3 year period 1992-1994 prior to the introduction in 1995 of the NHI Law, with that of the 4 year period 1995-1998 following its introduction. This analysis is similarly carried out for Israel's largest HMO, Clalit Health Services, and for the three smaller HMOs combined. Results: The pace of growth in the pre-NHI era in drug expenditures and particularly in drug revenues was drastically reduced in the NHI era - whether measured as totals or as per insured person (age-adjusted) or in real terms at constant medicine prices. These trends were mirrored to a large extent in Clalit and in the other HMOs, with some important differences noted between the HMOs. Despite declining growth rates in drug expenditures and netcosts, the proportion of these measures of the total HMO economy actually increased in the NHI era, reversing the trend seen in the preNHI era. Conclusions: The impact of the NHI Law on the HMO drug economy has been substantial. The evidence suggests a decline in both the qualitative (basket of drugs consumed) and quantitative (volume of drugs consumed) elements of growth. These changes in expenditure and revenue trends are discussed in the light of the evolving involvement of the Israel Ministry of Health in drug policy Within the framework of the NHI, with emphasis on the basket of drugs reimbursed and copayments for prescriptions.

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Documento generato il 28/03/20 alle ore 14:05:14