National health insurance

Under Directive 89/105/EEC relating to transparency of measures regulating the scope of national health insurance systems all measures introduced by national governments to control expenditure on medicines will have to be compatible with EU rules. 

The Directive applies to any national measures to control price or restrict the range of products covered by national health insurance systems. The specific articles of the Directive cover the various schemes operational within the Community and demands that objective and verifiable criteria are met in their implementation (see also page 532 Chapter 17.15.4). 

We used the cumulative number of drugs with NMEs approved and launched in Taiwan to measure pharmaceutical innovations. The annual number of NMEs introduced into Taiwan between 1985 and 2002 followed cyclic patterns (Fig. 13.1). In 1985, 95 NMEs were introduced in this market. This number decreased to 52 and 49 in the next two years, but increased subsequently. In 1995 only 15 NMEs were introduced, possibly reflecting delays in approvals caused by the transition from the then-existing health care financing system to national health insurance in Taiwan in that year. ... 

Pauly, M. V, P. Danzon, P. Feldstein, and J. Hoff. 1991. A Plan for Responsible National Health Insurance. Health Affairs 10(l) 5-25. 

Payment by third-party payers, especially by the national health insurance programs or social security funds, has expanded dramatically during the last several years and the program to promote rational use of drugs is soon expected to make significant contributions. A good example is a program such as... 

New techniques must be assessed with respect to efficiency and cost-effectiveness in comparison to already existing ones. So far only a few cost-effective analyses of management of recurrent colorectal cancer based on decision analysis models have been published. Cost calculations of two studies were based on US Medicare reimbursement rates [32-34], whereas one othereconomic analysis was performed from the French national health insurance s perspective [35]. 

The Blue Cross Commission was established in 1937. Throughout the New Deal, however, national health insurance was always on the periphery. It was omitted from Social Security and was never strongly endorsed by President Franklin D. Roosevelt. 

Woolhandler, S. and Himmelstein, D.U. (2002). Paying for national health insur-ance-and not getting it. Hlth. Aff. 21(4) 88-98. 

Adoption of identical policy statements by each member organization on National Health Insurance, which covers issues such as mechanisms for health care delivery, necessity of pharmacy services, reimbursement policies, role of deductibles and copayments in pharmacy services, cost control and quality assurance mechanisms. 

Sedwick Noble Lowndes Ltd. 1996). As a consequence of this, the National Health Insurance Administration, although with growing expenses, has reimbursed a relatively smaller percentage of all available medicines every year. This can be seen when competing the expenses paid by patients for medicines in pharmacies, which saw a 75.3 percent increase in one year between 1994 and 1995 when the total pharmacy turnover was only 26.7 percent. 

The National Health Insurance Law came into effect on January 1,1995. In the framework of this law every Israeli resident is automatically insured. The insurance offers a basic package of a comprehensive set of medical services including hospital services. All medicinal products available under the insurcince are specifically listed in a formulary. Any healthcare organization entitled to operate under the said law... 

Substitution by a pharmacist of a physician s prescription is possible only if the prescription is issued by a medical institution and the product to be dispensed is in the National Health Insurance formulary. 

Directive 89/105/EEC of December 21,1988, relating to the transparency of measures regulating the pricing of medicinal products for human use and their inclusion within the scope of national health insurance systems (transparency of price and reimbursement). 

Prescription drugs are listed on the National Health Insurance Drug Price List in order to be reimbursed... 

There is price control in both hospitals and pharmacies. In hospitals, products are eligible for reimbursement under the national health insurance scheme and are price controlled. In pharmacies, a standard retail price system is in force (30% markup on manufacturer s plant delivery price). Patent protection has been available since July 1987. 

Virtually all other industrialized countries have national health insurance programs that include prescription drug benefits. Good examples, later in this chapter, are Australia, Canada, France, Japan, and the United Kingdom, which illustrate what other nations are currently doing to control expenditures for prescription drugs and what these controls mean for revenues from new drugs yet to be developed. 

The National Health Insur c (Caisse Nationcd d Assurance Maladie - CNAM)/ Since 1945, CNAM, under the stqiervision of die Ministry of Health, has b n responsible for the conc ieasation of industrml accidents and the administration of occupational risks and occupational diseases. Its mission is also to prevent occupational accidents and occupational diseases by technical and financial means. CNAM administers the national hind for prevention which is based on contributions levied from enterprises. The prevention service and its regional offices and services is financed from this fund, as well as the work of INKS, the National Institute of Research and Safety. 

The consequences of the SARS epidemic were remarkable. In Taiwan, as an example, the impact of the SARS epidemic on the utilization of medical services was studied [12]. Using interrupted time-series analysis and National Health Insurance data between January 2000 and August 2003, this study assessed the impact of SARS epidemic on medical service utilization in Taiwan. At the peak of the SARS epidemic, signihcant reductions in ambulatory care (23.9%), inpatient care (35.2%), and dental care (16.7%) were observed. People s fears of SARS appear to have had a strong impact on access to care. Adverse health outcomes resulting from accessibility barriers posed by the fear of SARS are signihcant. 

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