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مشخصات

عنوان:

تدوین و اولویت بندی معیارهای موثر در پذیرش داروها در تعهدات بیمه های پایه خدمات درمانی و پیشنهاد مدل مناسب پذیرش دارو



گروه تخصصی:  پزشکی

سازمان مجری:  سازمان بیمه سلامت ایران (پایان نامه ها) 

گروه پژوهشی: 

پژوهشگران: 
ویانچی امیر (پژوهشگر)
راسخ حمیدرضا (استاد راهنما)
رجب زاده قطری علی (پژوهشگر)
صفی خانی حمیدرضا (استاد مشاور)

تاریخ خاتمه:  1393

کارفرما: سازمان بیمه سلامت ایران

خروجی طرح: 
نوع: پایان نامه

 
تلفن: 

نشانی سازمان مجری: 
 

چکیده:

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کلیدواژگان: اقتصاد دارو، معیار، بیمه سلامت و مدل تاپسیس

 
 
Title:

Effective Criteria Compilation and Prioritization for drug entering to health care base insurance undertakings listed and model suggestion for drug acceptation



Abstract:

According to the trend of increased drug use costs, the study of how to select the new drug in the country's health insurance and to provide a scientific model for accepting drugs in insurance commitments is very important. Three pillars of entering the drug to the market are Licensing, Pricing and Reimbursement and pharmaceutical companies are required to register their drug in the list of obligations of insurance organizations for more selling. In addition, insurer organizations like every other organization must establish a balance in three principles of cost, quality of service and justice for survival.
Objective: To provide a systematic model for the use of the drug economy knowledge, in order to accept medications in basic health insurance commitments.
Research method: In terms of the aim is applied and in terms of research methodology, is combination (descriptive and co relational analysis).
Type of study: It is combined with a practical approach to modeling.
Research environments: The Supreme Council of the health insurance, pharmaceutical companies and the food and drug organization.
Experts community: Members of the Supreme Council health insurance, pharmaceutical experts of health Ministry and Tehran medicinal industries, and other experts in health community (n=282).
Research tools: Developing three structured questionnaires for each of the 3-step of research and send them by email and presentation to the respondents.
Methods and results: In the first part of this study to enter the new drugs into list of insurance undertakings, 128 effective criteria were extracted from the country's data that were similar to Iran in national production or population and owner of valid data and those were divided in 4 sections of technical, economic, quality studies and socio- political, management. Firstly, 48 items of these criteria were selected in terms of experts and decision makers of Supreme Council of health insurance with standard deviation lesser than 25 and the selected criteria were ranked by sub criteria including Cost, Interpretability, Precision, and Timeliness in the second stage of this part with the same responders. These ratings were calculated with fuzzy MADM model and the decision matrices were formed by TOPSIS method. The model proposal took shape by specifying the criteria rating and explanation of the process and institutions and influential committees. In the second part assessed the validity of the model components from the view of health system experts using software smart _ pls, and five hypotheses were confirmed among six proposed hypotheses.
Conclusion: The proposed model for acceptance of medication to the list of Iranian health insurance undertakings were established from four stem sections that are evaluation of the study quality (with 8 criteria), technical and clinical assessment of medicine (with 17 criteria), economic analysis (with 10 criteria), and management appraisal (with 13 criteria), respectively. The hypotheses were not rejected with 99% confidence interval: 1- “Evaluation of the medicine study quality has a positive effect on the clinical assessment of drugs acceptance.” 2- “Evaluation of the medicine study quality has a positive effect on the economic analysis of drugs acceptance.” 3- “Evaluation of the medicine study quality has a positive effect on the management appraisal of drugs acceptance.” 4-“Clinical assessment of medicine has a positive effect on the economic analysis of drugs acceptance.” 5- “Clinical assessment of medicine has a positive effect on the management appraisal of drugs acceptance.” However, the hypothesis of “economic analysis of medicine has a positive effect on the management appraisal of drugs acceptance.” was rejected in this interval.



Keyword(s): pharmacoeconomic, criterion, health insurance and TOPSIS model