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Speech by BG George Yeo, Minister for Health, at the opening ceremony of the 28th Singapore-Malaysia Congress of Medicine

Ann Acad Med Singap, 1995 Mar;24(2):290-1.
PMID: 7653974
Matched MeSH terms: Insurance, Health, Reimbursement*
Can medicine serve two masters?

Lum MS

Med J Malaysia, 2000 Aug;55 Suppl B:30-4.
PMID: 11125518
Matched MeSH terms: Insurance, Health, Reimbursement
The Top 25 Laboratory Tests by Volume and Revenue in Five Different Countries

Horton S, Fleming KA, Kuti M, Looi LM, Pai SA, Sayed S, et al.

Am J Clin Pathol, 2019 04 02;151(5):446-451.
PMID: 30535132 DOI: 10.1093/ajcp/aqy165

OBJECTIVES: To compare the most common diagnostic/laboratory tests across five different referral hospitals by volume and revenue.
METHODS: The authors obtained data on volumes and reimbursement rates for the most common 25 tests at the five hospitals with which they are affiliated and organized them to be as comparable as possible. Simple descriptive statistics were used to make cross-country comparisons.
RESULTS: There are strong similarities across all five hospitals in the top five tests by both volume and revenue. However, the top five by volume differ from the top five by revenue. Reimbursement rates also follow common patterns, being lowest for the most common biochemical test; intermediate for the most common hematology and microbiology tests, respectively; and highest for the most common pathology test.
CONCLUSIONS: Most of the most common tests also appear in the new Essential Diagnostics List. This may inform plans for universal health coverage.

Matched MeSH terms: Insurance, Health, Reimbursement
Fulltext Generic medicines policies in the Asia Pacific region: ways forward

Nguyen TA, Hassali MAA, McLachlan A

WHO South East Asia J Public Health, 2013 Jan-Mar;2(1):72-74.
PMID: 28612828 DOI: 10.4103/2224-3151.115849

Generic medicines are a key strategy used by governments and third-party payers to contain medicines costs and improve the access to essential medicines. This strategy represents an important opportunity provided by the global intellectual property regimes to discover and develop copies of original products marketed by innovator companies once the patent protection term is over. While there is an extensive experience regarding generic medicines policies in developed countries, this evidence may not translate to developing countries. The generic medicines policies workshop at the Asia Pacific Conference on National Medicines Policies 2012 provided an important opportunity to discuss and document country-specific initiatives for improving access to and the rational of use of generic medicines in the Asia Pacific region. Based on the identified barriers and enablers to implementation of generic medicines policies in the region, a set of future action plans and recommendations has been made.

Matched MeSH terms: Insurance, Health, Reimbursement
Fulltext Persistence and treatment patterns of fixed combination drugs for glaucoma: a retrospective claims database study in Japan

Kashiwagi K, Chono E, Koesters S, Yap PS

BMC Ophthalmol, 2020 Jun 10;20(1):223.
PMID: 32522181 DOI: 10.1186/s12886-020-01508-8

BACKGROUND: Poor persistence with glaucoma therapy can lead to disease progression and subsequent blindness. Persistence with second-line glaucoma combination treatment in a Japanese real-world setting and whether it differed from fixed and unfixed combination drugs was investigated.
METHODS: This was a retrospective, non-interventional, cohort study using data from a Japanese medical claims database. Patients with glaucoma aged ≥20 years with a first drug claim for glaucoma treatment between 01 July 2005 and 30 October 2014 and with data for > 6 months before and after this first prescription were included. The primary endpoint was duration of drug persistence among glaucoma patients with and without the use of fixed combination drugs in the year following initiation of second-line combination treatment.
RESULTS: Of 1403 patients included in the analysis, 364 (25.94%) received fixed combination drugs and 1039 (74.06%) received unfixed combination drugs as second-line treatment. Baseline characteristics were generally comparable between the groups. A total of 39.01% of patients on fixed combination drugs, compared with 41.67% of patients on unfixed combination drugs, persisted on their glaucoma drugs 12 months post second-index date. Median persistence durations for the fixed combination drugs and unfixed combination drugs groups were 6 (95% confidence interval [CI]: 5-8) and 7 months (95% CI 6-9), respectively. Patients who received prostaglandin analogs (PGAs) were the most persistent with their treatment (n = 99, 12.84%). Patients diagnosed with primary open-angle glaucoma were less likely to experience treatment modification (hazard ratio [HR]: 0.800, 95% CI 0.649-0.986, P = 0.036), while those diagnosed with secondary glaucoma were more likely to experience treatment modification (HR: 1.678, 95% CI 1.231-2.288, P = 0.001) compared with glaucoma suspects.
CONCLUSIONS: In this retrospective claims database study, the persistence rate of second-line glaucoma combination treatment was low, with no difference in persistence between glaucoma patients receiving unfixed combination drugs compared with fixed combination drugs. Patients on PGA showed greater persistence rates compared with other treatments.

Matched MeSH terms: Insurance, Health, Reimbursement
Treatment of Type 2 diabetes mellitus in Chongqing of China: unaffordable care for the poor

Long Q, He M, Tang X, Allotey P, Tang S

Diabet Med, 2017 01;34(1):120-126.
PMID: 27472098 DOI: 10.1111/dme.13193

AIM: This study aims to investigate the medical expenditure of people with type 2 diabetes mellitus in Chongqing, China; to explore factors that contribute to the expenditure; and to examine the financial burden placed on households, particularly poor households.
METHODS: A cross sectional survey was conducted with a sample of people diagnosed with Type 2 diabetes mellitus in 2014. Of the 664 people eligible, 76% were interviewed. Descriptive statistics and log-linear regression were used to examine respondents' age, sex and level education, location of residence, income and type of health insurance associated with out-of-pocket expenditure on accessing diabetes mellitus care.
RESULTS: In a year, average out-of-pocket expenditure on the purchase of drugs from pharmacies and having outpatient care were US $333 and US $310, respectively. The average out-of-pocket expenditure on accessing inpatient care was 3.7 times (US $1159) that of accessing outpatient care. After adjusting for age and sex, out-of-pocket expenditure on diabetes care was significantly higher for people covered by the Urban Employee Basic Medical Insurance programme and those enrolled in the identified priority diseases reimbursement programme, which provided higher reimbursement rates for outpatient and (or) inpatient care. Out-of-pocket expenditures on the purchase of drugs from pharmacies, having outpatient and inpatient care, respectively, were 9.8%, 16.2% and 62.6% of annual household income in low-income group.
CONCLUSION: Even with health insurance coverage, poor people with Type 2 diabetes mellitus suffered from significant financial hardship. This has significant implications for models of care and healthcare financing in China with the growing burden of diabetes.
Study site: Township or community health centres, Chongqing, China

Matched MeSH terms: Insurance, Health, Reimbursement
Comparative aspects of the care of familial hypercholesterolemia in the "Ten Countries Study"

Pang J, Chan DC, Hu M, Muir LA, Kwok S, Charng MJ, et al.

J Clin Lipidol, 2019 01 25;13(2):287-300.
PMID: 30797720 DOI: 10.1016/j.jacl.2019.01.009

BACKGROUND: There is a lack of information on the health care of familial hypercholesterolemia (FH).
OBJECTIVE: The objective of this study was to compare the health care of FH in countries of the Asia-Pacific region and Southern Hemisphere.
METHODS: A series of questionnaires were completed by key opinion leaders from selected specialist centers in 12 countries concerning aspects of the care of FH, including screening, diagnosis, risk assessment, treatment, teaching/training, and research; the United Kingdom (UK) was used as the international benchmark.
RESULTS: The estimated percentage of patients diagnosed with the condition was low (overall <3%) in all countries, compared with ∼15% in the UK. Underdetection of FH was associated with government expenditure on health care (ϰ = 0.667, P health care system (ϰ = 0.571-0.800, P health technology assessments are needed to improve the care of patients with FH in these countries.

Matched MeSH terms: Insurance, Health, Reimbursement