شبیه‌سازی تقاضای داروهای بیماری‌های خاص و صعب‌العلاج در ایران با رویکرد مدل‌های مبتنی بر عامل (1397-1398)

نویسندگان
نرگس قاسمیان 1
حسین راغفر 1
فرامرز اختراعی 2
1 دانشگاه الزهرا (س)
2 شرکت طلایه‌داران صنعت فرآیند
10.52547/jemr.12.43.207
چکیده


دارو به عنوان یک کالای استراتژیک و مشمول یارانه در کشور و نیاز اساسی بیماران، همواره از اهمیت خاصی برخوردار بوده است و در سیستم سلامت یک جامعه جایگاه و نقش ویژه‌ای دارد. از سوی دیگر، یکی از شاخص‌های ارزیابی رفاه خانوار میزان هزینه‌ای است که برای تامین نیازهای گوناگون خود صرف می‌کند و هرچه سهم هزینه انجام شده برای رفع نیازهای اولیه‌ای مانند خوراک، مسکن، پوشاک و آموزش بالاتر باشد، می‌توان انتظار داشت که سهم کمتری برای مخارج سلامت باقی بماند. در مورد تقاضای دارو بسته به نگرش و نوع بیماری افراد و کشش‌های درآمدی و قیمتی آن‌ها، ممکن است تقاضا برای داروهای مختلف متفاوت باشد. هدف ما در این مقاله بررسی تقاضای داروهای بیماری‌های خاص و صعب العلاج (اورفان) برای گروه‌های مختلف درآمدی در ایران با استفاده از مدل‌های مبتنی بر عامل (ABM) است. در این مقاله پویایی رفتار متقاضیان داروهای اورفان و تغییرات تقاضای آن‌ها در سناریوهای مختلف قیمتی ناشی از تورم و تغییرات نرخ ارز، با استفاده از مدل‌های مبتنی بر عامل، بررسی شده است. بدین منظور، 1000 خانوار متقاضی داروهای اورفان که از مرکز آمار ایران استخراج شده‌اند، در پنج بیستک درآمدی و هزینه‌ای جای گرفته‌اند و با استفاده از نرم افزار شبیه‌سازی نت لوگو عکس‌العمل آن‌ها در برابر افزایش قیمت داروی مورد نیازشان پیش‌بینی می‌شود. نتایج نشان می‌دهد، میانگین کشش قیمتی تقاضا برای داروهای ژنریک و برند به ترتیب 39/0- و 05/1- درصد بوده است؛ به همین میزان از تقاضای دارو این دو گروه کاسته شده است. در پایین‌ترین بیستک درآمدی مشاهده می‌شود که با افزایش قیمت داروهای اورفان ژنریک و برند، مخارج تخصیص یافته برای آن‌ها به ترتیب 3/3و 85/31 درصد کاهش یافته است. می‌توان دلیل اصلی آن را در بودجه‌ پایین خانوار بیمار و تخصیص آن به نیازهای ضروری زندگی مانند خوراک و مسکن جستجو کرد. شدت کاهش مخارج صرف شده در گروه داروهای برند بخاطر آن است که، می‌توان در صورت افزایش قیمت آن، داروی ژنریک را جایگزین نمود.
کلیدواژه‌ها
تقاضای داروهای اورفان
شبیه‌سازی
مدل‌های مبتنی بر عامل

عنوان مقاله English

Simulation of Demand for Orphan Drugs in Iran with the Approach of Agent-based Modeling (2018-2019)

نویسندگان English

Narges Ghasemian 1
Hossein Raghfar 1
Faramarz Ekhteraei 2
1 Alzahra University
2 Pioneers of Industry Process
چکیده English

Drugs as a strategic and subsidized commodity and an urgent need for patients have been constantly of particular importance, specially, in the health-care system of a society. On the other hand, one of the parameters concerning the assessment of the family welfare is the amount spent for satisfaction of divergent needs. The more a family spends on essential necessities such as food, housing, clothing and higher education, the less is expected to be devoted to health care. Concerning drugs, the demand for different drugs may vary depending on the patients' attitudes, the type of illnesses and their income elasticity. The objective of the present research is to investigate the demand for orphan drugs for refractory diseases regarding various income groups in Iran applying Agent-based Models (ABMs). In this research, the behavior dynamics of the orphan drugs applicants and the diversity of their demands in miscellaneous price scenarios resulting from inflation and fluctuations in the exchange rate have been scrutinized in accordance with ABM. To this end, one thousand family applicants for orphan drugs, extracted from Iran's statistics center, were categorized in five different income ventiles. Their reactions towards the increase of the price of the aforementioned drugs are predicted based on Net Logo simulation software. The results indicate that the average of price elasticity of demand for generic and branded drugs has been -0.39 and -0.05 percent, respectively; similarly, the demand for these two drug groups has been decreased by the same amount. In the lowest income ventile as the price of generic and branded orphan drugs deceases, for the lowest income ventile families, the allocated expenses for these drugs has been decreased by 3.3 percent and 31.85 percent, respectively. The main reason for the aforementioned problem is assigned to the low budget of the patients' family and its allocation to essential necessities of life such as food and housing. The severity of the cost reduction in branded drugs is due to the fact that it can be replaced by generic drugs.

کلیدواژه‌ها English

Orphan Drugs Demand
Simulation
Agent Based Modeling
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