The diabetes mellitus (D.M.) is the leading fourth cause of death in Taiwan at present. The National Health Insurance (NHI) expenditure of D.M. is about New Taiwan Dollar (NTD)27.8 billions, and takes about 7.85% of the total NHI expenditure NTD 353.9 billions. The D.M. patients are parts of the multiple medicine users, they often bring about inappropriate prescriptions, such as the side effect or interaction of drugs. The majority of domestic researches have done in this field of D.M. patients in hospitals. However, to date, there has been relatively little empirical research conducted on the prescribing pattern and inappropriate prescriptions of the clinics. Not only in order to contain the pharmaceutical expenditure but also for the improving of the prescribing quality, Taiwan has implemented a Separation of Prescribing and Dispensing (SPD) policy since 1997, which provided adverse incentives, fostered an increase in market share of “gateway pharmacies”. In view of the preceding background, four purposes of this research are as follow: 1. To analyze the D.M. prescribing pattern of the NHI contracted clinics. 2. To understand the relationships between the characteristics of clinics, patients and dispensing sites with the prescribing pattern. 3. To examine the actual state of gateway pharmacies, and to investigate the prescribing pattern between the different dispensing sites. 4. To explore the influence factors of D.M. inappropriate prescriptions. Using the database of National Health Research Institutes, we will collect the secondary data on all of Taiwan’s NHI prescription claims data from clinics and pharmacies since 2002 to 2005. The NHI Pharmaceutical Subsidy ATC coding system is going to apply to extract the pharmaceutical classification records. The materials are classified into three parts, including dispensing by clinics themselves, dispensing the released prescriptions on gateway pharmacies and non-gateway pharmacies. The analysis shall use the SAS for Windows 9.1 statistical software package. This empirical research will attempt to examine the link between profits from pharmaceutical sales and physician prescribing behavior. It is likely that the results would have contributed considerably to ensure the patients’ pharmaceutical safety and prevent the conflict of interest in how medicines are prescribed under SDP policy in Taiwan.
