本文結合經濟理論分析與實證觀察，探討普遍存在東亞國家醫療市場的藥價差現象，也就是醫療院所藉著藥品給付（零售）價格與採購價格的差距，獲取利潤的現象。本文分析結果顯示，藥價差現象的產生，主要是根源於東亞國家的兩個重要醫療制度：(1)醫藥不分業，醫院同時擁有藥品處方權與調劑權；(2)醫院擁有龐大的門診部門，使醫院在藥品批發市場中具有獨買的力量。同時，本文進一步指出，藥價差的存在會對醫療市場產生三種價格扭曲效果，造成醫療市場資源配置效率的損失。本文分析結果的重要政策意涵，在於指出藥價差現象之所以成爲一個嚴重問題，並不在於其降低藥廠利潤，增加健保藥品支出，或是造成醫療浪費，而是在於其所導致的價格扭曲與效率損失；解決藥價差問題的根本對策，在於建立完全的醫藥分業制度，而在短期醫藥分業制度無法真正落實之前，應從消除醫療市場的價格扭曲著手。
In East Asian countries, physicians dispense the drugs that they prescribe and capture the profit margin between the reimbursement price and the acquisition price, which is widely known as the pharmaceutical price gap. This paper examines the causes and consequences of this price gap. Our results indicate that the pharmaceutical price gap is rooted in a system in which (1) physicians are allowed to both prescribe and dispense drugs; and (2) hospitals operate with large outpatient departments and possess significant market power on the demand side of the pharmaceutical wholesale market. The existence of the pharmaceutical price gap creates three distortions in relative prices in the health sector, which in turn lead to efficiency loss in resource allocation. The long run solution for the pharmaceutical price gap is to separate the pharmaceutical prescribing and dispensing. In the short run, the effective policy reform would be to mitigate the price distortion in the health care market.
