This Thesis examines the benefits and usefulness of a National Drug Policy (NDP) for the developing of the Health Care System in Kuwait. The NDP is one of the most important structures of the Health System which can lead to improved health services by establishing guidelines, proposals and directives to organize, structure and regulate health legislation; it is of help to ensure the availability of quality, safety and efficacy in using medicines and it can reduce the irrational use of medicines. The NDP is a frame work between the government, schools and universities, media, health professionals, pharmaceutical industries and companies and public. It is cooperation between the public and private sectors to achieve the goal of access to good quality medicines for all. However there are many key factors which need to be examined before the National Drug Policy is introduced and these are considered the baseline for establishing a good policy, and includes; selection of essential drugs, affordability of drugs, drug financing, supply management, drug regulation, rational use of drugs, drugs registration, purchasing of drugs, health research and human resource development. During this research study from 2012 – 2015 several visits to the public and private health areas, were undertaken. At this time there were discussions with 121 health professionals and data was collected and this indicated that in Kuwait there are no such policies. This is despite the availability of financial means, specialized human resources and the existence of the ministerial decisions and regulations governing the health sector in both public and private, whether hospitals, health centers, pharmacies and health departments. In addition it is suggested that the process of a good NDP should be built around 3 main components which includes: 1.Development, 2. Implementation and 3. Monitoring and Evaluation. Therefore the establishing of a NDP without implementation and monitoring is not enough and does not achieve the desired results. The aim of this Thesis is to establish a NDP in the State of Kuwait. This policy is necessary for the State of Kuwait to ensure development an improvement of the Health Care System and ensure better health for population.

Bakgrund: Den tekniska utvecklingen går snabbt framåt och kan innebära en utmaning för många grupper i samhället, framförallt äldre. Sverige har som mål att år 2025 vara bäst på eHälsa och som ett delmål har ett register i form av Nationella Läkemedelslistan tagits fram. Registret ska ge patienter, vård- och apotekspersonalen tillgång till samma information med målet att öka patientsäkerheten och patienters delaktighet i vården. För att komma åt den här information krävs inloggning till eHälsomyndighetens tjänst Läkemedelskollen. Äldre personer har ofta mindre datorvana och väljer i många fall papper framför digitala tjänster. Apotekslistan är den analoga tjänsten som just nu erbjuder receptinformation i pappersform till patienterna. Syfte: Studiens syfte var att beskriva äldre patienters upplevelser av att använda receptinformation i analog form och deras uppfattning om digitala alternativ. Material och metod: En kvalitativ semistrukturerad intervjustudie har genomförts och urval har skett strategiskt och målstyrt för att fånga respondenter med olika nivå av teknikvana och på olika demografiska platser i Sverige. Rekrytering skedde med snöbollsurval och resulterade i 9 respondenter. Resultatet tolkades sedan med hjälp av UTAUT och TTF. Resultat: Den fysiska Apotekslistan fyller en viktig funktion i patientens läkemedelsprocess och skapar trygghet för individen. Många respondenter har svårt att se fördelarna med en digital version och upplever att den fysiska listan är tillförlitlig och uppfyller alla krav och behov som finns. Slutsats: En del av den åldrande befolkningen vill ha tillgång till det fysiska pappret som ett alternativ till digitala tjänster och upplever att den skapar trygghet och förenklar vardagen. För att locka fler äldre att testa Läkemedelskollen kan utbildningar tas fram för att minska äldre personers teknostress. En utveckling av tjänsten skulle kunna öka intresset och tillföra ett mervärde som förenklar livet med läkemedel. / Background: Technical development is advancing rapidly and entails a need for skills development for many groups in society, especially the elderly. Sweden aims to be the best in eHealth by 2025, and as an intermediate goal, a register in the form of the “National Medication List” has been introduced. The register will give patients, care and pharmacy staff access to the same information with the aim of increasing patient safety and patients' participation in care. To access this information, login to the eHealth Authority's service Läkemedelskollen is required. Older people often have less computer skills and, in many cases, choose paper over digital services. Apotekslistan is the analogue service that currently offers prescription information on paper to patients. Purpose: The purpose of the study was to describe elderly patients' experiences of using prescription information in analog form and their attitude to digital alternatives. Material and method: A qualitative semi-structured interview study were conducted and selection has been made strategically and goal-oriented to capture participants with different levels of technical knowledge and in different demographic locations in Sweden. Recruitment took place with a snowball selection and resulted in 9 participants. The result was interpreted using UTAUT and TTF. Result: The physical list Apotekslistan fulfills an important function in the patient's drug process and gives the patient a feeling of security. Many people find it difficult to see the benefits of a digital version and feel that the physical list is reliable and meets all the requirements and needs that exist. Conclusion: Part of the aging population wants access to the physical paper as an alternative to digital services and feels that it creates security and simplifies everyday life. To attract more elderly people to try Läkemedelskollen, training can be developed to reduce older people's technology stress. A development of the service could increase interest and add value that simplifies living with chronic disease.

中國13億人口的內需市場已為各產業的新興目標，尤其是在醫藥產業，中國政府於2009年宣布將投注8,500億人民幣改革中國整體醫藥建設，更為目前身處於台灣飽和市場的本土藥廠的發展契機，加上兩岸近期簽署的兩岸經濟合作架構協議(ECFA)，未來兩岸商業互動將更為頻繁。台商藥廠如何在這各界搶占的中國市場占有一席之地？掌握通路即掌握市場。 影響通路建構的因素分析，是企業市場營銷的首要步驟，公司對影響通路建構的因素越是瞭解，越是能掌握變動的市場，做出調整以因應環境的變化。本研究首先從中國醫藥品生產企業發展概況的分析，引導出跨國藥廠(歐美等國與台灣企業)進入中國市場常見的問題，並研究影響其通路建構須掌握的三大分析構面，包括醫療體制、藥品管理相關法令，以及流通企業等。 在醫療體制部分，中國的醫療市場主要集中在國有醫院(public hospitals)，但國有醫院的營銷環境複雜，受到許多來自政策、地方主義、關係資本等因素的影響，使得外來投資企業在經營中國國有醫院市場上，皆需要各方面相當的營銷資源才足以支撐。 在藥品相關法令部分，中國政府為了整頓醫藥市場混亂的景象以及減輕民眾的用藥負擔，於1998年起陸續頒布了許多藥品管理相關法令，包括國家基本藥品目錄、藥品價格管理制度，以及藥品集中招標採購制度等，這些法令雖然規範與體制化了中國醫藥市場，但也約束了醫藥通路終端市場的藥品採購，並使藥廠的通路建構彈性大幅受限。另外，雖然過去由於中國專利法發展遲滯，致使許多歐美企業無法在中國發揮藥品發明專利之市場壟斷的作用，但中國於2007年再次修定並頒布新實施的藥品註冊管理辦法，已將中國的藥品專利保護之法律與行政制度進行初步連結，未來兩者整合性的發展，將塑造出更有利於擁有強大技術與專利能量的藥廠生存的環境，此為台商不可忽視的重要課題。 在流通企業部分，中國流通企業不僅了解當地行規，通常又擅長多角化經營，掌握了大多的終端客戶，往往能夠提供藥廠代銷、物流、倉儲、收款等服務，故在流通企業在中國醫藥通路上扮演著不可或缺的角色，藥廠對流通企業的通路功能依賴性極大。 台商過去進入中國醫藥市場發展十幾年來的商業模式，是否還能足以因應未來更變化多端的市場環境？而後進中國市場的台灣藥廠又該採取怎樣的進軍策略？面對未來，台商更應「衡外情、量已力」，從各面向深入瞭解影響中國醫藥品通路建構的因素，除了鞏固既有醫藥市場與通路資源外，更應積極思考如何提高通路系統的附加價值，開創嶄新的獲利模式。本研究後續將針對前述三大影響因素，分章論述分析，最後歸納與整理影響因素對台灣藥廠所造成的困難，並提具因應上的建議，期能提供在中國發展醫藥品市場的台商企業作為未來發展策略的參考依據。 / China’s great market demand has become the new target for international enterprises, especially in pharmaceutical industry. China government announced the investment of 850 billion RMB to ameliorate the medical infrastructure in China, which indicates an opportunity for Taiwan pharmaceutical companies. The Economic Cooperation Framework Agreement (ECFA) between Taiwan and China will encourage a more enthusiastic interaction across the strait. Channel strategy will be the key to predominate the highly competent China market for Taiwan pharmaceutical companies. Analysis on channel construction will be the first step for industrial marketing strategy. The better a company understands the factors influential for channel construction, the better it can get control in the ever-changing market and adjust itself to cope with any alteration in the environment. This thesis will begin with an introduction on the development of pharmaceutical industry in China and thus induce some common issues with which international pharmaceutical companies are confronted in China market. It will analyze the channel construction from three important perspectives, healthcare system, pharmaceutical regulations, and logistics industry. Public hospitals play a major role in the healthcare system of China market. The marketing in public hospital involves complicated variables, including policy, local protectionism, and relationship capital. Non-local companies need every considerable resource to manage the marketing in public hospitals. In order to reform the healthcare market and lower the medical expense, China government announced several pharmaceutical regulations, including National Reimbursement Drug List (NRDL), Medicine pricing policy, and Pharmaceutical Centralized Public Bidding Procurement process. On one hand, these regulations help to put the market into order; on the other hand, it sets restricts on the retail sales and the channeling flexibility of the pharmaceutical company. Due to the slow development of China patent law in the past, moreover, a lot of American or European pharmaceutical companies could not develop an exclusive market for their drug through patent system. New Provisions for Drug Registration revised and announced by China government in 2007 established an initial connection between legal and administrative system of drug patent protection. Such integrated development will form an environment more suitable for pharmaceutical companies which possess powerful technology and patents, a significant trend for Taiwan companies’ attentions. China logistics companies understand local law and regulation and are usually familiar with multi-business strategy. They control most of the retailers and can offer sales agency, logistics, storage, and agency receipt. Logistic industry plays an important role in China pharmaceutical channel and is indispensable to pharmaceutical companies. It will be questionable whether Taiwan companies’ old business model can be sufficient for the changing China pharmaceutical market in the future. The newcomers should ponder more on their strategy for the market as well. Taiwan companies need to take the external condition and their own strength into consideration, understanding every factor of China pharmaceutical channel construction. Besides strengthening the original market and channels, Taiwan companies should aggressively enhance the add-value of channel system and find out new profit model. This thesis will focus on and elaborate the three perspectives and analyze the difficulties they bring upon Taiwan pharmaceutical companies, proposing possible solutions and future strategy for those who aim to develop their pharmaceutical business in China.