Comments(1)

Concerns on the validity of the study conclusions

Ping-Ing Lee   (19 August 2008)  National Taiwan University Hospital

In this article, it should be noticed that the total expenditure increased significantly both in the exposure group and in the comparison group. It is apparent that such a phenomenon cannot be attributed to the price adjustment action alone because the price was not adjusted in the comparison group. This study ignores some important confounding factors. Some patients in the pre-action period may have a new diagnosis of cardiovascular disease, while all patients in the post-action period already have the diagnosis since the pre-action period. The total expenditure of patients with a new diagnosis in the pre-action period will surely be lower than others. As patients became older, they may require more drugs and more visits to control the poorly controlled illness. Therefore, I think the conclusion of this article is unreliable.

Competing interests

None declared

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