臺灣博碩士論文加值系統

關係行銷與關係強度對醫師處方行為之研究

學生：張承元 指導教授：李弘暉

元 智 大 學 管 理 研 究 所

中文摘要
隨著全民健保實施，醫療費用持續上漲，政府財政負擔日益加重，至民國98年中央健保局財務統計指出已累計有295億新台幣虧損。從另一方面來看，西藥產業為特許行業，整個產業從研發、製造到行銷不同於其他行業，在台灣處方藥品市場的特性明顯不同於一般的商品或服務的市場模式。藥品市場的特性為目標客戶是在醫院或診所裏從事診療服務的醫師，看病時由醫師診斷、處置及開立處方籤，病患再持處方籤至藥局領藥。病患手中處方籤的內容完全來自於醫師的專業與理性的判斷，雖然病人才是真正的藥品使用者，但是藥品的選擇權卻在醫師手中。本研究主要目的是想要了解在目前全民健保實施的體制下並且符合IRPMA藥品市場行銷規範，藥廠與醫藥代表的行銷模式對醫師處方行為的影響。整個研究目的歸納以下三點：
1.藥廠的何種關係行銷模式最能影響醫師處方行為
2.醫藥代表的何種關係強度行為最能影響醫師處方行為
3.關係強度是否能加強關係行銷的品質

關鍵字：關係行銷、關係強度、處方行為

EFFECTS OF RELATIONSHIP MARKETING AND RELATUONSHIP STRENGTH TO PHYSICIAN’S PRECRIPTION DECISION PROCESS

Student：Cheng-Yuan Chang Advisors：Dr. Hong-Hung Lee


Submitted to Graduate School of Management
Yuan-Ze University

ABSTRACT
After the National Health Insurance (NHI) program was put into practice, the medical expenses incurred by NHI scheme have been growing every year, which increases the financial burden to the government. According to the statistics provided by the Bureau of National Health Insurance in 2009, on the accrual basis, NHI program shows a net loss of NT29.5 billion since its implementation. From another aspect, licensing plays a major role in the highly-regulated pharmaceutical industry. The R&;D, manufacturing and sales processes in the pharmaceutical industry are not the same as those in other industries. Specifically, the prescription drug market in Taiwan is quite different from that of normal goods and services. Instead of the patients, the "target customers" in the prescription drug market are those physicians or other medical practitioners in the hospitals or in the clinics. Along the diagnosis process, a physician writes or issues a prescription to the patient. The patient subsequently brings that prescription to a pharmacist in order to obtain drugs. The contents of the prescriptions held by the patients are determined by the professional and rational analysis from the physicians. Even though the patients are the "end-user" of the medicine, it is the physicians who make the choice of which drugs to use. The main purpose of this research is to find the effect of marketing strategies --- from a pharmaceutical company and its sales specialist governed by current NHI system and regulations from IRPMA -- upon the prescription behavior of a physician. The whole research tries to conclude the following three points:
1. Which strategy in relationship marketing from a pharmaceutical company is the most effective practice over the physician's prescription decision process?
2. What kind of relationship strength (between a physician and a sales specialist of a pharmaceutical company) has the most influence over the prescription behavior of a physician?
3. Whether the relationship strength can improve the quality of relationship marketing.

Keywords: relationship marketing, relationship strength, physician prescription decision proces

目錄

中文摘要.................................................................Ⅲ
英文摘要…………………………………………………………………………………….Ⅳ
誌謝………………………………………………………………………………………….Ⅴ
第一章 緒論………………………………………………………………………………….6
1.1 研究背景與動機……………………………………………………………………….6
1.2 研究目的……………………………………………………………………………….7
1.3 研究流程……………………………………………………………………………….7
第二章 文獻探討…………………………………………………………………………….9
2.1 2008 IRPMA市場行銷規範…………………………………………………………….9
2.1.1 目的與適用範圍………………………………………………………………………9
2.1.2 總則………………………………………………………………………………….10
2.1.3 行銷訊息的標準…………………………………………………………………….10
2.1.4 與醫護人員的互動………………………………………………………………….10
2.1.5 樣品………………………………………………………………………………….11
2.1.6 捐贈………………………………………………………………………………….11
2.2 關係行銷……………………………………………………………………………….12
2.2.1 關係行銷的定義…………………………………………………………………….12
2.2.2 關係行銷品質模型………………………………………………………………….15
2.3 關係強度…………………………………………………………………………….17
2.3.1 關係強度的定義…………………………………………………………………….18
2.3.2 關係強度的研究模型……………………………………………………………….18
第三章 研究方法…………………………………………………………………………..20
3.1 研究架構……………………………………………………………………………….20
3.2 研究對象與問卷發放………………………………………………………………….20
3.3 統計分析方法………………………………………………………………………….20
3.3.1 敘述性統計分析…………………………………………………………………….21
3.3.2 無母數分析………………………………………………………………………….21
3.4 變數之操作化定義…………………………………………………………………….21
3.4.1 關係行銷影響醫師處方行為之因素……………………………………………….21
3.4.2 關係強度影響醫師處方行為之因素……………………………………………….21
3.4.3 關係強度是否能加強關係行銷的品質之因素…………………………………….22
第四章 研究結果分析……………………………………………………………………..23
4.1 樣本資料敘述性統計分析…………………………………………………………….23
4.2 研究結果分析………………………………………………………………………….31
4.2.1 關係行銷模式影響醫師處方行為………………………………………………….31
4.2.2 關係強度模式影響醫師處方行為………………………………………………….42
4.2.3 關係強度是否影響關係行銷……………………………………………………….52
第五章 結論與建議………………………………………………………………………..53
5.1 研究結論……………………………………………………………………………….53
5.1.1 關係行銷影響醫師處方行為……………………………………………………….53
5.1.2 關係強度影響醫師處方行為……………………………………………………….54
5.1.3 關係強度影響關係行銷…………………………………………………………….54
5.2 管理意涵……………………………………………………………………………….55
5.2.1 加強客戶分級與管理……………………………………………………………….55
5.2.2 人才管理與加強關係強度………………………………………………………….55
5.3 研究限制與未來研究建議…………………………………………………………….55













圖目錄

圖1-1 研究流程…………………………………………………………………………….8
圖2-1 Crosby et al. (1990)之關係品質模型…………………………………………15
圖2-2 KMV（Key Mediating Variable）模式 Morgan and Hunt (1994)……………16
圖2-3 Legace et al. (1991)之關係模型………………………………………………18
圖3-1 研究架構……………………………………………………………………………20
圖4-1 醫師性別比率………………………………………………………………………23
圖4-2 年齡分布比率………………………………………………………………………24
圖4-3 醫院屬性分布比率…………………………………………………………………24
圖4-4 醫院層級比率………………………………………………………………………25
圖4-5 教育程度比率………………………………………………………………………25
圖4-6 專科別比率…………………………………………………………………………26
圖4-7 執業經驗比率………………………………………………………………………26
圖4-8 用藥習慣比率………………………………………………………………………27
圖4-9 門診量比率…………………………………………………………………………27
圖4-10 醫師職級比率…………………………………………………………………….28
圖4-11 教職別比率……………………………………………………………………….28
圖4-12 閱讀醫療書籍的比率…………………………………………………………….29
圖4-13 每月參加院內學術會議………………………………………………………….29
圖4-14 每月參加院外學術會議次數比率……………………………………………….30
圖4-15 學術發表次數…………………………………………………………………….30















表目錄

表1-1 台灣2008年藥品銷售統計…………………………………………………………6
表2-1 關係行銷的定義……………………………………………………………………14
表3-1 關係行銷影響醫師處方行為之因素………………………………………………21
表3-2 關係強度影響醫師處方行為之因素………………………………………………22
表3-3 關係強度是否能加強關係行銷的品質之因素……………………………………22
表4-1 關係行銷模式影響醫師處方行為…………………………………………………31
表4-2 關係行銷模式影響公立醫院醫師處方行為………………………………………32
表4-3 關係行銷模式影響私立醫院醫師處方行為………………………………………32
表4-4 關係行銷模式影響內科醫師處方行為……………………………………………33
表4-5 關係行銷模式影響外科醫師處方行為……………………………………………34
表4-6 關係行銷模式影響習慣使用原廠藥醫師處方行為………………………………34
表4-7 關係行銷模式影響無特定用藥醫師處方行為……………………………………35
表4-8 關係行銷模式影響門診30-60人次醫師處方行為………………………………35
表4-9 關係行銷模式影響門診60-90人次醫師處方行為………………………………36
表4-10 關係行銷模式影響非主治醫師處方行為……………………………………….37
表4-11 關係行銷模式影響主治醫師處方行為………………………………………….37
表4-12 關係行銷模式影響有教職醫師處方行為……………………………………….38
表4-13 關係行銷模式影響無教職醫師處方行為……………………………………….39
表4-14 關係行銷模式影響每月參加院內會議四次以上的醫師處方行為…………….39
表4-15 關係行銷模式影響每月參加院外會議ㄧ次以上的醫師處方行為…………….40
表4-16 關係行銷模式影響沒有發表學術論文的醫師處方行為……………………….40
表4-17 關係行銷模式影響每年發表學術論文兩次的醫師處方行為………………….41
表4-18 關係行銷影響醫師處方行為…………………………………………………….42
表4-19 關係強度模式影響醫師處方行為……………………………………………….43
表4-20 關係強度模式影響公立醫院醫師處方行為…………………………………….43
表4-21 關係強度模式影響私立醫院醫師處方行為…………………………………….44
表4-22 關係強度模式影響內科醫師處方行為………………………………………….44
表4-23 關係強度模式影響外科醫師處方行為………………………………………….45
表4-24 關係強度模式影響習慣使用原廠藥醫師處方行為…………………………….45
表4-25 關係強度模式影響無特定用藥醫師處方行為………………………………….46
表4-26 關係強度模式影響門診30-60人次醫師處方行為…………………………….46
表4-27 關係強度模式影響門診60-90人次醫師處方行為…………………………….47
表4-28 關係強度模式影響非主治醫師處方行為……………………………………….47
表4-29 關係強度模式影響主治醫師處方行為………………………………………….48
表4-30 關係強度模式影響有教職醫師處方行為……………………………………….48
表4-31 關係強度模式影響無教職醫師處方行為……………………………………….49
表4-32 關係強度模式影響每月參加院內會議四次以上的醫師處方行為…………….49
表4-33 關係強度模式影響每月參加院外會議ㄧ次以上的醫師處方行為…………….50
表4-34 關係強度模式影響沒有發表學術論文的醫師處方行為……………………….50
表4-35 關係強度模式影響每年發表學術論文兩次的醫師處方行為………………….51
表4-36 關係強度影響醫師處方行為…………………………………………………….51
表4-37 關係強度是否影響關係行銷…………………………………………………….52

參考文獻……………………………………………………………………………………57
附錄 問卷………………………………………………………………………………….62

參考文獻
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