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1 34

2 35 / 5% D 2005 / / / / VB M&A First-Tier M&A

3 IMS Health 'Strategic Market Review: Overview of 2004 and Key Trend for 2005' Copyright 2006 IMS Health or its affiliates, Source: IMS Health MIDAS, Reprinted with permission 36

4 IMS Health 'Strategic Market Review: Overview of 2004 and Key Trend for 2005' Copyright 2006 IMS Health or its affiliates, Source: IMS Health MIDAS, Reprinted with permission 37

5 38

6 IMS Health 'RetailDrugMonitor' Copyright 2006 IMS Health or its affiliates, Source: IMS Health : Retail Drug Monitor, Reprinted with permission 39

7 HHS, National Health Expenditure 40

8 HHS, National Health Expenditure HHS, National Health Expenditure 41

9 42 US Bureau of Labor Statistics, CPI

10 14% 12% 10% % 8.2 6% 4% 5.3 2% 0% Kaiser Foundation, Employer Health Benefits, Annual Survey,

11 $240 $220 $200 $180 $160 $140 $120 $100 $80 $60 $40 $20 $0 $34 $37 $8 $28 Kaiser Foundation, Employer Health Benefits, Annual Survey, 2004 $50 $48 $45 $40 $35 $33 $ $ $25 $ $ $20 $19 $ $17 $17 $15 $15 $13 $10 $7 $10 $8 $9 $9 $5 $0 GENERIC DRUGS PREFERRED DRUGS NONPREFERRED DRUGS FOUR-TIER DRUGS $222 $201 $178 $149 $135 $124 $122 $52 $47 $39 $42 $ SINGLECONVERAGE FAMILYCOVERAGE Kaiser Foundation, Employer Health Benefits, Annual Survey,

12 Kaiser Foundation, Employer Health Benefits, Annual Survey,

13 46 HHS HHS, National Health Expenditure

14 Medco Drug Trend Report, Vol7, 2005, CMS Health Care Financing Review, Age Estimates in the National Health Accounts, Dec,

15 Kaiser Foundation, Employer Health Benefits, Annual Survey, 2004 D 4, CBO, Issue in Designing a Prescription Drug Benefit for Medicare 48

16 D % 29% 39% 47% 4% Health Affairs, U.S. Health Spending Projections For % 4% D % 20% 28% 49

17 50

18 51

19 IMS Health, Retail Drug Monitor Copyright 2006 IMS Health or its affiliates, Source: IMS Health : Retail Drug Monitor, Reprinted with permission IR 2005 GSK

20 Medco, Drug Trend Report, Vol7,

21 2004 Medco, Drug Trend Report, Vol7, 2005 IR 54

22 M&A IR 55

23 IR 56

24 J&J 57

25 58

26 IMS Health, Retail Drug Monitor Copyright 2006 IMS Health or its affiliates, Source: IMS Health : Retail Drug Monitor, Reprinted with permission 59

27 60

28 61

29 BMS 62

30 IR 63

31 IR 64

32 IR 65

33 IR 66

34 67

35 68 VB First Tier

36 FDA, CDER Drug and Biologic Approval Reports 69

37 70

38 71 J&J

39 72

40 73 IR

41 IR

42

43

fringe benefit 6565 1 FEHB Federal Employees Health Benefits States Employee Health Benefits Medicare 1965 TitleX VIII of the Social Security Act1966

fringe benefit 6565 1 FEHB Federal Employees Health Benefits States Employee Health Benefits Medicare 1965 TitleX VIII of the Social Security Act1966 特 集 :アメリカの 社 会 保 障 アメリカの 医 療 保 障 システム 雇 用 主 提 供 医 療 保 険 の 空 洞 化 とオバマ 医 療 保 険 改 革 長 谷 川 千 春 1980 20 1 2 2009 2010 2 Employer- Sponsored Health Insurance I 65 16 fringe benefit 6565 1 FEHB Federal Employees

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