제약산업의 R&D 투자, 기업 규모 및 성과에 대한 연구 : 슘페터 가설 검정과 신약 개발을 중심으로

사공진 ( Sakong Jin ),권지선 ( Kwon Ji-seon ) 한국보건경제정책학회(구 한국보건경제학회) 2017 보건경제와 정책연구 Vol.23 No.3

인구 고령화에 따라 신약에 대한 수요가 지속적으로 증가하고 있으나 국내 제약산업은 제네릭 위주의 생산 구조로 대부분 규모가 매우 영세할 뿐 더러 시장 규모에 비하여 과다한 수의 업체들이 난립하는 독점적 경쟁 구조를 나타내고 있다. 본 연구에서는 산업조직론 이론인 Schumpeter Mark Ⅱ 가설을 국내 상장 제약기업에 대해 검정하고 Triangular Model을 이용하여 R&D 투자가 기업 성과에 미치는 영향에 대해 분석하였다. 또한, 패널 포아송 회귀모형을 사용하여 전체 제약기업을 대상으로 신약 및 개량신약 개발 결정요인에 대해서도 추정하였다. 추정 결과, 상장기업에서 매출액과 R&D 집약도 간 U자형 관계가 있는 것으로 분석되었고 약79%의 기업에서 슘페터 가설이 성립하였다. 또한, 기업성과의 대리변수인 시가총액에 대해 R&D 집약도는 유의한 정(+)의 관계가 있는 것으로 분석되었다. 전체 제약기업에 대한 신약 및 개량신약 개발 결정요인 추정 결과, 기업의 누적 R&D 투자액이 클수록 신약 및 개량신약개발 확률이 높은 것으로 나타남으로써 기업 규모, 기업 성과, 신약 개발 그리고 기술혁신 활동 간에 유기적인 정(+)의 관계가 있는 것으로 분석되었다. As the population ages, the market demand for new drugs is increasing. However, South Korea`s pharmaceutical industry takes a profit structure on Generics, and an excessive number of companies make exclusive competitive market compared to the market size. We tested Schumpeter Mark Ⅱ, which is a theory of industrial organization theory and claims the positive relationship between R&D investment and the firm size. We also analyzed the effect of R&D on firm`s performance in the listed companies. In addition, we estimated the panel logistic regression to conduct an empirical analysis on the determinants of developing new drug and IMD. Estimation results showed the U-shaped relationship between the firm size and R&D intensities; Schumpeter hypothesis was established in about 75% of listed companies. R&D intensity has a positive influence on market capitalization. As a result of the analysis on the whole pharmaceutical industry, We found that the larger the amount of R&D investment is in two years, the higher the probability of developing new drugs and IMD is. Therefore, we found that there is an organic positive relationship between R&D, the firm size, firm performance and development of new drugs.

노인장기요양보험 지역별 인정률 결정요인에 대한 패널분석

사공진 ( Jin Sakong ),송현종 ( Hyunjong Song ) 한국보건행정학회 2017 보건행정학회지 Vol.27 No.1

Background: There have been deviations in the regional rate of certification in Korean long-term care insurance (LTCI). This study aimed to explore the determinants of the rate of certification in LTCI. Methods: The panel data of the year 2010-2014 of the 227 National Health Insurance Service (NHIS) regional office were used. Making use of 26 explanatory variables (socio-demographic factors, access to the long-term care services, etc.), we estimated the random effects model using STATA SE ver. 13.0 program (Stata Corp., College Station, TX, USA) and tried to find out the determinants of the regional rate of certification. Results: Estimation results showed that the most important determinants of the regional rate of certification in LTCI are the long-term care infrastructure such as capacity or number of the homecare service institution, sanatorium, or convalescent hospital. The number of the elderly who lives alone and the dimentia patients were positively related to the regional rate of certification in LTCI. Conclusion: The estimation results implied that the regional variation in the rate of certification in LTCI has nothing to do with the NHIS regional offices or their employees. To alleviate the deviation in the regional rate of certification in LTCI, we suggested the analysis of the deviation in the survey checklist. We also proposed to found the regional comprehensive support center to prevent the geriatric illness and to improve the residents` health, etc.

의료기관 간 경쟁이 의료공급자의 진료행태에 미치는 영향에 관한 연구

사공진 ( Jin Sakong ),권의정 ( Eui Jung Kwon ) 한국보건경제정책학회(구 한국보건경제학회) 2011 보건경제와 정책연구 Vol.17 No.2

우리나라는 전국민의료보험제도를 도입하는 과정에서 짧은 시간 동안 지속적으로 병상이 공급되었고, 이에 따라 의료기관 간 환자유치를 위한 경쟁이 심화되어 왔다. 본 연구는 실증분석을 통해 의료기관 간 경쟁정도의 변화에 따른 의료공급자 유인수요의 존재여부를 파악하고 그 효과를 분석하는 것을 목적으로 하고 있다. 분석 결과 병원급 이상 의료기관의 설립주체가 국공립 및 개인일 경우와 의원의 다빈도 질환에 대한 세부상병별 접근 시 경쟁의 증가에 따라 건당내원일수와 건당진료비가 증가하는 것으로 나타나 공급자 유인수요가 존재할 가능성이 있음이 확인되었다. 그러나 병원급 이상 의료기관의 진료권역별 분석과 의원의 전국단위 분석에서는 경쟁이 오히려 건당내원일수와 건당진료비를 감소시키는 효과를 보이고 있는 것으로 나타났다. In Korea, the sickbeds have increased substantially in the process of expanding national health insurance system. The purpose of this research is figuring out the existence of medical suppliers inducing demand which is caused by the competition between the medical care suppliers and analyzing the effect by the panel study. The result of analysis confirms that suppliers induced demand may exist. Because the research shows that visit days per case and treatment amount per case are increasing by the increase of competition. But in the national level analysis, it was found that competition makes visit days per case and treatment amounts per case decrease.

한국의 보건의료 개혁: 형평과 효율성의 측면

사공진 ( Jin Sakong ) 한국사회보장학회 2006 사회보장연구 Vol.22 No.1

안산시 삶의 질 지표 개발에 관한 연구

사공진(Jin Sakong) 한양대학교 디지털경제연구소 1998 디지털경제연구 Vol.3 No.-

건강보험 재정안정화 방안에 대한 연구

사공진 ( Jin Sakong ) 한국보건경제정책학회(구 한국보건경제학회) 2003 보건경제와 정책연구 Vol.9 No.2

Stochastic Frontier Analysis를 이용한 제약회사의 효율성과 그 결정요인분석

사공진 ( Jin Sakong ),김정규 ( Jeongkyu Kim ) 한국보건행정학회 2015 보건행정학회지 Vol.25 No.2

Background: In 2012, Ministry of Health and Welfare announced 5-year plan of the development of the pharmaceutical industry, which pointed out the problems of the pharmaceutical industry as the insufficient investment in research and development (R&D) and the unfair business practice, and suggested the technological innovation, market transparency and nurturing global enterprises as solutions. It is quite interesting to study which factors determine the efficiency of the pharmaceutical firms. Methods: To estimate the efficiency of the pharmaceutical firms and the determinants of their efficiency, methods of the stochastic frontier analysis and the panel study are applied to the data of 60 domestic pharmaceutical firms from 2006 to 2012. The efficiency is derived by the distance between the decision making units and the most efficient frontier curve. Results: First, the result of the stochastic frontier analysis shows that overall efficiency of the pharmaceutical firms is increasing as time goes by. If classified by the scale, the larger firms show higher efficiency and if classified by the degree of innovation, the innovative firms show higher efficiency compared to the less-innovative ones. Second, the result of estimation of the determinants of efficiency shows that the firms with larger expenses of the sales promotion and the entertainment, show lower efficiency. Conclusion: The first result implies that the scale of the firm and the investment in R&D explain the efficiency of the pharmaceutical firms. Therefore, it is necessary to increase the investment on the fundamental researches to vitalize R&D of the new drugs. The second result can be explained by the structural characteristics of the small pharmaceutical firms which produce generic drugs. Therefore, the government tries to make the pharmaceutical firms to optimize of the expenses of the sales promotion and the entertainment, and to increase R&D with the policies such as to boost up the R&D investment and to prohibit rebates, etc.

사망 관련 비용(Cost of Dying)에 대한 경제적 분석 - 과잉 진료와 삶의 질을 중심으로 - ¹⁾

안영 ( Young Ahn ),사공진 ( Jin Sakong ) 한국보건경제정책학회(구 한국보건경제학회) 2017 보건경제와 정책연구 Vol.23 No.3

본 연구에서는 의료비 급증의 주요인을 사망 관련 비용 즉, 사망 직전 사용한 의료비와 과잉진료를 이용하여 설명하고, 생애 말기에 투입되는 막대한 양의 의료비가 삶의 질에 미치는 영향을 분석하였다. 이를 위해 2009년부터 2013년까지 한국의료패널 5개년 자료를 이용하여 사망까지의 기간과 과잉진료가 의료비에 미치는 영향을 확인하고, 과잉진료의 발생 요인을 살펴보았다. 이와 함께, 생애 말기에 지출된 의료비인 사망 관련 비용을 따로 분리해 결정요인을 분석하고, 나아가 삶의 질에 미치는 영향을 확인하였다. 분석 결과, 사망이 임박함에 따라 의료비 지출이 유의하게 증가하였다. 사망에 가까울수록 과잉진료의 발생 확률은 증가하였고, 과잉진료는 의료비와 사망 관련 비용을 유의하게 증가시켰다. 그러나 생애 말기에 투입되는 사망 관련 비용은 삶의 질에 유의한 영향을 미치지 못하는 것으로 나타났다. 따라서 사망 관련비용의 효과성에 대하여 의문을 제기할 수 있으며, 생애 말기 의료비 지출 규모를 줄이고 이를 호스피스 완화의료로 대체시킬 필요성이 있다 하겠다. 본 연구는 과잉진료와 의료비 지출 간의 관계와 아울러 사망 관련 비용을 실증적으로 분석해보고 사망 관련 비용이 삶의 질에 미치는 영향을 살펴보았다는 점에서 의의가 있다고 하겠다. The purpose of this study is to analyze major causes of the surge in the medical expenditure using `cost of dying`, that is, medical expenses just before the death and overtreatment, and to identify the effect of enormous amount of medical expense before death on quality of life. This study used Korea Health Panel data from 2009 to 2013 to examine the effect of time to death and overtreatment on the medical care expenditure and the causes of overtreatment. In addition, we analyzed the determinants of the cost of dying spent at the end of life and confirmed their impact on the quality of life. As a result of the analysis, the medical expenditure was significantly increased as the death was imminent. The closer to death, the greater probability of overtreatment and overtreatment significantly increased the medical care expenditure and the cost of dying. However, the cost of dying at the end of life did not have significant effect on the quality of life. This suggest that there is no efficiency in cost of dying, which pointed out to be excessive, and it is necessary to reduce medical expense at the end of life and replace it with hospice and palliative care. This study is meaningful in the sense that it investigated the relationship between overtreatment and the medical expenditure as well as the cost of dying and examined the effect of the cost of dying on the quality of life.

MRI 외부병원 판독 수가 인상의 효과 분석: 뇌 관련 자기공명영상을 중심으로

김록영 ( Logyoung Kim ),사공진 ( Jin Sakong ),조민호 ( Minho Jo ),위세아 ( Seah Wee ),이진용 ( Jinyong Lee ),김용규 ( Yongkyu Kim ) 한국보건행정학회 2021 보건행정학회지 Vol.31 No.3

Background: In 2018, the government increased the fee for the magnetic resonance imaging (MRI) image deciphering services of the external hospital to discourage the redundant MRI scan and to induce appropriate use of the MRI services. It is important to evaluate the effect of the policy to provide the basis for establishing other MRI-related policies. Methods: The healthcare data of the patients who had brain MRI scans were organized by episode and analyzed using the panel study in order to find out the effect of the MRI-related policy on the substitution effect and the medical expenses. Results: As a result of the increase in the fee of deciphering the MRI image, there has been an uplift in deciphering the MRI scan of the external hospital. It implies that more hospitals chose to use the MRI scan taken by other clinics or hospitals, rather than the MRI scan taken at their own facilities. Conclusion: The research results imply that a policy that facilitates the exchange of the medical image data between the hospitals is needed in order to establish an efficient management system of the healthcare resources. Such improvement is expected to reduce the social cost and contribute to the stability in the finance of national health insurance.

노년기 상용치료원 보유의 효과 분석: 의료비와 주관적 건강상태에 대한 효과를 중심으로

전예지 ( Yeji Jeon ),사공진 ( Jin Sakong ) 한국보건행정학회 2021 보건행정학회지 Vol.31 No.4

Background: Population aging is a serious problem in Korea. And we have experienced a rapid increase in the health expenditures of the elderly. The purpose of this paper is to analyze the effect of having a usual source of care (USC) for the elderly. Methods: This study used the Korea Health Panel Survey data of 2012, 2013, 2016, 2017, and 2018. The sample was the person who answered the USC questions among the elderly. The panel logit model was used to analyze the determinants of having USC and the panel simultaneous equation model was used to analyze the effect of having USC among the elderly on the medical expenses, medical utilization, and subjective health status. Results: The estimation result shows that age, income, marriage, and so forth turn out to be the factors of having USC. Having the clinic level USC is estimated to reduce the health care utilization and the health expenditure and to improve the subjective health status. Conclusion: It is expected that the result of our analysis will provide evidence for encouraging having USC.