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한경희 ( Kyung Hee Han ),고수경 ( Su Kyoung Ko ),정설희 ( Seol Hee Jeong ) 한국병원경영학회 2007 병원경영학회지 Vol.12 No.1
This study was carried out to analyze the present condition of high-price medical technologies in South Korea and to compare it with OECD countries. This study included 10 high-price medical equipments and used medical equipment registry data of Health Insurance Review Agency. The major findings of this study are as follows; Firstly, The number and growth of high-price medical equipments in South Korea is much higher than those in other OECD countries. There are many of high-price medical equipments even in clinics. Secondly, the percentage of old poor-quality medical equipments is very high, especially in clinics. This is because of high-price of medical equipments. The results of this study implicated that there is high possibility of inappropriate use of high-price medical technologies. This may result in the increase of health expenditure; therefore, there should be a kind of regulation policy to control amount and quality of medical equipment.
참조가격제: 주요 국가의 사례 및 정책적 함의 -독일, 호주, 캐나다, 뉴질랜드, 노르웨이를 중심으로
이연주 ( Youn Joo Lee ),박지현 ( Ji Hyun Park ),신현호 ( Hyun Ho Shin ),고수경 ( Su Kyoung Ko ) 한국사회보장학회 2013 사회보장연구 Vol.29 No.4
우리나라에서는 지난 몇 년간 건강보험 재정안정화를 위해 다양한 정책적 변화를 시도하였으며, 이러한 약제비 규제 정책은 앞으로도 지속적으로 유지될 것으로 보인다. 참조가격제는 이미 여러 국가에서 운영되고 있는 제도 중 하나로 종종 국내 도입에 대한 논의가 이루어지는 제도 중 하나이다. 이러한 배경 하에서 본 연구는 주요국 참조가격제의 구체적인 내용을 고찰하고 이를 통해 정책적 함의를 찾고자 하였다. 각국 정부는 급격히 증가하는 약제비를 관리하기 위해 참조가격제를 도입하였고, 많은 국가에서 단기적으로 재정절감 효과를 보이기도 하였다. 하지만 재정절감에 대한 장기적인 효과에 대해서는 다른 견해가 존재하였다. 일부에서는 원하는 정책적 목적을 달성하지 못하고 참조가격제를 폐지하거나, 단순히 보험자가 부담했던 약제비의 일부가 환자에게 전가되는 현상이 나타나기도 하였다. 참조가격제의 도입이 우리나라 시장에서 어떤 방식으로 작동할 수 있을지에 대해 더많은 논의가 필요하다. 참조가격제를 포함한 새로운 약가 제도의 도입 논의에 앞서 모든 이해당사자들간에 충분한 의견 수렴과 사회적 합의를 이루어 향후 정책 결정에 고려하여야 한다. Many cost-containment measures have been introduced in Korea to stabilize increasing pharmaceutical expenditure. Recent changes, such as a government-mandate price cut for generics and off-patent products in Korea, can be viewed as a stepping stone for a new policy such as reference pricing. The purpose of this study is to understand reference pricing in other countries and draw implication for Korea. A literature review was conducted on MEDLINE and EMBASE using ‘reference pricing’ and ‘reference price’ as keywords. We reviewed studies according to the established criteria. A hand search was conducted to include broader categories of studies and reports related to reference pricing. Reference pricing was adopted in many countries in order to control rapidly growing pharmaceutical expenditure. The system evolved differently over many years among markets depending on the healthcare system and pricing policies. In terms of market response, reference pricing had a huge impact on both the prescription behavior and price level in many countries. However, overall savings seemed to be moderate so the payers eventually came up with more comprehensive cost-containment policies either in addition to reference pricing or following the abolishment of it. Considerable portion of cost savings came from increased patient co-payments in some countries. It is unclear to tell whether the reference pricing system will be able to yield much savings to the government if it is introduced in Korea. More researches on the system`s implication to the stakeholders should be conducted to further study the effects of the system.