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의약품 선별등재제도 도입 전후 건강보험 등재의약품의 특성별 현황
이진이,허지행,이의경,Rhee, Jin-Nie,Heo, Ji-Haeng,Lee, Eui-Kyung 대한약학회 2011 약학회지 Vol.55 No.4
This study aimed to identify the changes in the list of drugs covered by national health insurance(NHI) after the introduction of positive list system (PLS) in Korea in December, 2006. Six-year (pre-policy:2004-2006, post-policy:2007-2009) lists of the NHI reimbursable drugs filed from Health Insurance Review and Assessment Service (HIRA) were analyzed. The total number of listed drugs as well as drug ingredients, and the average number of listed drugs per manufacturer decreased annually after the introduction of PLS. More than 8,000 drugs were delisted in the year 2007 right after the policy change. Prescription-only drugs occupied more than 85% of NHI listed drugs. The percentage of oral type of listed drugs has been increased to more than 60% after the policy change. Korean pharmaceutical manufacturers occupied more than 90% of listed drugs than multinational firms. The gap between Korean and foreign manufacturer in terms of the average number of newly listed drugs per manufacturer in each year has decreased two years after the PLS (Korean 7.7 vs. foreign 6.3 in 2009) as the price negotiation power of foreign firms has increased. The total number of listed drugs is expected to decrease in the future as the Korean government makes an effort to delist the unnecessary drugs that do not show cost-effectiveness.
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공개경쟁입찰을 통해 구매한 의약품 가격의 결정요인: 1개 국공립병원 사례를 중심으로
김혜린 ( Hye Lin Kim ),이진이 ( Jin Nie Rhee ),이의경 ( Eui Kyung Lee ) 한국보건경제정책학회 2011 보건경제와 정책연구 Vol.17 No.2
Korean government has made efforts to contain the pharmaceutical expenditure recently. The actual transaction price (ATP) reimbursement system, introduced in 1999, lacked health care institutions`` incentives to purchase lower-priced drugs. The policy change to the market-based ATP reimbursement system in 2010 permits the institutions to take some profits from the purchase of lower-priced drugs. In addition to the policy change, the degree of competition within a drug ingredient, purchasing power of a wholesaler, and several characteristics of a pharmaceutical are expected to be associated with the contract price of a pharmaceutical purchased through competitive bidding. This study analyzes pharmaceutical contract price data of a period of 2007 to 2010 in a public general hospital which has adopted competitive bidding system on its purchase of the pharmaceuticals. The relative price was defined as ``the contract price compared to the maximum insurance reimbursable price`` for each pharmaceutical. As the number of brands per a generic name ingredient as well as a wholesaler``s buying power increases, the lower the relative price is. Oral type as well as non-ethical drugs are more likely to have lower price. The relative price decreases yearly, but it increases in 2010 because some wholesalers and pharmaceutical manufacturers in face of the reimbursement policy change were reluctant to participate in the bidding. The study results provide information to the health institutions and the government that have tried (or will try) to manage the competitive bidding system as a way of lowering pharmaceutical price and controlling the pharmaceutical expenditure.
ScienceON
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