Korean Journal of Clinical Pharmacy (한국임상약학회지)

Korean College Of Clinical Pharmacy (한국임상약학회)
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An Overview of the Risk Sharing Management in Korean National Health Insurance, Focused on the Effect of the Patient Access and Insurance Finance

우리나라 건강보험의 위험분담제도가 재정 및 환자접근성에 미친 영향

  • Lee, Jong Hyuk (Department of Pharmaceutical Engineering, College of Life and Health Science, Hoseo University) ;
  • Bang, Joon Seok (Graduate School of Clinical Pharmacy, Sookmyung Women's University)
  • 이종혁 (호서대학교 생명보건과학대학 제약공학전공) ;
  • 방준석 (숙명여자대학교 임상약학대학원)
  • Received : 2018.04.18
  • Accepted : 2018.06.18
  • Published : 2018.06.29
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Abstract

Objective: This study examined the Risk Sharing Agreement (RSA) on pharmaceutical pricing system in Korean national health insurance. Through RSA, the insurer was able to maintain the principles in the price listing process while managing the budget effectively and improving patient access to new drugs. Despite these positive effects, there are still issues raised by some stakeholders, such as lack of transparency in the listing process and doubts about its effectiveness. Therefore, we investigated the impacts of RSA on national health insurance financing and patient access to analyze the effects of RSA. Methods: The impact of RSA was investigated by analyzing the health insurance claims data for 2014~2016. The degree of improvement in patient access was determined by the decreased amount of patients' payment. Results: Results showed that the financial impact of RSA was not significant and patients' access to the new drug greatly improved. Conclusion: These results show that RSA is a good system for improving patient access to new drugs without additional expense on insurance.

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References

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