Browse > Article
http://dx.doi.org/10.5392/JKCA.2022.22.06.712

Current Status of the Reimbursement for Pharmacist-provided Health Care Services in Japan, the United States, and the United Kingdom  

Park, Ji Hyun (덕성여자대학교 약학대학)
Publication Information
Abstract
World-widely, there has never been a greater need for people to access high-quality expertise about the effective and safe use of medications. Therefore, the profession of pharmacy should meet these needs of the times, as the demographic shifts have led to a situation where older adults now outnumber children, and polypharmacy is also a commonplace. However, the reimbursement system covered by the National Health Insurance (NHI) in Korea is still limited to the traditional dispensing and compounding role of pharmacist. To provide a take-home message to Korean pharmacy reimbursement system, we aimed to review and analyze the international trends in pharmacy remuneration systems. This is a comparative study between Korea, Japan, the United Kingdom, and the United States. Comparison was conducted by reviewing each country's policy and enforcement programs, as well as the related literature. Japan, the UK and the US systems remunerate diverse patient-centered pharmaceutical care services. The Korean pharmacy service fee is, however, narrowly focused on the traditional product-oriented pharmacy services. This study discussed the future direction of improving pharmacist reimbursement systems in Korea, by expanding professional pharmacy service coverage and diversifying fee schedule.
Keywords
Pharmacy Services; Pharmacy Reimbursement; Health Insurance Fee Schedule; Health Policy; Pharmacist Remuneration;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 PIP, "DRUG TARIFF PRICE INFORMATION,"
2 P. S. N. Committee, Professional Fees (Drug Tariff Part IIIA). 2022. https://psnc.org.uk/dispensing-supply/endorsement/fees-allowances/
3 D. K. Lee, "UK, Pharmacist prescriber status to be expanded," The Yakup, 2000. https://www.yakup.com/news/index.html?mode=view&nid=4945
4 E. Birbeck, "Clinical pharmacists supporting inpatient diabetes patients," Diabetes & Primary Care, Vol.21, No.5, 2019.
5 M. Ross, Pharmacist Tops Forbes' List of Best Health Care Jobs in 2015, Pharmacy Times, 2014. https://www.pharmacytimes.com/view/pharmacist-tops-em-forbes-em-list-of-best-health-care-jobs-in-2015.
6 C. Cheong and S. E. Choi, "Global trends in remuneration systems for community pharmacy services and implications to Korea," The Korean Journal of Health Economics and Policy, Vol.19, No.4, pp.129-151, 2013.
7 M. Matalavage, Navigating the Complexities of Pharmacy Reimbursement: Will We Ever Reach Transparency?, Pharmacy Times, 2016. https://www.pharmacytimes.com/view/navigating-the-complexities-of-pharmacy-reimbursement-will-we-ever-reach-transparency
8 S. M. Sarah Shoemaker-Hunt, Olivia Bacon, Jacqueline Gillis, Jason Brinkley, Marci Schalk, and Lauren Olsho, Cost of Dispensing Study, A. Associates, 2020.
9 W. H. Kim and E. Han, "A Review of the Efficiency of Pharmaceutical Expenditure in Korea," Public Finance Forum, Vol.290, pp.59-62, 2020. http://kiss.kstudy.com/thesis/thesis-view.asp?g=kissmeta&m=exp&enc=1A1EEE1DF2A2CA232BB7E
10 H. L. Kim, Y. H. Jo, J. H. Lee, E. Y. Jeon, J. Y. Lee, and E. M. Kim, "Research on the Relative Value of Pharmaceutical Care Services Performed by Hospital Pharmacists," [Research on the Relative Value of Pharmaceutical Care Services Performed by Hospital Pharmacists]. Journal of Korean Society of Health-System Pharmacists, Vol.38, No.2, pp.155-170, 2021. https://www.kci.go.kr/kciportal/ci/sereArticleSearch/ciSereArtiView.kci?sereArticleSearchBean.artiId=ART002719368 2021.   DOI
11 Y. Song, "Position and valuation of hospital pharmacy services within the fee-for-service system," Journal of Korean Society of Health-System Pharmacists, Vol.31, No.6, pp.1054-1066, 2014.
12 H. L. Kim, M. H. Kim and H. Park, "Comparative Study on Reimbursement Fees Related to Hospital Pharmacists'Services in Korea and Japan," Journal of Korean Society of Health-System Pharmacists, Vol.38, No.1, pp.75-92, 2021.   DOI
13 Y. H. Lee, J. N. Nam, and E. Cho, "The Factors Related to the Intention of Pharmacists for Participating in the Designated Pharmacy Program," Korean Journal of Community Pharmacy, Vol.3, No.2, pp.93-101, 2017.
14 W. Baqir, D. Miller, and G. Richardson, "A brief history of pharmacist prescribing in the UK," European Journal of Hospital Pharmacy: Science and Practice, Vol.19, No.5, pp.487-488, 2012.   DOI
15 M. Yearm, "The effect of the improvement of the sales regulation of general medicine and political proposals," Journal of channel and retailing, Vol.15, No.5, pp.237-255, 2010.
16 C. Wohlin, "Guidelines for snowballing in systematic literature studies and a replication in software engineering," Proceedings of the 18th international conference on evaluation and assessment in software engineering, 2014.
17 J. Kim, "A Study on the Health Insurance System in Japan : Comparison with Korea's Health Insurance," Ewha Women's University The Graduate School of Converging Clinical & Public Health, Master's Degree Thesis, 2019.
18 I. H. Lee, N. K. Je, E. J. Kyung, J. Y. Kim, and S. Lee, "Drug utilization review from a perspective of community pharmacists in South Korea: a qualitative study," The Korean Journal of Health Economics and Policy, Vol.17, No.3, pp.127-161. 2011.
19 B. K. Yoo, Y. S. Lee, and R. Y. Kang, "Current status of pharmaceutical care service in community pharmacy in Korea," Yaghag-hoi-ji, Vol.62, No.1, pp.14-20, 2018. https://doi.org/10.17480/psk.2018.62.1.142018.   DOI
20 B. Kim, "From Beveridge Welfare State to Cameron Government: A Case Study of Britain on the Role and Strategies of Think Tanks in Welfare State Paradigm Changes," Korean Journal of Social Welfare, Vol.67, No.2, pp.259-284. 2015.   DOI
21 J. Cylus, E. Richardson, L. Findley, M. Longley, C. O'Neill, D. Steel, and W. H. Organization, "United Kingdom: health system review," 2015.
22 A. M. Association, "CPT (Current Procedural Terminology)," Retrieved from https://www.ama-assn.org/amaone/cpt-current-proceduralterminology 2021.
23 S. H. Kim, M. H. Kim, E. H. Son, and H. Kim, "A Review on Service Fees of Pharmacists : Focused on the Medication Therapy Management Service in the United States," Journal of Korean Academy of Managed Care Pharmacy, Vol.7, No.2, pp.102-110, 2019.
24 G. B. Lee and H. Y. Kang, "Review of National Policies for Safe and Appropriate Use of Medications in Korea and Selected Countries," Journal of Korean academy of social & managed care pharmacy, Vol.5, No.1, pp.16-28, 2016,
25 K. E. Kwon, M. G. Kim, M. K. Shim, and H. Sohn, "The Status and Perception on Compounding Powdered Medicine for Adult Patients in Community Pharmacies," [The Status and Perception on Compounding Powdered Medicine for Adult Patients in Community Pharmacies]. Yakhak Hoeji, Vol.63, No.4, pp.185-191, 2019. https://www.kci.go.kr/kciportal/ci/sereArticleSearch/ciSereArtiView.kci?sereArticleSearchBean.artiId=ART002500320 2019.   DOI
26 K. Park, N. Kim, J. H. Kim, and S. Jang, "2019 The current health insurance systems and reformation trend in major countries," National Health Insurance Services, 8(United Kingdom). https://nl.go.kr/NL/contents/N20103000000.do?schM=contView&schOpt1=CA0000000031&schOpt2=CA0000000374&schOpt3=01&schIdSub=CO202011101402426521 2019, Services, N. H. "Primary care services," Retrieved from https://www.england.nhs.uk/get-involved/get-involved/how/primarycare/ 2022.
27 S. H. Kwon, E. H. Sohn, and H. L. Kim, "A Comparative Study on Health Insurance Fees Related to Community Pharmacists' Services in Korea and Japan," [A Comparative Study on Health Insurance Fees Related to Community Pharmacists' Services in Korea and Japan]. Yakhak Hoeji, Vol.65, No.1, pp.10-16, 2021. https://www.kci.go.kr/kciportal/ci/sereArticleSearch/ciSereArtiView.kci?sereArticleSearchBean.artiId=ART002690957   DOI
28 D. Chung, 2022 Dispensing Fee to rise by 3.6%, Korea Pharmaceutical Association News, 2021.
29 H. O. Lee and J. O. Byeon, "Capturing the Patient-centeredness and New Communities in the Perceived Roles of Community Pharmacists," Yakhak Hoeji, Vol.64, No.5, pp.418-429, 2020.   DOI
30 J. Yoon, "Development of a Pharmaceutical Care Service Model for Patients with Diabetes in Ambulatory Care Settings," Korean Journal of Clinical Pharmacy, Vol.27, No.1, pp.1-8, 2017.   DOI
31 Y. D. Park, [Contribution] Need to increase pharmacy service fee by reevaluation, Dailypharm, 2020. http://www.dailypharm.com/Users/News/NewsView.html?ID=270328
32 S. Y. Suha, et al., "Analysis of Work Activities and Proportion of Time Performed by Hospital Pharmacists," Journal of Korean Society of Health-System Pharmacists, Vol.37. No.2, pp.126-150, 2020.   DOI
33 S. Y. Nam, "The Study on Japanese Health Care Insurance and Medical Service Reimbursement System," Korean Medical Association, pp.1-346, 2010.
34 S. Lee, "Pharmacy retail system under the reformed pharmacy law," Korea Legislation Research Institute, 2009.
35 H. Eom, "The Revision of Medical Fee Schedule in Japan, 2020," HIRA Research, Vol.14, No.3, pp.66-76, 2020.
36 Y. S. Shin. H. J. Kang, D. K. Hwang, S. J. Kim, S. W. Kim, S. L. Ha, K. R. Park, J. H. Kim, E. W. Seo, Y. Ahn, J. H. Kim, H. S. Jung, H. S. Kim, J. I. Na, and S. J. Kim, Research on the finantial accountability for the 3rd reform of relative value scale, 2019.
37 Y. J. Kim, "NHS Hospital Pharmacist Training Programme in UK," Korean Journal of Clinical Pharmacy, Vol.25, No.4, pp.209-215, 2015.
38 C. Eickhoff, N. Griese-Mammen, U. Meller, A. Said, and M. Schulz, "Primary healthcare policy and vision for community pharmacy and pharmacists in Germany," Pharm Pract (Granada), Vol.19, No.1, 2248, 2021. https://doi.org/10.18549/PharmPract.2021.1.2248   DOI
39 G. Sachdev, M. A. Kliethermes, V. Vernon, S. Leal, and G. Crabtree, "Current status of prescriptive authority by pharmacists in the United States," Journal of the American College of Clinical Pharmacy, Vol.3, No.4, pp.807-817, 2020.   DOI
40 N. Agrawal, "Understanding Medicare Part B incident to billing," Bulletin of the American College of Surgeons, Vol.101, No.8, pp.51-52, 2016.
41 H. C. H. Karen Whalen, Reimbursement for pharmacist services, In Medication Therapy Management: A Comprehensive Approach (2e ed.). https://accesspharmacy.mhmedical.com/book.aspx?bookID=2319 2018.
42 D. Weitzman, Provider Status for Pharmacists: It's About Time, Pharmacy Times, 2020. https://www.pharmacytimes.com/view/provider-status-for-pharmacists-its-about-time
43 D. Oh, "A Study on the Sensitivity of Conversion Factor According to Change of Base Year," [A Study on the Sensitivity of Conversion Factor According to Change of Base Year]. Journal of the Korea Academy Industrial Cooperation Society, Vol.21, No.4, pp.201-209. 2020. https://www.kci.go.kr/kciportal/ci/sereArticleSearch/ciSereArtiView.kci?sereArticleSearchBean.artiId=ART002580068 2020.
44 J, H, Lee, H. S. Shin, and H. T. Shin, "Quality Evaluation of Medication Counseling in Korean Community Pharmacies," Korean Journal of Clinical Pharmacy, Vol.19, No.2, pp.131-145, 2009.
45 A. Cernasev, M. Aruru, S. Clark, K. Patel, N. Dipietro Mager, V. Subramaniam, andH. A. Truong, "Empowering Public Health Pharmacy Practice-Moving from Collaborative Practice Agreements to Provider Status in the U.S." Pharmacy, Vol.9, No.1, p.57, 2021. https://doi.org/10.3390/pharmacy90100572021.   DOI
46 Y. S. Shin, H. W Shin, D. K. Hwang, P. K. Yoon, and J. Na, "A research on the improvement of differential payment policy in primary care (dispensing)," In: Health Insurance Review and Assessment Service, 2009.