• Title/Summary/Keyword: Drug administration cost

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Definition of Medical Drug Administration Cost and Development of Its Costing Model under the Korean Medical Insurance Fee-for-Service System (의료보험 의약품 관리원가의 정의 및 산정모형 개발)

  • 황인경
    • Health Policy and Management
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    • v.9 no.1
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    • pp.1-29
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    • 1999
  • The Government has recently planned to improve the medical insurance drug price systems by removing the drug margin occurring from the difference between the official and purchasing prices, and instead by setting prices through adding drug administration casts calculated to the purchasing costs. In the circumstances, the major policy and implementing issues are how to define the drug administrance cost and how to calculate them. This study attempts to provide for the conceptional and operational definitions and thereby develop a costing model for the cost. The relationship between the current systems of medical services costs and prices were reviewed to define the concept of the costs. The study defined the costs from the narrow and wide prospective of meaning, and three operational definitions were provided. The costing model was developed applying the departmental costing principles. Finally, several prerequisites that have to be considered for the implementation of the definition and the model from the practical viewpoint.

Socioeconomic Costs of Food-Borne Disease Using the Cost-of-Illness Model: Applying the QALY Method (식중독의 사회경제적 비용추정: 삶의 질 개념을 적용한 질병비용추정법을 이용하여)

  • Shin, Ho-Sung;Lee, Sue-Hyung;Kim, Jong-Soo;Kim, Jin-Suk;Han, Kyu-Hong
    • Journal of Preventive Medicine and Public Health
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    • v.43 no.4
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    • pp.352-361
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    • 2010
  • Objectives: This study estimated the annual socioeconomic costs of food-borne disease in 2008 from a societal perspective and using a cost-of-illness method. Methods: Our model employed a comprehensive set of diagnostic disease codes to define food-borne diseases with using the Korea National Health Insurance (KNHI) reimbursement data. This study classified the food borne illness as three types of symptoms according to the severity of the illness: mild, moderate, severe. In addition to the traditional method of assessing the cost-of-illness, the study included measures to account for the lost quality of life. We estimated the cost of the lost quality of life using quality-adjusted life years and a visual analog scale. The direct cost included medical and medication costs, and the non-medical costs included transportation costs, caregiver's cost and administration costs. The lost productivity costs included lost workdays due to illness and lost earnings due to premature death. Results: The study found the estimated annual socioeconomic costs of food-borne disease in 2008 were 954.9 billion won (735.3 billion won-996.9 billion won). The medical cost was 73.4 -76.8% of the cost, the lost productivity cost was 22.6% and the cost of the lost quality of life was 26.0%. Conclusions: Most of the cost-of-illness studies are known to have underestimated the actual socioeconomic costs of the subjects, and these studies excluded many important social costs, such as the value of pain, suffering and functional disability. The study addressed the uncertainty related to estimating the socioeconomic costs of food-borne disease as well as the updated cost estimates. Our estimates could contribute to develop and evaluate policies for food-borne disease.

Development of Analytical Method for Ambroxol Hydrochloride and Clenbuterol Hydrochloride Formulation in Korean Pharmaceutical Codex (고시수재 의약품 중 암브록솔염산염 및 클렌부테롤염산염 함유 제제의 함량 시험법 개선)

  • Lee, Tae-Woong;Jeong, Rae-Seok;Park, Soo-Jin;Choi, Lan;Shim, Young-Hun;Choi, Bo-Kyung;Kwak, Hyo-Sun
    • YAKHAK HOEJI
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    • v.58 no.3
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    • pp.190-199
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    • 2014
  • The Korean Pharmaceutical Codex (KPC) analytical method of ambroxol hydrochloride and clenbuterol hydrochloride formulation is complicated and needed to carry out multiple processes during the test. To improve the low efficiency of analytical procedure that makes pharmaceutical laboratory consume much time and high cost to conduct the test of this formulation, this study was performed for simplifying the pretreatment process and optimizing conditions of the HPLC assay. The analytical procedure using HPLC was developed to establish analytical specification for ambroxol hydrochloride and clenbuterol hydrochloride formulations. The newly developed analytical method has good linearity ($R^2$ >0.999), specificity, precision (RSD<1.0%) and the recovery ranges of 98.50~101.84% for ambroxol, 98.29~101.35% for clenbuterol syrup and 98.66~101.71% for clenbuterol tablets. The LOQs were 0.204 ${\mu}g/ml$ for ambroxol, 0.021 ${\mu}g/ml$ for clenbuterol syrup and 0.073 ${\mu}g/ml$ for clenbuterol tablets. The new method was performed with commercially available samples to confirm analytical conditions and validated to be suitable for saving time and cost to control the quality of routine manufactured products. This analytical method will be used for revising the monograph of ambroxol hydrochloride and clenbuterol hydrochloride formulation in next supplement of KPC.

Changes in Hospital and Clinic Care Patterns Under the Medical Insurance System (의료보험 실시후 2년간의 진료양상의 변화 -서울시내 의료기관 입원환자를 중심으로-)

  • Suh, Il
    • Journal of Preventive Medicine and Public Health
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    • v.14 no.1
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    • pp.3-12
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    • 1981
  • To identify the changes in professional care patterns after the introduction of medical insurance in Korea, professional care in hospitals and clinics of two succeeding years were compared. The hospitals and clinics selected for this study were those which located in Seoul city. Hospitals were classified into 3 categories: university hospital, general hospital and hospital. The diseases selected for this study were acute appendicitis and normal delivery. They were selected because their disease courses are considered to be fairly stable. The variables used for this study were length of stay, total hospital costs, costs of each components of cares. The information used for this study was obtained from the official forms requested by the medical facilities to the Korea Medical Insurance Corporation. The two periods studied were 3 months of each year from March 1st to May 31st in 1979 and 1980, The total number of normal delivery studied was 289 in 1979, 301 in 1980 respectively and the acute appendicitis was 92 and 111 respectively. In order to compare the quantity of medical care between 2 study periods the insurance price scores of 1979 were converted to prices of 1980. For statistical test of difference between 2 periods T-test and Welch's test were used. The result of the study were briefly summarized in below. 1. No significant difference was observed in the average length of stay of both disease between two study periods in all types of hospitals. 2. No significant difference was observed in the average total hospital costs of both diseases in all types of hospital, but in the private clinic the average clinic costs was rather decreased significantly in 1980. 3. More cost decrease were seen than cost increase in 1980 in all types of facilities, More cost changes by items were seen in acute appendicitis than in normal delivery between two study periods. The total hospital costs can be devided into 2 portions: charges for drug and material and for physician. In normal delivery, costs for physician's charges was significantly decreased in almost all the hospitals and costs for drug and material were not changed significantly in all the hospitals in 1980. In the university hospitals, however, the costs for drug and material were increased significantly in 1980. The cost decrease for physician's charge were mainly due to the decrease in the costs of laboratory test, treatment and physical therapy. The increase in the costs for the drug and material in the university hospitals was mainly due to the increase in the cost for drugs for oral administration and injection. 4. The proportion of components of medical care in the hospital has not been changed significantly, however, the cost for injection in normal delivery was characteristically increased in 1980 in all hospitals studied. In general the proportion of the costs for drug and material was tended to increase and the costs for physician was tended to decrease in 1980. The increase in the costs for drug and material were considered to be due to increase in the cost for drugs for oral administration and injection. The decrease in the costs for physician were due to decrease in the costs of laboratory test, treatment and physical therapy. Above mentioned changes in hospital and clinic care patterns are considered to be mostly influenced by the review criteria set by the K.I.C. for the assessment of the fee request made by clinics and hospitals.

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Study of the Amount and Share of Drug Cost in the Total Medical Fee under Medical Insurance Scheme (의료보험(醫療保險) 의약품(醫藥品)의 요양취급기관(療養取扱機關) 종별(種別), 약효군별(藥效群別), 상병별(傷病別) 사용(使用)에 관(關)한 조사연구(調査硏究))

  • Lee, Chu-Won;Hahn, Oh-Surk
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.2 s.26
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    • pp.223-235
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    • 1989
  • To grasp the idea about how drugs are used under Medical Insurance Scheme, the amount and share of drug cost in the total medical fee have been reviewed and analyzed for different types of patients (in-patient out-patient), medical institutions and frequently seen diseases and following findings were revealed. In 1986, drug cost took 32.78% of total medical fee for in-patients and 32.98% for out-patients averaged over 30% share as a whole. When drug cost per case in 1980 be indexed to 100, it has shown steady growth to become 200 for in-patients and about 150 for out-patients in 1986. The contribution of drug cost to the total medical fee is, regardless of patient type-in-patients and out-patients, the highest in University hospitals and followed by General hospitals, Hospitals and Clinics in decending order That for the most frequent 10 diseases came out the highest,79 a with the essential benign hypertension of out-patients in the General hospitals, 61% for the gastric ulcer of out-patients in Hospitals and 33% for the female genital diseases of out-patients in Clinics. The drug cost of oral formula was contributed the most, 7.93% by cardiovascular agents followed by hepatic detoxicants(5.47%) and out-patients(4.93%), and that of injectable formula was contributed the most by antibiotics(24.17%), followed by protein amino-acid preparations(6.19%). The order of drug usage by specialty for the in-patients was the highest with internal medicine followed by general surgery and E.N.T, and that for the out-parients was in the order of Internal medicine, neuropsychology and Ob/Gy. This study revealed that the drug dependency was characteristically different to specialty. In view of the fact that drug cost on average exceeds over 30% of total medical fee, proper drug administration appears to be vitally important for the stabilization of the financial standing of the Medical Insurance Scheme. As a consequence, drug usage guidelines including antibiotics usage shall be established first of all and the voluntary participation for the regulation of drug usage and propagation of the guidelines to medical institutions are strongly coerced.

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Comparison of Fentanyl-Based Rapid Onset Opioids for the Relief of Breakthrough Cancer Pain: Drug Price Based on Effect Size

  • Seongchul Kim;Hayoun Jung;Jina Park;Jinsol Baek;Yeojin Yun;Junghwa Hong;Eunyoung Kim
    • Korean Journal of Clinical Pharmacy
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    • v.33 no.1
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    • pp.43-50
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    • 2023
  • Background and Objective: With the advancement of cancer treatments and increased life expectancy, managing breakthrough cancer pain (BTcP) is essential to improve the quality of life for cancer patients. This study aimed to compare the major rapid onset opioids in Korea based on their characteristics and costs to determine the best option for each patient. Methods: Based on sales information from IQVIA-MIDAS, sublingual fentanyl tablet (SLF), fentanyl buccal tablet (FBT), and oral transmucosal fentanyl citrate (OTFC) were selected as the top three drugs for the treatment of BTcP in Korea, considering them the most comparable drugs. The cost and cost-pain relief ratio of the drugs for short-term (1 month) and long-term (1 year) treatment were compared and the ease of administration based on various factors, including pharmacokinetics, onset of action, and administration procedures were evaluated. Results: SLF was evaluated as the best overall in terms of rapid onset of action, ease of administration, and drug cost and also had the highest market share. SLF had the lowest cost pain relief ratio for both the initial and supplemental treatment for the 1-month pain intensity difference 15 (PID15) ratio. However, for the 1-month PID30 ratio, SLF was not superior to OTFC or FBT. The longer the breakthrough cancer pain duration, the more cost-effective the other rapid onset opioids. Conclusion: The rapid onset opioids that fit the patient's breakthrough cancer pain pattern have the best cost-effectiveness.

Genetically Engineered Mouse Models for Drug Development and Preclinical Trials

  • Lee, Ho
    • Biomolecules & Therapeutics
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    • v.22 no.4
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    • pp.267-274
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    • 2014
  • Drug development and preclinical trials are challenging processes and more than 80% to 90% of drug candidates fail to gain approval from the United States Food and Drug Administration. Predictive and efficient tools are required to discover high quality targets and increase the probability of success in the process of new drug development. One such solution to the challenges faced in the development of new drugs and combination therapies is the use of low-cost and experimentally manageable in vivo animal models. Since the 1980's, scientists have been able to genetically modify the mouse genome by removing or replacing a specific gene, which has improved the identification and validation of target genes of interest. Now genetically engineered mouse models (GEMMs) are widely used and have proved to be a powerful tool in drug discovery processes. This review particularly covers recent fascinating technologies for drug discovery and preclinical trials, targeted transgenesis and RNAi mouse, including application and combination of inducible system. Improvements in technologies and the development of new GEMMs are expected to guide future applications of these models to drug discovery and preclinical trials.

Progress in the Direct Application of Pharmacogenomics to Patient Care: Sustaining innovation

  • Burckart, Gilbert J.;Frueh, Felix W.;Lesko, Lawrence J.
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 2006.11a
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    • pp.23-39
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    • 2006
  • The application of the knowledge from the Human Genome Project to clinical medicine will be through both industrial drug development and the application of pharmacogenomics (PG) to patient care. The slow uptake of clinical innovations into clinical practice can be frustrating, but understanding the history of acceptance and sustaining medical innovation is critically important to position PG to succeed. This primarily means that PG tests must have legitimacy; they must be thoroughly validated, must be cost-effective, must be widely accepted by medical practitioners, must be supported by public policy, and must have a way of being easily incorporated into current medical practice. They must also lead to actionalble decisions by health care providers for their patients. Innovative PG assays should be tested in the best US laboratories, and reimbursement for testing must be accepted at the federal and state level. The companies providing these PG tests should be capable of supporting the interpretation and use of the test throughout medical practice. Advances such as the addition of PG information to drug labeling and the routine use of validated biomarkers to determine choice of cancer chemotherapy have been made. The PG research community must pay attention to the principles that have been previously described for acceptance and sustaining medical innovations in order for PG to be widely accepted in clinical medical practice.

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Progress in the Direct Application of Pharmacogenomics to Patient Care: Sustaining innovation

  • Frueh, Felix W.;Lesko, Lawrence J.;Burckart, Gilbert J.
    • Biomolecules & Therapeutics
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    • v.15 no.1
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    • pp.1-6
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    • 2007
  • The application of the knowledge from the Human Genome Project to clinical medicine will be through both industrial drug development and the application of pharmacogenomics (PG) to patient care. The slow uptake of clinical innovations into clinical practice can be frustrating, but understanding the history of acceptance and sustaining medical innovation is critically important to position PG to succeed. This primarily means that PG tests must have legitimacy; they must be thoroughly validated, must be cost-effective, must be widely accepted by medical practitioners, must be supported by public policy, and must have a way of being easily incorporated into current medical practice. They must also lead to actionalble decisions by health care providers for their patients. Innovative PG assays should be tested in the best US laboratories, and reimbursement for testing must be accepted at the federal and state level. The companies providing these PG tests should be capable of sup-porting the interpretation and use of the test throughout medical practice. Advances such as the addition of PG information to drug labeling and the routine use of validated biomarkers to determine choice of cancer chemotherapy have been made. The PG research community must pay attention to the principles that have been previously described for acceptance and sustaining medical innovations in order for PG to be widely accepted in clinical medical practice.