• Health Policy and Management
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• v.22 no.4
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• pp.561-578
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• 2012

This study was performed in order to compare a change in pharmaceutical expenditures per outpatient of clinic and to analyze factors relevant to a systems as part of evaluating policies for the incentive scheme to reduce total prescribed drug expenditure and for the drug utilization review system("DUR system" hereafter). For this, it had finally analytical subjects as 21,320 clinics nationwide without a change in location, clinics symbol and signed subject during both terms of the first half of 2010 and the first half of 2011. As a result, the odds ratio with reduction in pharmaceutical expenditures of clinic was statistically higher significantly in the shorter year number of opening clinic, in the larger number of doctors, when the classification of establishment is other, not individual, and when the signed subject is surgical division. Also, the odds ratio was significantly higher in the less patient number of clinic and in the lower ratio of patients aged over 65. Finally, the odds ratio was significantly high when a clinic had been located in DUR system demonstrative project area. Through this, a case of policy for improvement in doctor's autonomous prescription behavior like DUR system can be known to be effective for reduction in pharmaceutical expenditures. A future research on evaluation of policy for pharmaceutical expenditure management system will need to be performed in-depth analysis in consideration of diverse characteristics on the participatory entities.

• Health Policy and Management
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• v.26 no.3
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• pp.207-218
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• 2016

Background: This study was performed to identify factors associated with the utilization of tests for diabetes complication and hemoglobin A1c (HbA1c) among diabetes patients in Jeollanam-do, Korea. Methods: The study subjects were 2,310 diabetes patients participated in 2014 community health survey in Jeollanam-do, Korea. Dependent variables were the utilizations of fundus examination, microalbuminuria test, and HbA1c test. The used statistical analysis methods were chi-square test and hierarchical regression analysis with weight in consideration of complex sample design. Results: The utilization rates of fundus examination, microalbuminuria test, and HbA1c test were 25.8%, 27.4%, and 12.3%, respectively. In the results of hierarchical regression, fundus examination was significantly related to age, education level in predisposing factors, residential area in enabling factors and recognition of blood sugar, drug therapy, and subjective health status in need factors. Microalbuminuria examination was significantly related to monthly income, residential area in predisposing and health screening, recognition of blood sugar, drug therapy, diabetic education, number of chronic disease, and subjective health status in need factors. HbA1c examination was significantly related to age, education level, marital status in predisposing factors, residential area in enabling factors and drinking, recognition of blood sugar, drug therapy, and diabetic education in need factors. Conclusion: The results of this study were shown that perception of their disease seriousness, education about diabetes management, and accessibility of tests were important to utilization of test for diabetes complication and HbA1c. It might be necessary to the develop and strength strategies for enhancing the utilization of tests for diabetes complication and management in diabetes patients.

• 대한임상약리학회:학술대회논문집
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• 2003.06a
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• pp.3-4
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• 2003

• Korean Journal of Clinical Pharmacy
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• v.26 no.3
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• pp.220-229
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• 2016

Background: The treatment goal for patients with chronic hepatitis B infection is to prevent progression of the disease to cirrhosis and hepatocellular carcinoma. Current therapies include standard and pegylated interferon-alfa and nucleoside/nucleotide analogues: lamivudine, adefovir, entecavir, telbivudine, clevudine, and tenofovir. This study aims to analyze changes in the prescribing patterns of chronic hepatitis B (CHB) medications in South Korea between 2013 and 2014. Methods: A cross-sectional study was conducted using National Patients Sample data compiled by the Health Insurance Review and Assessment Service from 2013 and 2014. Patients with CHB were identified with Korean Standard Classification of Diseases code-6 (B18.0 and B18.1) and those who were maintaining active prescriptions with CHB medications covering the index date (December $1^{st}$, each year) were included. The utilization of antiviral therapy was investigated during 2013 and 2014. Results: A total of 4,204 and 4,552 patients in 2013 and 2014 respectively, were included in the analysis. The proportion of male patients was two of third and the patients 41-60 years old accounted for 60% of all analyzed patients. The most utilized drug was entecavir (55.1% in 2013 and 44.8% in 2014) and the second most utilized drug was tenofovir in both years (18.8% in 2013 and 29.0% in 2014). The percentage of combination therapy was 13.6% and 13.1% in 2013 and 2014, respectively. The proportion of tenofovir prescriptions was increased in 2014 compared with 2013. Conclusion: With the development of new drugs and the changes in clinical practice guidelines, the prescription pattern of the antiviral agents for patients with CHB has changed. The rate of utilization of tenofovir has increased.

• Korean Journal of Clinical Pharmacy
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• v.27 no.3
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• pp.127-135
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• 2017

Background: Kawasaki disease (KD) is an acute febrile, systemic vasculitis as a leading cause of acquired heart disease in children. Intravenous immunoglobulin G (IVIG) and aspirin are the standard initial therapy in the treatment of acute KD. The purpose of this study was to investigate drug utilization in children with KD, and to compare "IVIG + high-dose aspirin" and "IVIG + moderate-dose aspirin" in preventing cardiac complications. Methods: We analyzed pediatric patient sample data compiled by the Health Insurance Review & Assessment Service from 2010 to 2015. We identified patients with KD using the KCD-6 code of M30.3. We excluded patients in chronic phase or ${\geq}1$0 years. We also excluded patients who were diagnosed KD in November or December. Drug utilization pattern were assessed in acute KD patients and 30-day and 60-day cardiac complications were investigated between "IVIG + high-dose aspirin" group and "IVIG + moderate-dose aspirin" group. Results: In acute phase, IVIG was administered to 95.8% patients, and 57.1% patients were prescribed moderate-dose aspirin and 25% patients were with high-dose aspirin. Steroid use was rapidly increased from 4.0% in 2010 to 11.3% in 2015. Both 30-day and 60-day cardiac complications occurred less in "IVIG + high-dose aspirin" group compared to "IVIG + moderate-dose aspirin" group, but not statistically significant (0.9% vs 1.8%, p=0.252 for 30-day complication rate; 1.5% vs 2.7%. p=0.073 for 60-day complication rate). Conclusion: We were not able to demonstrate which aspirin therapy is superior for preventing cardiac complications in acute KD patients and further research is warranted.

• Korean Journal of Clinical Pharmacy
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• v.30 no.2
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• pp.73-80
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• 2020

Objective: The Australian Pharmaceutical Benefits Scheme (PBS) is a national drug subsidy program. Given the similarity and comprehensiveness of the Australian PBS and the Korean National Health Insurance (NHI) data, these data are increasingly used for pharmacoepidemiological investigations, as well as international comparative studies. This study aims to introduce the various sources of publicly available PBS data and provide a practical guide to researchers conducting drug utilization studies. Methods: We searched literature and websites to detail and compare the collection, structure, components, and characteristics of each PBS data format. We identified different characteristics of the PBS data from the Korean NHI claims data which are mainly owing to their unique co-payment policies and data collection processes. In addition, the utilization and expenditure of atorvastatin, a widely used treatment for hyperlipidemia, were analyzed using two different sources of PBS data and the different results were interpreted. Results: There exist differences in when data were collected or non-subsidized uses of medicine were included among sources of PBS data. Additionally, two countries have different cost sharing methods inmedicine subsidy scheme; co-payment in Australia and co-insurance in Korea. Therefore, it should be noted that prescriptions under co-payment are not included in some data sources in Australia. Conclusion: Despite several analytical challenges, open access and easy data management are the strengths of the PBS data sources. A detailed knowledge of the PBS data can ensure robust methodology and interpretation of pharmacoepidemiological investigations or international comparative studies.

• The Journal of the Korea Contents Association
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• v.20 no.2
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• pp.462-471
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• 2020

The Zolpidem, commonly used as a sleeping pill, binds to GABA receptors to increase neuro-inhibiting transporters. There are many cases where people take Zolpidem for more than four weeks in a row. The Drug Utilization Review, currently in effect in South Korea, can identify the use patterns of Zolpidem. It is necessary to prevent Zolpidem's misuse. The study was conducted from May 10, 2019 to May 15, 2019. Primary and secondary screening was performed out of 125,197 total retrieved documents. The final 254 literature cases directly related to Zolpidem's misuse were selected. Through systematic literature research through meta-analysis, we tried to find a way to prevent Zolpidem's misuse through the Drug Utilization Review. The distortion was minimized by applying it in the screening process. Zolpidem's misuse was severe and continued to increase its use. There has also been an increase in crime using Zolpidem. It has been analyzed that Zolpidem can be managed through Narcotics Integrated Management System and Drug Utilization Review. In order to reduce the use of Zolpidem, the supply through the Narcotics Integrated Management System and the demand through long-term user education should be suppressed.

• Korean Journal of Clinical Pharmacy
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• v.20 no.3
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• pp.213-220
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• 2010

Therapeutic duplication (TD) is a serious problem that frequently occurring primarily in the ambulatory setting in Korea. Implementation of concurrent drug utilization review (DUR) is a promising way to reduce inappropriate prescription and dispensing, and improve patient safety. This study was aimed to develop the process of DUR module of TD. Sixty-five drug ingredients classified into the drug category of the antipyretic, analgesic, and anti-inflammatory drug approved in Korea (The KFDA-dess nated classification codes of 114 or 264) were reviewed for this purpose. The drug ingredients (and products) were reclassified based on WHO's Anatomical, Therapeutic and Chemical (ATC) classification system. The clinical practice guidelines, textbooks and product labels on therapeutic uses of these drugs in Korea and several fores n countries were reviewed. If the drugs were categorized into the same therapeutically duplicable class, they were defined not to be used concurrently because the concurrent use was "therapeutically duplicated (unnecessary or even harmful)". Among the studied drug products, the following 5 drug classes were considto beas "therapeutic duplication": (1), on-t tooid DURnti-inflammatory drugs (NSAIDs, including s Dicylates), (2),Anilidts, (3),Opioids, (4) Ergot Dk Doids and (5) 5-$HT_1$ receptor agonot s. Therefore, concurrent prescribing or dispensing of more than 2 drug ingredients any in the above same classes should be considered as TD and needed to be warrant for careful review by pharmacists before dispensing.

• Biomolecules & Therapeutics
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• v.23 no.6
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• pp.510-516
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• 2015

In this review, lipid A, from its discovery to recent findings, is presented as a drug target and therapeutic molecule. First, the biosynthetic pathway for lipid A, the Raetz pathway, serves as a good drug target for antibiotic development. Several assay methods used to screen for inhibitors of lipid A synthesis will be presented, and some of the promising lead compounds will be described. Second, utilization of lipid A biosynthetic pathways by various bacterial species can generate modified lipid A molecules with therapeutic value.

• Korean Journal of Health Education and Promotion
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• v.29 no.2
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• pp.1-12
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• 2012

Objectives: Several practice guidelines recommended both medication and behavior modification to control hypertension. The objective of this study was to analyze ambulatory care utilization pattern and related factors. Methods: A retrospective cohort study was conducted among 45,267 new users who initiated treatment with hypertensive drugs in 2003. Korean National Health Insurance Claims Data was used to study the medical care utilization behavior and related factors after treatment initiation for up to four years. Taking prescription was considered as medical care utilization. Results: More than 20% of patients discontinued visiting physicians for prescription after initiating antihypertensive drug therapy. The average number of institutions visited by patients was about 1.3 annually. Clinic was the most frequently visited institution by patients. In GEE analysis, probability of continuous visit one institution after initiating antihypertensive drug treatment increased in patients who were women, old, have comorbidity, visited clinic or hospital mainly in previous year. Conclusions: Young hypertensive male patients who have no major comorbidity showed high possibility to discontinue medical service utilization. It is necessary to educate these targeted patients about importance of hypertension management in early stage after treatment initiation.