• Health Policy and Management
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• v.16 no.4
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• pp.147-168
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• 2006

Technological innovation has been regarded as the core competence for the economic growth of individual, as well as organization and country. Pharmaceutical innovation, what we call new medicines, influence people's longevity and productivity by increasing output per hour worked. Therefore, using claims data on virtually all the drugs and diseases of over 550,000 people enrolled in National Health Insurance Program in Korea, we examined the impact of the vintage (original FDA and KFDA approval year) of drugs used to treat a patients from July 1st to December 31st in 2002 on the patient's mortality at the end of 2004, controlling for demographic characteristics(age and sex), utilization of medical services, and the nature and complexity of illness. We found that people using newer drugs are less likely to die at the end of 2004, conditional on covariates. The estimated mortality rates were declining with respect to drug vintage for 1970s, 1980s and 1990s and highly significant. In addition to estimating the model for the entire sample, we estimated the model separately for several disease categories classified by Korean Classification of Disease. Estimates of three drug vintage variables for subgroups of people with (1)neoplasms, (2)endocrine, nutritional and metabolic diseases, and (3)the diseases of circulatory system displayed similar patterns.

• International journal of advanced smart convergence
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• v.10 no.3
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• pp.66-71
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• 2021

Recent healthcare environments have characteristics of expanding the scope of healthcare-impacting healthcare, complexity resulting from diversification of components, and accelerating the pace of change. Drugs are used for the prevention, mitigation, and treatment of diseases, so they can inevitably cause harm, while they have efficacy and effectiveness, which are key elements of health recovery. Therefore, many countries regulate permits for safe and effective medicines, and also designate essential drugs directly related to life as pay targets and guarantee health insurance. Especially Pharmacist relying on manpower for composition medicine is liable for mal-manufacture due to combination of toxic medical substances or other chemical usage. In this paper, we focus on using Kiosk and Optical Character Recognition (OCR) for automated pharmacy to level up medical service and create labor friendly environment for pharmacist themselves through maintenance of prescription data and automated manufacturing solution. Presentation of drug substances and precautions will lead to efficient drug prescription and prevent misuse of information while auto manufacturing system efficiently maintain labor force and raise patient satisfaction level by reduction of waiting time.

• Korean Journal of Clinical Pharmacy
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• v.31 no.1
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• pp.1-11
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• 2021

Objective: This study aimed to overview and assess the effectiveness of the policies and regulations that have governed new drug access in Korea, and to propose policies to enhance patient access to drugs, particularly for new innovative medicines. Methods: We approached drug access issues in two perspectives: approval lag (or availability) and reimbursement lag (or affordability). The issues were identified and evaluated through the review of literature, public documents, reports published by the government agencies and private organizations, and news articles. Results: To shorten approval lag, it is recommended to hire and train more reviewers at the Ministry of Food and Drug Safety. Increasing user fees to a realistic level can facilitate this process. To reduce reimbursement lag, flexible incremental cost-effectiveness ratio threshold, alternative cost-effectiveness evaluation, and establishment of funding source other than the national health insurance are identified as the areas to be improved. Conclusion: The current policies and regulations had to be supplemented by new systems to drastically promote patient accessibility to new drugs, consequently in order to promote national public health.

• The Korean Society of Law and Medicine
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• v.18 no.2
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• pp.195-218
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• 2017

The increase in medical expenses for convalescent hospitals is increasing abnormally, which puts enormous burden on the National health insurance finances. This is a phenomenon that has been associated with the social phenomenon of rapid aging. The fact that the convalescent hospitals are paid the fixed amount per day for hospitalization became the incentive for some hospitals to use the patients as means of making money. And these hospitals intend to get regular care or take medicines at other hospitals in order to reduce medical expenses, even when the medical fee is paid. In order to prevent such financial leaks, the Health Insurance Review and Assessment Service adjusted the patient group for inpatients in a hospital with the above behavior, and then cut the cost of medical care benefits. However, Above decision was canceled by the court on the grounds that there was no basis rule. However, based on the above case, I think that it can be an opportunity to draw up the problem and to improve of the Medical Fee System of hospital. The modified medical fee system can strengthen the medical function of the convalescent hospital. In addition, it seems reasonable to exclude admission for "physically disabled group". Even if admission is allowed for the physically disabled group due to social needs, it should be excluded from the National health insurance for the fianacial soundness and the sustainability of the system.

• The Journal of the Korea Contents Association
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• v.19 no.3
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• pp.365-374
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• 2019

Unlike benign tumors, malignant tumors are capable of metastasis, easy to relapse, poor survival, and low quality of life. In Korea, here is a tendency to treat the tumors collectively according to the General Principles of Cancer Chemotherapy(GPCC) of the Health Insurance Review & Assessment Service (HIRA). But recently, companion diagnostics(CDx) is recommended rather than unilateral medication because biomarker-based molecular diagnostics is possible to predict the drug response of patients before drug treatment. Not only domestic but also overseas Food and Drug Administratio (FDA) recommends the development of the CDx system at the stage of drug development to ensure the responsiveness and safety of medicines. In this study, I focused on the necessity of CDx development direction as well as CDx development status through literature review. Furthermore I also discussed CDx types according to the molecular diagnostic technology such as immunohistochemistry (IHC), polymerase chain reaction (PCR), in situ hybridization (ISH), and next-generation sequencing (NGS) not only in the approved CDx but also in the developing one by US FDA. And I suggested the technology issue of CDx development process such as a selection of molecular diagnostics at the time of release, a clear understanding of the CDx mechanism, and a convergence of drug with CDx development. The necessity of social insurance system also was proposed for CDx development.

• Korean Journal of Acupuncture
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• v.38 no.1
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• pp.16-31
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• 2021

Objectives : The purpose of this study was to investigate the current status of clinical practice for gout in Korean Medicine (KM). Methods : On-line survey was adopted for this study, targeted at KM Doctors who were registered in the Association of Korean Medicine. The questionnaire included the general status of treatment, pattern identification and treatment method according to three stages given: acute, chronic and asymptomatic hyperuricemia stage. Results : Data from a total of 384 respondents was analyzed. Participants who responded most were in their 40s, working in KM clinics located in Seoul. Acupuncture and herbal medicines were the top priority treatments in preparing recommendations in clinical practice guidelines for gout, and where clinical trials were considered essential. As of the past year, the average number of first visits per month was 86.7%, and the average treatment duration was less than 1 month, accounting for 72.9%. As for the diagnostic method used for gout patients, the "diagnosed by clinical pattern" response was the highest, and the "blood and urine test" response was the highest as the diagnostic equipment used. As for the evaluation scale being used, the "VAS/NRS" response was the highest. Regardless of the gout stage, acupuncture was the most commonly used treatment method for gout patients, and bee venom pharmacopuncture was the highest for the pharmacopuncture used. In the case of herbal medicine, it was found that a wider variety of herbal medication uninsured in health insurance and herbal prescription were used for the staged treatment of gout than herbal medication in national health insurance coverage. In clinical practice, "acupuncture treatment three times a week" was the most common, and the "acupoints in the limb" were the most frequently used; LR3 and SP3 were the most frequently used acupoints. Conclusions : It is suggested that this survey should be helpful to develop clinical practice guideline for gout that reflects actual clinical practice.

• Korean Journal of Adult Nursing
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• v.18 no.1
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• pp.92-101
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• 2006

Purpose: The purpose of this study was to study complementary and alternative medicines (CAM) used among cancer patients in Korea. Method: This study was a descriptive survey. Study participants were 1,150 cancer patients selected from 28 representative hospitals in Korea. Data were collected between December 1, 2004 and March 30, 2005. Results: Their diagnosis were as follows : 20.0% for breast cancer, 15.6% for stomach cancer, 14.4% for liver cancer, 10.8% for lung cancer, 10.0% for colon cancer, and 10.0% for uterine cancer. 75.0% of cancer patients had used CAM. The most popular categories of CAM use were diet with 153.2%, non- prescription of oriental medical doctor 47.9% and mind-body control 20.3%. CAM use gender, age, cancer type, cancer treatment method, and current treatment type was significantly different in. Conclusion: CAM use among cancer patients in Korea was very popular(75.0%) and so systemic guidelines of CAM use are needed.

• Health Policy and Management
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• v.23 no.2
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• pp.112-123
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• 2013

Background: Under the risk of financial sustainability of National Health Insurance, Korean government attempted a series of regulations over pharmaceutical prices. The first price-cut was implemented to the hyperlipidemial treatments, and the prices of statins were reduced on 15th, April in 2009. The purposes of this study are 1) to investigate the impact of this price-cut on pharmaceutical expenditure, and 2) to identify the factors associated with drug-switch among statins. Methods: Using the national patients sample data, this study conducted time series analysis on the expenditures, prices, and volumes of statin drugs. To understand the factors associated with drug-switch, the multinomial logit model was analyzed at the patients level. Results: The results of time series analysis demonstrated that the price-cut of hyperlipidemic medicines did not lead to the reduced expenditure, suggesting the increased volume was the major cause. The multinomial logit analysis identified the switch of healthcare provider as the significant factor that was highly associated with drug-switch, implying the physicians' preference was the major motivation of drug-switch. Conclusion: Without control of utilization, price regulation itself could not reduce pharmaceutical expenditure. This suggests that the pharmaceutical regulations should be implemented on the basis of understanding of provider behaviors. The findings of this study will form the first step for further empirical studies.

• Journal of Preventive Medicine and Public Health
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• v.37 no.2
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• pp.141-149
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• 2004

Objectives : To evaluate the cost and proportion of complementary and alternative medicines (CAM) in the total healthcare costs among the elderly in the last 6 months of life. Methods : The care-giving families of 301 persons older than 65 years, who died between July 1st and December 31st of 2001, and were also registered in Self-Employed Health Insurance Programs in Seoul, were interviewed. Results : The cost of CAM was 1.09 million Won, which as a proportion of the total healthcare cost was 38.1%. The elderly aged between 65 and 69 year-old, male, living with their spouse, Buddhist and having cancers had higher CAM costs in an ANOVA and simple regression analysis. After controlling of various factors, age was the only significant factor associated with the cost of CAM. The elderly above 80 years old, female, bereaved and Buddhist had higher proportional CAM costs, and the elderly having cancers or cardiovascular diseases had lower proportional CAM costs in an ANOVA and simple regression analysis. After adjusting for various factors, the elderly above 85 years old, female and Buddhist had higher proportional CAM costs, and the elderly having cancers had lower proportional CAM costs. Conclusion : The very old and Buddhist, and/or the ill with no clear diagnosis, may depend more on CAM. Further research will be needed on the meaning and impact of CAM and their costs to public health and the total healthcare system.

• Journal of Preventive Medicine and Public Health
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• v.50 no.2
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• pp.91-99
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• 2017

Objectives: As in many low-income and middle-income countries, out-of-pocket (OOP) payments by patients or their families are a key healthcare financing mechanism in Bangladesh that leads to economic burdens for households. The objective of this study was to identify whether and to what extent socioeconomic, demographic, and behavioral factors of the population had an impact on OOP expenditures in Bangladesh. Methods: A total of 12 400 patients who had paid to receive any type of healthcare services within the previous 30 days were analyzed from the Bangladesh Household Income and Expenditure Survey data, 2010. We employed regression analysis for identify factors influencing OOP health expenditures using the ordinary least square method. Results: The mean total OOP healthcare expenditures was US dollar (USD) 27.66; while, the cost of medicines (USD 16.98) was the highest cost driver (61% of total OOP healthcare expenditure). In addition, this study identified age, sex, marital status, place of residence, and family wealth as significant factors associated with higher OOP healthcare expenditures. In contrary, unemployment and not receiving financial social benefits were inversely associated with OOP expenditures. Conclusions: The findings of this study can help decision-makers by clarifying the determinants of OOP, discussing the mechanisms driving these determinants, and there by underscoring the need to develop policy options for building stronger financial protection mechanisms. The government should consider devoting more resources to providing free or subsidized care. In parallel with government action, the development of other prudential and sustainable risk-pooling mechanisms may help attract enthusiastic subscribers to community-based health insurance schemes.