• 보건행정학회지
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• 제13권4호
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• pp.48-65
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• 2003

Detailed analyses of total health expenditure and its sub­categories are essential for the evidence­based health policy(EBHP). These analyses, again, should be based on timely and reliable data that are comparable across countries. The System of Health Accounts (SHA), published by the OECD in 2000, provides an integrated system of comprehensive and internationally comparable accounts. The author has implemented the SHA manual into Korean situation, and examined overall expenditure estimate and its basic functional breakdown following the manual. This study explains how pharmaceutical expenditure is estimated. The results are, then, analyzed particularly from the international perspective. Both administrative data in Statistical Yearbooks (National Health Insurance, Medical Aid, Industrial Accident Compensation Insurance) and survey data on Health and Nutrition are used for the estimation. Per capita pharmaceutical expenditure in Korea (183 US$ PPPs) was far less than the OECD average (308 US$ PPPs) in 2001, but pharmaceutical expenditure share in total health expenditure (20.3％) was higher than the average (16.7％). This can be explained by the fact that there is a statistically significant correlation between pharmaceutical expenditure share and per capita GDP of each country. Korean people follow the tendency of relatively low­income countries to spend less than OECD average for health care, but follow again their tendency to spend more on drugs than on other health care services. In consideration of results and analysis as above, per capita pharmaceutical expenditure in Korea is expected to grow in the future, but the growth rate of the pharmaceutical expenditure is expected to be less than that of overall health expenditure.

• 보건행정학회지
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• 제28권4호
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• pp.360-368
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• 2018

Background: The proportion of pharmaceutical expenditure out of total health-care expenditure in South Korea is high. In 2016, 25.7% of national health insurance (NHI) spending was for pharmaceuticals. Given the increasing demands for the access to newly introduced medicines and following increase in pharmaceutical spending, the management of NHI pharmaceutical expenditure is becoming more difficult. Methods: This study analyzed the data claimed to NHI for pharmaceutical reimbursement from 2010 to 2016. Results: The policy implications with respect to the trends and problems in spending by drug groups were elicited. First, the proportion of off-patent drugs spending which were treated to chronic disease was much higher than anti-cancer drug spending. Second, the spending to the newly introduced high-costed medicine increased, however, current price-reduction mechanism was not sufficient to manage their expenditure efficiently. Conclusion: Our system seems to need several revisions to improve the efficiency of pharmaceutical expenditure and to cope with high-costed medicines. This study suggested that the prices of off-patent drugs need to be regularly readjusted and the Price-Volume Agreement System should be operated more flexibly as well.

• 보건행정학회지
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• 제18권3호
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• pp.110-127
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• 2008

Expenditures on pharmaceuticals of different concepts were estimated and their functional, financing and providers' breakdowns were examined in line with the OECD's System of Health Accounts (SHA) manual. This study also shows the way such estimates are made. The results are then analyzed particularly from the international perspective. Data from both Household Survey by the National Statistical Office and the National Health and Nutritional Survey by the Ministry of Health and Welfare of Korea were used to estimate pharmaceutical expenditures that. are financed by out-of-pocket payments of the household, while national health insurance data etc. were used for estimation of pharmaceutical expenditures that are financed by public funding sources. The 'per capita expenditure on pharmaceutical/medical non-durables' in Korea stood at 380 US$ PPPs, less than the OECD average of 443 US$ PPPs in 2006, but its share of the per capita health expenditure of 25.9% noticeably outnumbered the OECD average of 17.1%, due partly to low per capita health expenditure as a denominator of the ratio. This indicates that Koreans tend to spend less on health care than an OECD average, while tending to spend more on pharmaceuticals than on other health care services, much like the pattern found in relatively low income countries. An international pharmaceuticals pricing mechanism is most likely responsible for such a tendency. In addition, it is to be noted that the percentage comes down to 21.0%, when expenditures on both medical non-durables and herbal medicine, which is locally quite popular among the elderly, have been excluded.

• 보건행정학회지
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• 제23권2호
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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.

• 보건행정학회지
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• 제22권4호
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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.

• 보건행정학회지
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• 제30권3호
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• pp.311-325
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• 2020

Background: Health statistics of pharmaceutical use and expenditure are essential to make and implement evidence-based pharmaceutical policy. This study aims to demonstrate the methods and results of pharmaceutical consumption and sales in 2018 according to the sources and methods given by the Organization for Economic Cooperation and Development (OECD). Methods: The medication list contains 39,346 medicines both reimbursed and non-reimbursed by the National Health Insurance in 2018. We used the therapeutic categories based on Anatomic Therapeutic Chemical Classification of World Health Organization. This study analyzed National Health Insurance claims data and supply data generated from wholesalers to health care facilities. The indicators are defined daily dose (DDD), per 1,000 inhabitants per day and US$ per capita. Results: In South Korea, the number of medications to which DDD were assigned was 18,055 and it was 45.9% of the total number of medications on the list. The consumption in anti-infective for systemic use (J) and musculo-skeletal system (M) was higher than the mean consumption among the OECD countries. The pharmaceutical sales per person in Korea was also higher than the mean sales per person across the OECD countries. Conclusion: We sought to explain the methods to produce pharmaceutical consumption and sales statistics which we had submitted annually to OECD. Considering the characteristics of pharmaceutical statistics, a direct comparison should be approached with caution. Since the growth in pharmaceutical spending has greatly increased over the past decade, we need to monitor pharmaceutical consumption and expenditure consistently.

• 보건행정학회지
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• 제10권3호
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• pp.50-67
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• 2000

This study aims to estimate the consumption of antibiotics in Korea and to suggest the further studies. To measure the amount of antibiotics consumption, we referred to the statistic of NFHI(National Federation of Health Insurance) and a private institute of pharmaceutical information(Korea Intercontinental Medical Statistics; IMS Korea). There were 1,563 antibiotics produced in Korea in 1997. The total amount of antibiotics production was 1,197 billion won in 1997. Antibiotics accounted for 17.6% of the total pharmaceutical productions in 1997. Cephalosporins have taken the largest part of antibiotics production since 1992. The estimation using NFHI data showed that the total expenditure of antibiotics used in health facilities was 268 billion won, 608 billion won, 911 billion won in 1990, 1994, 1997 respectively. Tertiary hospitals spent 246 billion won, general hospitals 287 billion won, hospitals 78 billion won, clinics 300 billion won in 1997. The amount of expenditure and the intensity of antibiotics consumption in hospitals have increased more steeply than any other health facilities. The total expenditure of antibiotics consumption in health facilities and pharmacies was 778 billion won when estimated using the data from IMS Korea, and 999 billion won from NFHI. Cephalosporins was the fast growing antibiotics group in all of the market- hospitals, clinics, pharmacies since 1991. To measure the amount and patterns of antibiotics consumption more precisely, a pharmaceutical monitoring or surveillance system is needed.

• 약학회지
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• 제52권2호
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• pp.160-164
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• 2008

This study investigated the current status and drug expenditure of the drug shortage prevention program in Korea. National health insurance claims data from 2001 to 2005 were analyzed for the drugs with inadequate supply, which were designated as shortage prevention drugs (SPDs). Drug use of SPDs have increased every year, but the average increase rate of drug expenditure for SPDs, 13.5% was lower than that for all the reimbursed drugs, 18.6%. Drugs with price increase based on production cost were more actively used than drugs with prescription incentives for doctors.

• 보건행정학회지
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• 제21권2호
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• pp.249-262
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• 2011

Since May 1st in 2008, the products of ginkgo biloba extract have had to be used with the patient's out-of-pocket payment due to reimbursement restriction guidelines. This study aims to analyze the policy effects of reimbursement restriction on pharmaceutical expenditures using interrupted time series(ITS) analysis. We retrieved monthly NHI claims data for the period between May, 2005 and December 2009. The ingredients identified as a substitute for ginkgo biloba have similar indications based on the similar pharmacological activities. The effects of changes in reimbursement scope were evaluated both for all relevant pharmaceuticals within the same therapeutic class and for 2 separate groups : ginkgo biloba's and its substitutes. According to the study results, restrictions on reimbursement scope resulted in savings of the drug expenditures in the targeted therapeutic class. Direct restriction on ginkgo biloba was associated with a decrease in expenditure level by 60.1% and changes in trend from an average increase rate of 1.4% to an average decrease rate of 1.5% for the therapeutic class, with a dramatic decrease in expenditure level(-191.5%) for ginkgo biloba itself, but with an increased expenditure level(+50.1%) and changes in trend from an average increase rate of 2.0% to an average decrease rate of 1.0% for the substitute group. Further policy to restrict nicergoline was associated with additional decrease in expenditure level for the therapeutic class. Additionally, we could identify the balloon effect - a new policy squeezing one part results in bulging out elsewhere. After the restriction of ginkgo biloba, the utilization of and expenditures on its substitutes increased significantly. In conclusion, we demonstrated that consecutively introduced policies effectively reduced overall expenditures on the therapeutic class of interest. Some ingredients played as a substitute while others did not. Further studies need to be conducted to identify which factors determine a substitute.

• 한국산학기술학회논문지
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• 제20권11호
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• pp.487-493
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• 2019

본 연구는 제약기업대상 연구개발비 무형자산비중을 살펴보고, 무형자산화 비중이 기업 가치에 영향을 미치는지 코스닥제약기업 중심으로 살펴보았다. 연구대상은 2011년부터 2017년까지 코스닥에 상장된 연도별, 기업별 연구개발비 회계자료가 있는 제약기업 39개를 표본으로 종속변수로 토빈Q, 독립변수로 연구개발비 무형자산화 비중으로 설계하여 패널데이터모형으로 분석하였다. 결론은 코스닥제약기업은 연구개발비 무형자산화 비중이 토빈Q(기업가치)에 부정적인 영향을 미치는 것으로 나타났다. 연구개발비 무형자산비중이 클수록 코스닥 제약기업에서는 기업가치가 낮아질 수 있다는 시사점을 제공한다. 즉, 코스닥 제약기업에서는 부채비율이 높을수록 투자규모를 늘리는 현상을 반영하기에 무형자산 비중이 커진다고 해서 기업가치가 증가하지 않는다는 것으로 설명할 수 있다. 본 연구는 기존 연구들은 연구개발비 총액을 기업 가치와 관련성을 규명한 연구들이 대부분인 반면, 연구개발비를 좀 더 세분화해서 '무형자산화 비중'만을 놓고, 코스닥 제약기업의 기업 가치에 영향을 미치는지 여부를 연구했다는 데 그 의의가 있다.