• Journal of Pharmacopuncture
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• v.24 no.3
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• pp.142-151
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• 2021

Objectives: Although Korean Medicine (KM) subsidized by the National Health Insurance (NHI) has been used for a long time, there has been no active analysis using claims data. Therefore, the purpose of this study was to examine the NHI KM utilization trend using NHI statistics and to measure the level of market concentration by year. Methods: By restructuring the contents of NHI Statistics for Pharmaceuticals for 2010-2019, the claim cases, costs, and annual growth rates of KM were demonstrated by year, sex, age group, region, therapeutic group, and KM treatment. The proportion of highly used k treatments in cost was calculated as the concentration ratio (CR) k and its trend by year was investigated. Results: In 2019, the NHI cost on KM amounted to ₩38.2 billion KRW, increasing by 11.6% per year on average in 2010-2019. Notably, KM was used more frequently among women and patients aged ≥ 65 years, and the mixed formulation accounted for 95% of the total cost of KM. The CR of the simple formulation increased rapidly, whereas that of the mixed formulation remained constant. In 2019, three simple formulation treatments- peony, licorice, and ginseng- accounted for 93.8% of the total cost for KM (CR3 = 93.8%). Conclusion: NHI KM is rapidly increasing. Investigating the CR of KM confirmed that KM prescriptions have been concentrated in small numbers over the past 10 years.

• YAKHAK HOEJI
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• v.52 no.2
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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.

• Korean Journal of Clinical Pharmacy
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• v.26 no.3
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• pp.238-244
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• 2016

Background: Mupirocin, a topical antimicrobial agent has been used for patients with methicillin-resistant Staphylococcus aureus and recently mupirocin resistance was issued in some studies. The objective of this study was to analyze prescription patterns of topical mupirocin, to evaluate appropriateness of prescriptions in the ambulatory setting, and to compare frequency of mupirocin usage in South Korea with that in United States. Methods: Topical mupirocin prescription patterns (the number of prescription and a prescription period), and appropriateness of prescription (including a prescription rate over 10 days, a repeat prescription rate within 30 days and a prescription rate within labeled indications) were analyzed using the 2012 Health Insurance and Review and Assessment service-National Patient Sample dataset of South Korea. The National Ambulatory Medical Care Survey dataset was used to quantify topical mupirocin prescription in United States for comparison. Results: In South Korea, the prescriptions rate for use over 10 days was 3%, the repeat prescription rate within 30 days was 8.87% and the prescription proportion within labeled indications was 33.84%. The most frequent diagnostic code was nonbacterial infection. The prescription rate per 1000 population of topical mupirocin in South Korea was calculated to be 46.07, whereas in United States was calculated to be 13.10. Conclusion: Topical mupirocin has been used frequently and inappropriately, so further studies are required to investigate the rationale behind such prescribing mupirocin patterns.

• Korean Journal of Clinical Pharmacy
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• v.28 no.1
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• pp.57-64
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• 2018

Background: Patients experience significant differences in aspects of mortality, quality of life, and costs between during the year of receiving liver transplant (LT) and the subsequent years (post-LT). This study aimed to estimate the medical utilization and cost of LT for patients compared to post-LT patients by using a recent National Patient Sample (NPS) data provided by the Korean Health Insurance Review and Assessment Service (HIRA). Methods: This study used a subset of the 2015 HIRA-NPS. Patient claims data that included Z944 (Korean Standard Classification of Diseases code for LT status) were selected. Within the selected data, LT patients were identified based on whether the national health insurance number code of Q80 (procedure code for LT surgery) was included, and they were compared to post-LT patients. Results: In the analysis, 330 patients were included. The average cost per patient was $90,066{\pm}36,959$ thousand KRW and $10,557{\pm}9,668$ thousand KRW for LT and post-LT patients, respectively. Especially, LT patients' costs for injection/procedure, surgery/treatment, and examination were higher than other costs, being $35,983{\pm}18,115$ thousand KRW, $28,246{\pm}9,408$ thousand KRW, and $12,131{\pm}6,604$ thousand KRW, respectively. For inpatients, the average number of hospitalized days was $63.5{\pm}66.0$ days for LT patients and $22.3{\pm}35.1$ days for post-LT patients. Conclusion: Compared to post-LT patients, LT patients had higher costs, especially for injection/procedure, surgery/treatment, and examination. Additionally, the LT group had longer hospitalization duration and higher costs for their hospital admission, whereas they did not show a significant difference in number of visits and medical costs for outpatient-care.

• YAKHAK HOEJI
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• v.58 no.2
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• pp.99-106
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• 2014

This study explores the prescribing pattern of generic drugs and the relationship between socio-demographic factors and the use of generics in South Korea. The analysis was based on claims data of 2011 from Korean National Health Insurance. We examined utilization, costs, and market share of oral preparations by original and generic product. Multiple logistic regression was performed to evaluate the predictive factors of generic use among multi-source medications. Generics accounted for 37~41% of utilization and 34~41% of costs in the insured market of oral preparations. In the generic market, costly generics made up about 58~61%, 56~66% of volume and value, respectively. Other things being equal, institutional factors affected generic use to the largest degree. The odds of having generics were 6 times higher in clinics, 4 times higher in hospitals, and 1.7 times higher in general hospitals than in teaching hospitals. Those in metropolitan or rural area were more likely to prescribe generics than those in the capital area. While generics were frequently prescribed for off-site pharmacy (OR=1.173), the odds of having generics was 0.88 after weighting the data by units prescribed. This study empirically presented the pattern of generic prescribing, confirming the widely accepted view that costly generics were more likely to be utilized in the Korean market. Up to two thirds of the generic market consisted of costly products. The strongest factors affecting generic use were institutional variables.

• Korean Journal of Clinical Pharmacy
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• v.28 no.2
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• pp.117-123
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• 2018

Background: Prostatitis, one of the most common diseases of the prostate, is a complex disease with various clinical features. This study aims to analyze the utilization and prescribing patterns of antibiotics in Korean patients with prostatitis between 2008 and 2015. Methods: We used the National Health Insurance Database complied from the Health Insurance Review and Assessment Service (HIRA). The outcomes included the number of claims, number of patients, medical cost, and length of stay for each year. In addition, the prescribing patterns of antibiotics, including fluoroquinolone, and low-dose use of ciprofloxacin and levofloxacin were investigated. Results: The total number of patients and medical cost increased by 9.5% and 51.7% from 2008 to 2015, respectively. Most prostatitis patients were classified as chronic prostatitis patients. The prescribing proportion of antibiotics for chronic prostatitis outpatients decreased from 71.0% to 66.9% from 2008 to 2015, and fluoroquinolone accounted for more than half of the total antibiotics. Over 80% of prescription of levofloxacin and ciprofloxacin was identified to be for low-dose use. Conclusion: Most of the patients with prostatitis experienced pain relief and condition improvement after antibiotic treatment; however, chronic prostatitis and chronic pelvic pain syndrome recur easily. Therefore, active disease management and further studies are needed to enhance our understanding of effective treatment for prostatitis.

• The Journal of Dong Guk Oriental Medicine
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• v.11
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• pp.41-51
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• 2008

Dietary supplements are used by more than one-half of the adult US population. By contrast, herbal products in Germany are carefully regulated by the same standards as drugs, and efforts are under way to standardize their regulation in the entire European Union. Most herbal users do not inform their physicians that they are taking these supplements, and most physicians do not inquire. Although some herbal products have clinically proven benefits, it is increasingly apparent that many contain potentially toxic substances, particularly in relation to interactions with drugs. Hence, it is essential that practicing physicians develop a working knowledge of herbals-specifically, about claims for their usage and potential or proven efficacies and toxicities-and that they incorporate such knowledge into the evaluation and management of their patients. By contrast, functional foods-integral components of the diet that are understood to contribute added health benefits-are the subject of intense and widespread research in food and nutritional science. Examples include many polyphenolic substances, carotenoids, soy isoflavones, fish oils, and components of nuts that possess antioxidant and other properties that decrease the risk of vascular diseases and cancer. Practicing physicians are advised to stay abreast of these emerging findings in order to best advise their patients on the value of health-promoting diets in disease prevention.

• Korean Journal of Clinical Pharmacy
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• v.19 no.2
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• pp.167-179
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• 2009

Hypertension is one of the most common chronic diseases and it causes cardiovascular and cerebrovascular disease. While antihypertensive drug use increased, it took 15% of national health insurance drug expenditure. This study aimed to examine the pattern of antihypertensive drug prescription using National Health Insurance claims database and compare it with recommendations of Korea Hypertension Treatment Guidelines. Among the antihypertensive drugs, calcium channel blocker(64.4%) was most commonly prescribed class, and diuretics(44.6%), angiotensin II receptor blocker(33.3%), angiotensin converting enzyme inhibitor(11.7%) was followed. Approximately 81% of antihypertensives prescription were without cardiovascular or cerebrovascular disease, and among the comorbid conditions, diabetes(10.7%) was most common. calcium channel blocker(62.3%) was mostly prescribed class for hypertension with angina pectoris, angiotensin receptor blocker(45.3%) with myocardial infarction, diuretics(70.2%) and calcium channel blocker(49.5%) with congestive heart failure. For Hypertension with cerebrovascular disease, calcium channel blocker(68.0%) and angiotensin receptor blocker(43.3%) were prescribed mainly. When it comes to diabetes, calcium channel blocker(57.2%) was still mostly prescribed and angiotensin receptor blocker(45.9%) followed. But in hospitals and tertiary hospitals, angiotensin receptor blocker(65.7, 66.1%) was mostly prescribed for the patients with diabetes. For Hypertension with chronic renal disease, angiotensin receptor blocker(59.5%), calcium channel blocker(56.5%), diuretics(54.6%) were mainly used. Average number of classes per prescribing was $1.89{\pm}0.89$ class, average days per prescribing was $33{\pm}19$ day. Among the hypertension without comorbidity, 40.5% of prescription was monotherapy and 58.8% of polytherapy included diuretics. Among the outpatient prescriptions, calcium channel blocker was the most commonly used class, and the prescription pattern in clinic did not closely followed recommendations of Hypertension Treatment Guidelines.

• Journal of Preventive Medicine and Public Health
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• v.45 no.5
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• pp.291-300
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• 2012

Objectives: We aimed to estimate the annual socioeconomic burden of coronary heart disease (CHD) in Korea in 2005, using the National Health Insurance (NHI) claims data. Methods: A prevalence-based, top-down, cost-of-treatment method was used to assess the direct and indirect costs of CHD (International Classification of Diseases, 10th revision codes of I20-I25), angina pectoris (I20), and myocardial infarction (MI, I21-I23) from a societal perspective. Results: Estimated national spending on CHD in 2005 was $2.52 billion. The majority of the spending was attributable to medical costs (53.3%), followed by productivity loss due to morbidity and premature death (33.6%), transportation (8.1%), and informal caregiver costs (4.9%). While medical cost was the predominant cost attribute in treating angina (74.3% of the total cost), premature death was the largest cost attribute for patients with MI (66.9%). Annual per-capita cost of treating MI, excluding premature death cost, was $3183, which is about 2 times higher than the cost for angina ($1556). Conclusions: The total insurance-covered medical cost ($1.13 billion) of CHD accounted for approximately 6.02% of the total annual NHI expenditure. These findings suggest that the current burden of CHD on society is tremendous and that more effective prevention strategies are required in Korea.

• Health Policy and Management
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• v.26 no.1
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• pp.4-11
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• 2016

Background: Hospital admissions for ambulatory care sensitive conditions (ACSCs), which are widely used as an indicator of poor access to primary care, can be used as an efficiency indicator of healthcare use in countries providing good access to health care. Korea, which has a national health insurance (NHI) system and a good supply of health care resources, is one such country. To quantify admission rates of ACSC and identify characteristics influencing variation in Korean health care institutions. Methods: By using NHI claims data, we computed the mean ACSC admission rate for all institutions with ACSC admissions. Results: The average ACSC admission rate for 4,461 institutions was 1.45%. Hospitals and clinics with inpatient beds showed larger variations in the ACSC admission rate (0%-87.9% and 0%-99.6%, respectively) and a higher coefficient of variation (7.96 and 2.29) than general/tertiary care hospitals (0%-19.1%, 0.85). The regression analysis results indicate that the ACSC admission rate was significantly higher for hospitals than for clinics (${\beta}=0.986$, p<0.05), and for private corporate institutions than public institutions (${\beta}=0.271$, p<0.05). Conclusion: Substantial variations in ACSC admission rates could suggest the potential problem of inefficient use of healthcare resources. Since hospitals and private corporate institutions tend to increase ACSC admission rates, future health policy should focus on these types of institutions.