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Impact of Price Control on Drug Expenditure and Factors Associated with the Drug Switch among Statins: Analysis of HIRA-NPS Data

스타틴 의약품의 약가인하 효과 및 약물 교체 관련 요인: 건강보험심사평가원 환자표본자료를 이용한 분석

  • Lee, Hye-Jae (Graduate School of Public Health, Seoul National University) ;
  • Lee, Tae-Jin (Graduate School of Public Health, Seoul National University)
  • 이혜재 (서울대학교 보건대학원) ;
  • 이태진 (서울대학교 보건대학원)
  • Received : 2013.01.11
  • Accepted : 2013.03.20
  • Published : 2013.06.30

Abstract

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.

Keywords

National Patients Sample data;Drug-switch;Pharmaceutical expenditure;Pharmaceutical prices;Physician behavior

Acknowledgement

Supported by : 보건장학회

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