Changes in the List of Drugs Covered by National Health Insurance after the Introduction of Positive List System in Korea

의약품 선별등재제도 도입 전후 건강보험 등재의약품의 특성별 현황

  • Rhee, Jin-Nie (Graduate School of Clinical Pharmacy, Sookmyung Women's University) ;
  • Heo, Ji-Haeng (Graduate School of Clinical Pharmacy, Sookmyung Women's University) ;
  • Lee, Eui-Kyung (Graduate School of Clinical Pharmacy, Sookmyung Women's University)
  • 이진이 (숙명여자대학교 임상약학대학원) ;
  • 허지행 (숙명여자대학교 임상약학대학원) ;
  • 이의경 (숙명여자대학교 임상약학대학원)
  • Received : 2011.05.23
  • Accepted : 2011.07.04
  • Published : 2011.08.31

Abstract

This study aimed to identify the changes in the list of drugs covered by national health insurance(NHI) after the introduction of positive list system (PLS) in Korea in December, 2006. Six-year (pre-policy:2004-2006, post-policy:2007-2009) lists of the NHI reimbursable drugs filed from Health Insurance Review and Assessment Service (HIRA) were analyzed. The total number of listed drugs as well as drug ingredients, and the average number of listed drugs per manufacturer decreased annually after the introduction of PLS. More than 8,000 drugs were delisted in the year 2007 right after the policy change. Prescription-only drugs occupied more than 85% of NHI listed drugs. The percentage of oral type of listed drugs has been increased to more than 60% after the policy change. Korean pharmaceutical manufacturers occupied more than 90% of listed drugs than multinational firms. The gap between Korean and foreign manufacturer in terms of the average number of newly listed drugs per manufacturer in each year has decreased two years after the PLS (Korean 7.7 vs. foreign 6.3 in 2009) as the price negotiation power of foreign firms has increased. The total number of listed drugs is expected to decrease in the future as the Korean government makes an effort to delist the unnecessary drugs that do not show cost-effectiveness.

Keywords

References

  1. 이의경, 김성옥, 배정윤, 강현하, 김지연 : 약제비 적정화방안이 약국 및 제약업계에 미치는 영향분석과 정책대안, 숙명여자대학교.의약품정책연구소, 서울 p.19-21 (2007).
  2. 보건복지부 보도자료: "건강보험 약제비 적정화 방안 시행", 서울 (2006년 12월 27일).
  3. 건강보험심사평가원 : EDI 약가화일. Available at http://www. hira.or.kr/common/dummy.jsp ?pgmid=HIRAQ010104000000.
  4. 한국다국적의약산업협회 : 회원사. Available at http://www. krpia.or.kr/company/member.asp.
  5. 한국다국적의약산업협회 : 회원사. Available at http://www. krpia.or.kr/company/member.asp.
  6. 이의경 : 선별목록(positive list) 중심의 보험의약품 등재관리제도 개선방안 연구, 보건복지부, 서울 (2005).
  7. 보건복지부 보도자료: "기등재 의약품 목록정비 사업 속도낸다", 서울 (2010년 7월 28일).
  8. 건강보험심사평가원 : 건강보험 약품비 변동요인 분석, 서울 (2010).
  9. 김성옥 : 2005 외국보험약가 관리제도, 국민건강보험공단, 서울 (2005).
  10. 윤선영 : 선별등재제도 실시 이후 의약품의 협상과정 및 현황 분석, 숙명여자대학교 석사학위 논문, 서울 (2010).
  11. 하동문 : 선별등재제도 도입 후 신약의 보험등재 현황과 정책 인식도 분석, 성균관대학교 박사학위 논문, 경기도 (2010).