Evidence-based Pharmaceutical Policy-making; A Challenging Task? Vivid Voices from Korean Experts

근거중심 의약품 정책 결정; 극복하기 어려운 과제인가? 한국 전문가의 생생한 의견

  • Received : 2013.04.14
  • Accepted : 2013.09.06
  • Published : 2013.09.30

Abstract

This study aims to explore the difficulties of evidence-based pharmaceutical policy-making in the Korean context where several pharmaceutical policies were introduced within a short period. Semi-structured in-depth interviews were performed with eight experts in the Korean pharmaceutical arena. The key challenge in Korean situation might be the apparent lack of available evidence caused by the limited resources, the lack of policy consistency and coordination ability in the authorities and distrust across stakeholders. To build an evidence-based tradition, it is essential to resolve the tangible lack. At once, more fundamental changes seem to be required in the intangible policy environments.

Keywords

References

  1. Wilson DC, Smith NA, Blakey NC, et al., Using researchbased knowledge to underpin waste and resources policy. Waste Manage Res 2007; 25: 247-56. https://doi.org/10.1177/0734242X07079154
  2. van Kammen J, de Savigny D, Sewankambo, et al., Using knowledge brokering to promote evidence-based policy-making: The need for support structures. Bulletin of the World Health Organization 2006; 84: 608-12. https://doi.org/10.2471/BLT.05.028308
  3. Department of Health. Policy research programme: purpose, objectives and priorities. London: Department of Health, 2008.
  4. Soumerai SB, Ross-Degnan D, Fortess, EE, et al., Determinants of change in Medicaid pharmaceutical cost sharing: does evidence affect policy? Milbank Quarterly 2007; 75: 11-34.
  5. Cho JG, Lee EK, Kim JY, et al., Evaluation and policy implication of the Separation of prescribing and dispensing drugs. Seoul: Korea Institute for Health and Social Affairs, 2001.
  6. Cho JG, Kim JY, Jang SM, et al., Monitoring health care utilisation behaviour after the inception of the separation of prescribing and dispensing drugs. Seoul: Korea Institute for Health and Social Affairs, 2002.
  7. Jang SM, Lee EK, Kim Y, et al., Pharmaceutical utilisation before and after the separation of prescribing and dispensing of drugs; focusing on changes in prescribing behaviour. Seoul: Korea Institute for Health and Social Affairs, 2001.
  8. Lee EK, Malone DC. Comparison of peptic-ulcer drug use and expenditures before and after the implementation of a government policy to separate prescribing and dispensing practices in South Korea. Clin Ther 2003; 25: 578-92. https://doi.org/10.1016/S0149-2918(03)80098-X
  9. Lee IH, Bloor K, Hewitt C, et al., The effects of new pricing and copayment schemes for pharmaceuticals in South Korea. Health Policy 2012; 104: 40-9. https://doi.org/10.1016/j.healthpol.2011.09.003
  10. Healy, D. The new medical oikumene. In: Petryna A, Lakoff A, Kleinman A, eds., Global pharmaceuticals: ethics, markets, practices. London: Duke University Press, 2006.
  11. Lovell, A. M. Addiction markets: the case of high-dose buprenorphine in France. In: Petryna A, Lakoff A, Kleinman A, eds., Global pharmaceuticals: ethics, markets, practices. London: Duke University Press, 2006.
  12. Jacobzone, S. Pharmaceutical policies in OECD countries: reconciling social and industrial goals. Paris: Organisation for Economic Co-operation and Development, 2000.
  13. Denscombe, M. Surveys. The good research guide for small-scale social research projects. 3rd ed. Open University Press. Maidenhead. p7-34, 2007.
  14. Patton, M. Q. Designing qualitative studies. Qualitative evaluation and research methods. 2nd ed. SAGE Publications Ltd. London. p143-98, 1990.
  15. Guest G, Bunce A, Johnson L. How many interviews are enough? An experiment with data saturation and variability. Field Methods 2006; 18: 59-82. https://doi.org/10.1177/1525822X05279903
  16. Leech, NL. The role of sampling in qualitative research. Academic Exchange Quarterly. 2005; 9: 280-84.
  17. Adamson J, Gooberman-Hill R, Woolhead G, et al., 'Questerviews': using questionnaires in qualitative interviews as a method of integrating qualitative and quantitative health services research. J Health Serv Res Policy 2004; 9: 139-45. https://doi.org/10.1258/1355819041403268
  18. National Centre for Social Research. Framework; the qualitative data analysis tool. London: National Centre for Social Research, 2010.
  19. Ritchie J, Spencer L. Qualitative data analysis for applied policy research. In: Bryman A, Burgess RG, eds., Analysing qualitative data. Routledge. London. p173-94, 1994.
  20. Marshall C, Rossman GB. Data collection methods. Designing qualitative research. 4th ed. Sage Publications Ltd. London. p97-150, 2006.
  21. Klein R. Learning from others: shall the last be the first? J Health Politics Policy Law 1997; 22: 1267-78.
  22. Rose R. Introduction: why learn lessons from abroad? Learning from comparative public policy: a practical guide. Routledge. London, 2005.
  23. Salter B. Doctors and managers. The new politics of medicine. Palgrave. Basingstoke. p68-92, 2004.
  24. Harrison S, Wistow G. Managing health care: balancing interests and influence. In: Davey B, Popay J, eds., Dilemmas in health care. Buckingham: Open University Press, 1993.
  25. Ameringer CF. Federal antitrust policy and physician discontent: defining moments in the struggle for congressional relief. J Health Politics Policy Law 2002; 27: 543-74. https://doi.org/10.1215/03616878-27-4-543
  26. DailyPharm. [Doctors' representatives, "stop the generic prescribing programme"]. DailyPharm. Seoul, 2007.
  27. DailyPharm. [Medical academy doubts the quality of generic products]. DailyPharm. Seoul, 2007.
  28. DailyPharm. [Head director of NMC Dr. Kang, "pharmacists would dispense profitable products under a generic prescribing programme]. DailyPharm. Seoul, 2007.
  29. Danzon PM, Chao LW. Does regulation drive out competition in pharmaceutical markets? J Law Econ 2000; 43: 311-57. https://doi.org/10.1086/467458
  30. Danzon PM, Furukawa MF. Prices and availability of pharmaceuticals: evidence from nine countries. Health Aff (Millwood) 2003; Suppl Web Exclusives: W3-521-36.
  31. Guillen AM, Cabiedes L. Reforming pharmaceutical policies in the European Union: a "penguin effect"? Int J Health Serv 2003; 33: 1-28. https://doi.org/10.2190/1JC6-FRL4-QM2L-QN6E
  32. Lee SY, Kim YM. Globalization and independency of populist nations' welfare policies: focusing on the influences of multinational pharmaceutical companies on the Korean government's policy on the pharmaceutical industry. Korean J Social Welfare 2005; 57: 5-30.
  33. Lee SY. The conflict between the protection of patents for pharmaceuticals under the TRIPS Agreement and the sovereign power to address domestic health crisis: a case study of Gleevec in South Korea. Korean J Social Welfare Studies 2004; 23: 139-67.
  34. DongA IIbo. [US urged Korean government to give up the PERP]. Dong-A Ilbo. Seoul, 2006.
  35. Cookson, R. Evidence-based policy making in health care: what it is and what it isn't. J Health Serv Res Policy 2005; 10: 118-21. https://doi.org/10.1258/1355819053559083
  36. Innvaer S, Vist G, Trommald M, et al., A. Health policymakers' perceptions of their use of evidence: a systematic review. J Health Serv Res Policy 2002; 7: 239-44. https://doi.org/10.1258/135581902320432778
  37. Choi BC, Pang T, Lin V, et al., Can scientists and policy makers work together? J Epidemiol Commun H 2005; 59: 632-7. https://doi.org/10.1136/jech.2004.031765
  38. Sharpe M. Weighing the evidence: prospects for evidence-based policy-making. J Environ Monitor 2004; 6: 114N-17N. https://doi.org/10.1039/b414359k