Health Policy and Management (보건행정학회지)

Korean Academy of Health Policy and Management (한국보건행정학회)
권호 표지
DOI QR코드

DOI QR Code

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)
  • Received : 2013.01.11
  • Accepted : 2013.03.20
  • Published : 2013.06.30
Download PDF
⟨ Previous Next ⟩

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

References

  1. Organization for Economic Cooperation and Development. Pharmaceutical expenditure [Internet]. Paris: Organization for Economic Cooperation and Development; 2012 [cited 2012 Jul 5]. Available from: http://www.oecd.org/health/healthdata.
  2. National Health Insurance Service. National health insurance statistical yearbook: 2010 pharmacy prescription data [Internet]. Seoul: National Health Insurance Service; 2010 [cited 2012 Dec 28]. Available from: http://www.nhic.or.kr.
  3. IMS Health. Top 20 global therapeutic classes, 2010: total audited markets [Internet]. Danbury (CT): IMS Health; 2010 [cited 2012 Jul 5]. Available from: http://www.imshealth.com.
  4. Shin SY, Song HJ, Jang SM, Sung YN. Development of the outcome index of hyperlipidemia treatments (lipid lowering agents). Seoul: Health Insurance Review and Assessment Service; 2009.
  5. Mrazek MF. Comparative approaches to pharmaceutical price regulation in the European Union. Croat Med J 2002;43(4):453-461.
  6. Maynard A, Bloor K. Dilemmas in regulation of the market for pharmaceuticals. Health Aff (Millwood) 2003;22(3):31-41. https://doi.org/10.1377/hlthaff.22.3.31
  7. Ess SM, Schneeweiss S, Szucs TD. European healthcare policies for controlling drug expenditure. Pharmacoeconomics 2003;21(2):89-103. https://doi.org/10.2165/00019053-200321020-00002
  8. Meng Q, Cheng G, Silver L, Sun X, Rehnberg C, Tomson G. The impact of China's retail drug price control policy on hospital expenditures: a case study in two Shandong hospitals. Health Policy Plan 2005;20(3):185-196. https://doi.org/10.1093/heapol/czi018
  9. Yang BM, Bae EY, Kim J. Economic evaluation and pharmaceutical reimbursement reform in South Korea's National Health Insurance. Health Aff (Millwood) 2008;27(1):179-187. https://doi.org/10.1377/hlthaff.27.1.179
  10. Bae EY, Lee EK. Pharmacoeconomic guidelines and their implementation in the positive list system in South Korea. Value Health 2009;12 Suppl 3:S36-S41.
  11. Bae EY. Challenges in drug re-evaluation system based on health technology assessment. Korean J Health Econ Policy 2010;16(3):163-187.
  12. Bae EY. Study on the drug expenditure trend in Korea. Korean J Health Econ Policy 2007;13(2):39-54.
  13. Choi YJ, Shalowitz JI. Major growths of Korean pharmaceutical expenditure. J Korea Soc Health Inform Stat 2011;36(1):15-24.
  14. Kim YS, Kim SO. Analysis of the factors associated increased pharmaceutical expenditure and its management policies. Seoul: National Health Insurance Service; 2009.
  15. Jang SM, Park CM, Bae GR, Lee HJ, Kim HS. Analysis of the factors related to the pharmaceutical expenditure of the National Health Insurance. Seoul: Health Insurance Review and Assessment Service; 2010.
  16. Kwon HY, Yang BM. Drug mix effect of newly reimbursed drugs on pharmaceutical expenditures. Korean J Health Econ Policy 2011;17(2):151-169.
  17. Kwon HY, Yang BM. Do generics really create savings on drug expenditures? Korean J Health Econ Policy 2011;17(4):23-42.
  18. Lee JA, Oh J, Moon S, Lim JT, Lee JS, Lee JY, Kim Y. Assessment of needs and accessibility towards health insurance claims data. Korean J Health Policy Admin 2011;21(1):77-92. https://doi.org/10.4332/KJHPA.2011.21.1.077
  19. Health Insurance Review and Assessment Service. Drug list and tariff [Internet]. Seoul: Health Insurance Review and Assessment Service; 2010 [cited 2012 Jul 11]. Available from: http://www.hira.or.kr.
  20. Jung SW, Lee TJ, Cho BH. Market competition structure after original drug patent expiry. Korean J Health Econ Policy 2008;14(2):1-25.
  21. Park SV. Risk-sharing agreement on the pricing and reimbursement of new drugs. Korean J Health Econ Policy 2010;16(2):125-153.
  22. Lee SM, Kim NS. The development research on a prescribing incentive model to reduce priscribing cost in the health insurance system. Korean J Health Econ Policy 2010;16(3):63-89.
  23. Kwon HY, Yang BM. Fixed budget for pharmaceuticals. Korean J Health Econ Policy 2011;17(1):25-45.
  24. Health Insurance Review and Assessment Service. The results of clinical effectiveness and cost-effectiveness of hyperlipidemia treatments. Seoul: Health Insurance Review and Assessment Service; 2009.
  25. Kim D, Kim N, Lee S. Determination of defined daily dose of medicines using nominal group technique and analysis of antibiotics use in national insurance claim data: focused on antibiotics without DDD of WHO. Korean J Clin Pharm 2007;17(1):19-32.

Cited by

  1. Do newly marketed generic medicines expand markets using descriptive time series analysis and mixed logit models? Korea as an exemplar and its implications vol.16, pp.1, 2016, https://doi.org/10.1186/s12913-016-1356-z
  2. Patterns of Antipsychotic Prescription to Patients with Schizophrenia in Korea: Results from the Health Insurance Review & Assessment Service-National Patient Sample vol.29, pp.5, 2014, https://doi.org/10.3346/jkms.2014.29.5.719