OBJECTIVES

This study aims to explore the performance of price negotiations over 10 years and identify individual variations in pricing that directly affect the consistency of pricing decisions.

METHODS

Existing literature and relative regulations were reviewed and data provided by the National Health Insurance Service (NHIS) were analysed to evaluate the performance of price negotiations. To examine individual variations in pricing, hypothesized scenarios of four types of drugs were developed and given to the reviewers who have been actually conducting price negotiations at the National Health Insurance Service.

RESULTS

Over the last decade, negotiations have succeeded at a rate of 85.5%, with a higher agreement rate in more recent years. The reduction rate via price negotiations from the price approved for reimbursement by the HIRA was 12.2%. The results of the survey for reviewers at the NHIS confirmed a significant individual variation in pricing. Especially, in the case of Drug N1, the higher grade personnel and non-pharmacists tended to give higher prices with a significant difference.

CONCLUSIONS

The individual variations that would greatly affect the financial results were confirmed when decision making on price of new drugs. For the consistency of drug pricing, some measures to minimize the variation of reviewers’ judgement are needed.