OBJECTIVES: Since economic evaluation has been enforced to be considered for new drug reimbursement decisions in 2007, the structure and constituents of decision body, “Drug Reimbursement Evaluation Committee”, as well as the pharmacoeconomics report guideline promulgated by Health Insurance Review Assessment have been modified in Korea. These changes reflect deficiency in systematic adoption of economic evaluation and discontent among stakeholders. Recently, the fair and reasonable process and criteria have been highly emphasized at every level of policy administration in developed countries with concerns of increasing public demands for sustainable public practices and political acceptance of the importance of public accountability. Now, imminent practical task is how to connect the conceptual framework and feasible practice for publicly accountable drug reimbursement decisions. METHODS: Using theoretical structure of public accountability published in the European Governance Paper, we analyzed qualifications of drug reimbursement policy as ‘accountability’ and appraised the public accountability. We also performed interviews with ten key stakeholders from democratic, constitutional and learning perspectives. And then, recent reimbursement decision papers on two new drugs were analyzed to examine concrete shape of the accountability forums. RESULTS: Following scope of improvement would be suggested: (1) Clear and reasonable standards for coverage decision; (2) relevance of the standards to population’s health needs and health equity impacts; (3) disclosure of data used for decision, procedure and results to public; and (4) the procurement of due process of challenging decisions. CONCLUSIONS: Given value pluralism in democratic liberalism, it is matter of course that formal or procedural justice is given prominence. Conclusively, an explicit discussion for formal criteria and procedure is the essential component of the ongoing policy process. Accountable drug policy administration is impossible without accountable policy process which is impossible without transparent criteria for all decision stages.