THE INFLUENCE OF PHARMACEUTICAL REFORM IN KOREA A DECADE AGO- WHAT WE WALKED
Author(s)
Na Y1, Oh R1, Kim H2, Ryu M1
1HIRA (Health Insurance Review & Assessment Service), Wonju-si, Gangwon-do, Korea, Republic of (South), 2HIRA (Health Insurance Review & Assessment Service), Gangwon-do, Korea, Republic of (South)
OBJECTIVES: Korea had reformed the pharmaceutical listing/pricing system in 2007 according to the governmental DERP (drug expenditure rationalization plan) policy. It has brought innovative changes on the National Health Insurance (NHI) drug reimbursement including the transition into the Positive List System. The aim of this study was to look back the outcome of 10-years’ of it. METHODS: Total 15 literatures were selected and data from governmental published reports and internal data of HIRA were included. Impacts of the reform was categorized into 1) pharmaceutical benefit decision, 2) access to affordable drugs, 3) national drug expenditure corresponding the intermediate measures as quality, access, and efficiency to assess health-system performance (Marc Roberts et al. 2008). RESULTS: It has institutionalized evidence–based decision-making for medicines; acceptable only if clinically effective and cost-effective. Benefit decision is supported by the Committee equipped with advisory and sub-committees. Appraisal results are disclosed to the public from 2008 transparently. Although the concern on high-cost new drug entry is not only of Korea, the acceptance rate of new medicine (HIRA) is 60.7%~82.7% in 2011~2015 and lower than the UK but greater than Australia or Canada. For severe and rare disease treatments, equitable access was contributed by (i) the risk-sharing scheme for 9 products since 2013 (ii) more flexible ICER level comparing to common drugs (iii) economic evaluation exemption (2015). To streamline access, it reduced statutory period twice. The reform contributes to stabilize pharmaceutical expenditure; as a share of total healthcare expenditure has stopped increasing and maintained the level of <30% (2007~2011). There is no evidence it may strengthen or weaken industrial market or R&D. CONCLUSIONS: The reform has led to the improvement of the quality of drug benefit decision, reinforcement of the access to the appropriate medicine, rationalization of the national drug expenditure and more efficient allocation of resources.
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PHP42
Topic
Health Policy & Regulatory, Health Service Delivery & Process of Care
Topic Subcategory
Formulary Development, Pricing Policy & Schemes
Disease
Multiple Diseases