의약품 급여기준 외 사용에 대한 본인부담 경감방안 도입 타당성에 대한 전문가 의견 조사 결과

Abstract

Background and Objective: The selective benefit, introduced in June 2013, is a new copayment system to cover 50~80% of expenditures of pharmaceuticals which are not essential but with social demand. The purpose of this study was to investigate the feasibility of introducing a selective benefit by conducting an expert opinion survey. Method: Expert opinion surveys were conducted from May 4, 2015 to May 17, 2015. We distributed questionnaire to members of the Health and Medical Technology Evaluation Society, members of the Health, Social and Pharmacy Management Association, citizen group and member of patient group. As a result, 30 responded(response rate 23.1%). The questionnaire was based on the assumption that the four types of severe disease drug selective benefit introduction, and the opinions on the measures to reduce the burden on the user based on the criteria, application method. Results: Of the 30 respondents, 56.7% of the total respondents represented neutral opinion on introduction of drug selective benefits, 30% agreed with the introduction of selective benefits, and 13.3% disagreed. The evaluation items should be related to clinical utility, cost of medication, social needs. As for alternative plan to reduce patients' financial burden, 38.9% of respondents answered it is needed to strengthen upper limit for copayment, another 38.9% of respondents answered it is needed patient-based special fund, and 19.4% of respondents answered it is not necessary to introduce another support. Conclusion: To increase the coverage rate of the health insurance, it is more adequate to expand financial support on the basis of patients’ level rather than introducing drug selective benefit scheme.