의약품 보험 급여 및 가격 결정과 경제성 평가의 활용
Use of Economic Evaluation in the Listing and Pricing of Pharmaceuticals
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To curb a rapid increase in expenditures for pharmaceuticals, the Korean government introduced a positive list system and a negotiation process for drug prices at the end of 2006. Economic evaluation of pharmaceuticals has begun to have a pivotal role in the listing and pricing of drugs for the Korean National Health Insurance. There are some points to discuss regarding the use of economic evaluation in the listing and pricing in the context of the Korean system. First, the listing and pricing processes have been fragmented, evoking complaints from pharmaceutical companies and delaying the access of new drugs to patients. Second, there is a concern that the positive list system may limit the range and availability of drugs for patients to choose for treatment. Third, the time schedule for de-listing of existing drugs may not be realistic. Fourth, it is not always easy to provide reliable evidence of cost-effectiveness due to a lack of materials. Fifth, there is no consensus on the range of the ICER (incremental cost-effectiveness ratio) acceptable to the Korean society. In conclusion, in the near future, it will be necessary to evaluate the achievements that the economic evaluation has provided to the Korean society.
Abstract
To curb a rapid increase in expenditures for pharmaceuticals, the Korean government introduced a positive list system and a negotiation process for drug prices at the end of 2006. Economic evaluation of pharmaceuticals has begun to have a pivotal role in the listing and pricing of drugs for the Korean National Health Insurance. There are some points to discuss regarding the use of economic evaluation in the listing and pricing in the context of the Korean system. First, the listing and pricing processes have been fragmented, evoking complaints from pharmaceutical companies and delaying the access of new drugs to patients. Second, there is a concern that the positive list system may limit the range and availability of drugs for patients to choose for treatment. Third, the time schedule for de-listing of existing drugs may not be realistic. Fourth, it is not always easy to provide reliable evidence of cost-effectiveness due to a lack of materials. Fifth, there is no consensus on the range of the ICER (incremental cost-effectiveness ratio) acceptable to the Korean society. In conclusion, in the near future, it will be necessary to evaluate the achievements that the economic evaluation has provided to the Korean society.
참고문헌 (8)
- Ministry of Health and Welfare, "Measures to Contain the Drug Expenditures in the National Health Insurance" (2006), Ministry of Health and Welfare
- Drummond, M., "The role of economic evaluation in the pricing and reimbursement of medicines", Health Policy, 40(3), pp.199~215 (1997)
- Harris, R.P., "Current methods of the US Preventive Services Task Force: A review of the process", Am J Prev Med, 20, pp.21~35 (2001)
- Lee, E.K., "Policy Measures to Improve Drug Benefit Program" (2002), Korea Institute for Health and Social Affairs
- "Health Insurance Review & Assessment Service. Details on evaluation criteria for the listing of drugs"[URL]
- "Health Insurance Review & Assessment Service. Evaluation criteria of the Evaluation Committee on the Listing of Drugs"[URL]
- "National Health Insurance Corporation. Guideline for the negotiation on drug prices"[URL]
- Huh, S.I., "The policy reform of swedish pharmaceutical reimbursement and its implications", Health Welfare Policy Forum, 133, pp.113~123 (2007)