우리나라 건강보험의 위험분담제도가 재정 및 환자접근성에 미친 영향
An Overview of the Risk Sharing Management in Korean National Health Insurance, Focused on the Effect of the Patient Access and Insurance Finance
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Objective: This study examined the Risk Sharing Agreement (RSA) on pharmaceutical pricing system in Korean national healthinsurance. Through RSA, the insurer was able to maintain the principles in the price listing process while managing the budgeteffectively and improving patient access to new drugs. Despite these positive effects, there are still issues raised by somestakeholders, such as lack of transparency in the listing process and doubts about its effectiveness. Therefore, we investigated theimpacts of RSA on national health insurance financing and patient access to analyze the effects of RSA. Methods: The impact ofRSA was investigated by analyzing the health insurance claims data for 2014∼2016. The degree of improvement in patient accesswas determined by the decreased amount of patients’ payment. Results: Results showed that the financial impact of RSA was notsignificant and patients’ access to the new drug greatly improved. Conclusion: These results show that RSA is a good system forimproving patient access to new drugs without additional expense on insurance.
Abstract
Objective: This study examined the Risk Sharing Agreement (RSA) on pharmaceutical pricing system in Korean national healthinsurance. Through RSA, the insurer was able to maintain the principles in the price listing process while managing the budgeteffectively and improving patient access to new drugs. Despite these positive effects, there are still issues raised by somestakeholders, such as lack of transparency in the listing process and doubts about its effectiveness. Therefore, we investigated theimpacts of RSA on national health insurance financing and patient access to analyze the effects of RSA. Methods: The impact ofRSA was investigated by analyzing the health insurance claims data for 2014∼2016. The degree of improvement in patient accesswas determined by the decreased amount of patients’ payment. Results: Results showed that the financial impact of RSA was notsignificant and patients’ access to the new drug greatly improved. Conclusion: These results show that RSA is a good system forimproving patient access to new drugs without additional expense on insurance.
참고문헌 (13)
- Health Insurance Review, "Improvement of patients' access of drugs for 4 major diseases" (2016)
- "Health insurance coverage for high-priced drugs such as targeted cancer drugs is expanded"[URL]
- "Detailed evaluation criteria for drugs subject to negotiation include new drugs, etc"[URL]
- Regulation for evaluation criteria and procedures for reimbursement eligibility of drugs, "Health Insurance Review and Assessment Service", ~ (2016)
- Klemp M, "What principles should govern the use of managed entry agreements?", Int J Technol Assess Health Care, 27(1), pp.77~83 (2011)[DOI]
- Spoors J, "Patient access schemes in the new NHS", Brit J Healthc Manag, 18(8), pp.412~418 (2012)[DOI]
- Vitry A, "Managed entry agreements for pharmaceuticals in Australia", Health Policy, 117(3), pp.345~352 (2014)[DOI]
- Garattini L, "Risk sharing agreements: What lessons from Italy?", Int J Technol Assess, 27(2), pp.169~172 (2011)[DOI]
- Cheong C, "Risk Sharing Agreements on Pharmaceuticals: Lessons from Foreign Countries' Experience", J Health Tech Assess, 1(1), pp.51~60 (2013)
- "Managed entry agreements for pharmaceuticals: the European experience"[URL]
- "List of technologies with approved Patient Access Schemes"[URL]
- A study on the post-listed management of the drug that listed by risk sharing management, "Health Insurance Review and Assessment Service", ~ (2016)
- 이영실, "주요 외국의 의약품 위험분담제도에 대한 고찰: 계약현황과 사후관리방안을 중심으로", 보건의료기술평가, 5(1), pp.13~21 (2017), 한국보건의료기술평가학회[DOI]