요양급여심사기준 완화에 따른 비스테로이드성 항염제 및 위장관 보호제 처방 변화 및 안정성 분석
Prescribing Pattern and Safety Analysis of Nonsteroidal Anti-inflammatory Drug and Gastro- Protective Agent following Reimbursement Guidelines Relaxation
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Objective: The prevalence rate of osteoarthritis in Koreans aged 50 years or older is 14.3%, and the total amount of medical costsis more than KRW 1 trillion. Recently, the reimbursement guidelines for osteoarthritis treatment have changed. Methods: In thisstudy, we sought to describe prescription patterns of nonsteroidal anti-inflammatory drugs (NSAIDs) and gastro-protective agent(GPA) and analyze the clinical and economic impacts of the new policy using the national health insurance claims data. Theincidence of upper gastrointestinal adverse event by policy change was identified through the odds ratio, and changes in medicineand medical costs related to osteoarthritis through mean and median. Results: There were 204,552 patients before thereimbursement guidelines relaxation and 239,710 after it, a 17.2% rise. The prescription ratio was 3.3% for the patients prescribedwith COX-2 selective NSAIDs alone and 1.3% for those with both COX-2 selective NSAIDs and GPA combination before thereimbursement guidelines relaxation. The reimbursement guidelines relaxation significantly increased their ratios to 6.9% and 2.8%,respectively. Gastrointestinal adverse events significantly reduced by 1.21%p after reimbursement guidelines relaxation. The averagemedicine cost per person increased significantly to KRW 140,291 from KRW 137,323 after the reimbursement guidelines relaxation,while the average medical cost per person slightly decreased from KRW 311,605 to KRW 310,755 after the relaxation, showing nomeaningful difference. Conclusion: The reimbursement guidelines relaxation may influence on decreasing the upper gastrointestinaladverse event, increasing the medicine costs and maintaining the medical costs for osteoarthritis.
Abstract
Objective: The prevalence rate of osteoarthritis in Koreans aged 50 years or older is 14.3%, and the total amount of medical costsis more than KRW 1 trillion. Recently, the reimbursement guidelines for osteoarthritis treatment have changed. Methods: In thisstudy, we sought to describe prescription patterns of nonsteroidal anti-inflammatory drugs (NSAIDs) and gastro-protective agent(GPA) and analyze the clinical and economic impacts of the new policy using the national health insurance claims data. Theincidence of upper gastrointestinal adverse event by policy change was identified through the odds ratio, and changes in medicineand medical costs related to osteoarthritis through mean and median. Results: There were 204,552 patients before thereimbursement guidelines relaxation and 239,710 after it, a 17.2% rise. The prescription ratio was 3.3% for the patients prescribedwith COX-2 selective NSAIDs alone and 1.3% for those with both COX-2 selective NSAIDs and GPA combination before thereimbursement guidelines relaxation. The reimbursement guidelines relaxation significantly increased their ratios to 6.9% and 2.8%,respectively. Gastrointestinal adverse events significantly reduced by 1.21%p after reimbursement guidelines relaxation. The averagemedicine cost per person increased significantly to KRW 140,291 from KRW 137,323 after the reimbursement guidelines relaxation,while the average medical cost per person slightly decreased from KRW 311,605 to KRW 310,755 after the relaxation, showing nomeaningful difference. Conclusion: The reimbursement guidelines relaxation may influence on decreasing the upper gastrointestinaladverse event, increasing the medicine costs and maintaining the medical costs for osteoarthritis.
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