Price cuts and drug spending in South Korea: The case of antihyperlipidemic agents

Health Policy

Volumn 112, Issue 3, 2013, Pages 217-226

  Kwon, Hye Young ^a   Hong, Ji Min ^a   Godman, Brian ^b,c   Yang, Bong Min ^a  

^a Seoul National University   (South Korea)

^b KAROLINSKA UNIVERSITY HOSPITAL   (Sweden)

^c UNIVERSITY OF STRATHCLYDE   (United Kingdom)

Author keywords

Antihyperlipidemics; Drug utilisation; Pharmaceutical expenditures; Price control; Price reduction

Indexed keywords

ATORVASTATIN;

ARTICLE; DRUG COST; HEALTH CARE COST; HUMAN; HYPERLIPIDEMIA; INTERVENTION STUDY; NATIONAL HEALTH INSURANCE; RETROSPECTIVE STUDY; SOUTH KOREA; TREND STUDY;

ANTIHYPERLIPIDEMICS; DRUG UTILISATION; PHARMACEUTICAL EXPENDITURES; PRICE CONTROL; PRICE REDUCTION;

COST CONTROL; DRUG AND NARCOTIC CONTROL; DRUG COSTS; ECONOMICS, PHARMACEUTICAL; HEALTH EXPENDITURES; HUMANS; HYPOLIPIDEMIC AGENTS; INSURANCE, HEALTH, REIMBURSEMENT; REPUBLIC OF KOREA; RETROSPECTIVE STUDIES;

EID: 84887032983     PISSN: 01688510     EISSN: 18726054     Source Type: Journal    
DOI: 10.1016/j.healthpol.2013.08.011     Document Type: Article

References (55)

1. OECD Pharmaceutical expenditure, Health: Key Tables from OECD, No. 7 2012, http://dx.doi.org/10.1787/pharmexp-table-2012-2-en [accessed 10.04.13].
2. Ess S.M., Schneeweiss S., Szucs T.D. European healthcare policies for controlling drug expenditure. Pharmacoeconomics 2003, 21(2):89-103.
3. Hakonsen H., Horn A.M., Toverud E.L. Price control as a strategy for pharmaceutical cost containment-what has been achieved in Norway in the period 1994-2004?. Health Policy 2009, 90(23):277-285.
4. Mrazek M. Comparative approaches to pharmaceutical price regulation in the European Union. Croatian Medical Journal 2002, 43(4):453-461.
5. Mrazek M., Mossialos E. Regulating pharmaceutical prices in the European Union. Regulating pharmaceuticals in Europe: striving for efficiency, equity, and quality 2004, Open University Press, Berkshire. E. Mossialos, M. Mrazek, T. Walley (Eds.).
6. Rietved A.H., Haaijier-Ruskamp F.M. Policy options for cost containment of pharmaceuticals. International Journal of Risk & Safety in Medicine 2002, 15:29-54.
7. Menon D. Pharmaceutical cost control in Canada: does it work?. Health Affairs 2001, 20(3):92-103.
8. Contiades X., Golna C., Souliotis K. Pharmaceutical regulation in Greece at the crossroad of change: economic, political and constitutional considerations for a new regulatory paradigm. Health Policy 2007, 82:116-129.
9. Lambrelli D., O'Donnell O. The impotence of price controls: Failed attempts to constrain pharmaceutical expenditures in Greece. Health Policy 2010, 101(2):162-171.
10. Meng Q., Cheng G., Silver L., Sun X., Rehnberg C., Tomson G. The impact of China's retail drug price control policy on hospital expenditures: a case study in two Shandong hospitals. Health Policy and Planning 2005, 20(3):185-196.
11. Bastida J.L., Mossialos E. Pharmaceutical expenditure in Spain. Cost and Control International Journal of Health Services 2000, 30(3):597-616.
12. Delnoij D., Brenner G. Importing budget systems from other countries: what can we learn from the German drug budget and the British GP fundholding?. Health Policy 2000, 52:157-169.
13. de Wolf P., Brouwer W.B., Rutten F.F. Regulating the Dutch pharmaceutical market: improving efficiency or controlling costs. International Journal of Health Planning and Management 2005, 20:351-374.
14. Hu S., Chen W., Cheng X., Chen K., Zhou H., Wang L. Pharmaceutical cost-containment policy: experiences in Shanhai. China Health Policy and Planning 2001, 16(Suppl 2):4-9.
15. Lee Y.C., Yang M.C., Huang Y.T., Liu C.H., Chen S.B. Impacts of cost containment strategies on pharmaceutical expenditures of the national health insurance in Taiwan, 1996. Pharmacoeconomics 2006, 24(9):891-902.
16. Kwon H.Y., Yang B.M. Fixed budget for pharmaceuticals. Korean Journal of Health Economics and Policy 2011, 17(1):25-45. [in Korean].
17. Kwon S.M. Pharmaceutical reform and physician strikes in Korea: separation of drug prescribing and dispensing. Social Science & Medicine 2003, 57:529-538.
18. Kim H.J., Chung W.K., Lee S.K. Lessons from Korea's pharmaceutical policy reform: the separation of medical institutions and pharmacies for outpatient care. Health Policy 2004, 68:267-275.
19. Bae E.Y. Decomposition analysis on contributing factors to drug expenditures. Health Insurance Review and Assessment Service 2007, [in Korean].
20. Jang S.M., Park C.M., Choi Y.J., Bae G. Analysis of determinants of inpatient drug expenditure in NHI. Korean Journal of Health Economics and Policy 2010, 16(3):115-137. [in Korean].
21. Hurh S.M., Jung J.C., Lee H.Y. Study on the reasonable drug expenditures 2006, National Health Insurance Corporation, [in Korean].
22. Ministry of Health and Welfare A massive markdown, relieve the burden of drug expenditures. Press Release, August 12 2011.
23. Price-Volume Agreement, Maximum 20% of price cuts, Dailypharm April 5, 2013. Available from: [accessed 10.04.13]. http://www.dailypharm.com/News/169306.
24. Ministry of Health and Welfare (MOHW) Drug list rearrangement project. Notification No. 2007-116. March 30 2007.
25. Evaluation of antihyperlipidemics, it's wrong from the start. Dailypharm May 15, 2008. Available from: [accessed 17.01.12]. http://www.dailypharm.com/Users/News/NewsView.html%3FID=97403.
26. Ministry of Health and Welfare Notification of drug reimbursement list (revised). No. 2008-54. June 19 2008, Department of Pharmaceutical Benefit, Available from: http://www.hira.or.kr/dummy.do?pgmid=HIRAA030010000000&cmsurl=/cms/information/04/01/01/1189624_13511.html&subject=2008-54 [accessed 17.01.12].
27. Ministry of Health and Welfare Notification of drug reimbursement list (revised) No. 2009-58. March 30 2009, Department of Pharmaceutical Benefit, Available from: http://www.hira.or.kr/dummy.do?pgmid=HIRAA030010000000&cmsurl=/cms/information/04/01/01/1191615_13511.html&subject=2009-58 [accessed 17.01.12].
28. England E. How interrupted time series analysis can evaluate guideline implementation. Pharmaceutical Journal 2005, 275(7367):344-347.
29. Wagner A., Soumerai S., Zhang F., Ross-Degnan D. Segmented regression analysis of interrupted time series studies in medication use research. Journal of Clinical Pharmacy and Therapeutics 2002, 27(4):299-309.
30. Ramsey C.R., Matowe L., Grilli R., Grimshaw J.M., Thomas R.E. Interrupted time series designs in health technology assessment: lessons from two systematic reviews of behavior change strategies. International Journal of Technology Assessment in Health Care 2003, 19(4):613-623.
31. National Health Insurance Statistical Year Book 2011, National Health Insurance Corporation. http://www.nhic.or.kr/portal/site/main/MENU_WBDDG02/.
32. Yang B.M., Kwon H.Y., Kim S., Kim E., Baik S.H. Strengthening public role in production and supply of pharmaceuticals 2013, National Health Insurance Corporation (NHIC) and Seoul National University, March.
33. WHO/DDD. http://www.whocc.no/atc_ddd_index/.
34. Vončina L., Strizrep T., Godman B., Bennie M., Bishop I., Campbell S., et al. Influence of demand-side measures to enhance renin-angiotensin prescribing efficiency in Europe: implications for the future. Expert Review of Pharmacoeconomics and Outcomes Research 2011, 11:469-479.
35. Godman B., Shrank W., Andersen M., Berg C., Bishop I., Burkhardt T., et al. Policies to enhance prescribing efficiency in Europe: findings and future implications. Frontiers in Pharmacology 2011, 1(141):1-16. 10.3389/fphar.2010.00141.
36. Godman B., Shrank W., Andersen M., Berg C., Bishop I., Burkhardt T., et al. Comparing policies to enhance prescribing efficiency in Europe through increasing generic utilisation: changes seen and global implications. Expert Review of Pharmacoeconomics and Outcomes Research 2010, 10:707-722.
37. Bennie M., Godman B., Bishop I., Campbell S. Multiple initiatives continue to enhance the prescribing efficiency for the proton pump inhibitors and statins in Scotland. Expert Review Pharmacoeconomics and Outcomes Research 2012, 12:125-130.
38. Sakshaug S., Furu K., Karlstad Ø., Rønning M., Skurtveit S. Switching statins in Norway after new reimbursement policy - a nationwide prescription study. British Journal of Clinical Pharmacology 2007, 64:476-481.
39. Godman B., Burkhardt T., Bucsics A., Wettermark B., Wieninger P. Impact of recent reforms in Austria on utilisation and expenditure of PPIs and lipid lowering drugs; implications for the future. Expert Review Pharmacoeconomics and Outcomes Research 2009, 9:475-484.
40. van Woerkom M., Piepenbrink J.F., Godman B., Metz J., Campbell S., Bennie M., et al. Ongoing measures to enhance the efficiency of prescribing of PPIs and statins in the Netherlands; influence and future implications. Journal of Comparative Effectiveness Research 2012, 1:527-538.
41. Wettermark B., Godman B., Jacobsson B., Haaijer-Ruskamp F. Soft regulations in pharmaceutical policymaking - an overview of current approaches and their consequences. Applied Health Economics and Health Policy 2009, 7:137-147.
42. Nelson A.A., Reeder C.E., Dickson W.M. The effect of a Medicaid drug copayment program on the utilisation and cost of prescription services. Medical Care 1984, 22(8):724-736.
43. Van De Voorde C., Van Doorslaer E., Schokkaert E. Effects of cost sharing on physician utilization under favourable conditions for supplier-induced demand. Health Economics 2001, 10(5):457-471.
44. Durbin J., Watson G.S. Testing for serial correlation in least square regression. Biometrika 1951, 37:409-428.
45. Draper N., Smith H. Applied regression analysis 1981, Wiley, New York.
46. Kim H., Ruger J.P. Pharmaceutical reform in South Korea and the lessons it provides. Health Affairs 2008, 27(4):w260-w269.
47. Park S.E., Lim S.H., Choi H.W., Lee S.M., Kim D.W., Yim E.Y., et al. Evaluation on the first 2 years of the positive list system in South Korea. Health Policy 2010, 104. 32-29.
48. Health Insurance Review and Assessment Service. Continuously growing pharmaceutical expenditure: Still 30% of Total Health Expenditure in 2009, Press release. Available at: [accessed 17.01.12]. http://www.hira.or.kr/.
49. Ministry of Health and Welfare Facts and Statistics for Health Insurance Policy, Seoul 2011.
50. Andersson K., Petzold M.G., Sonesson C., Lonnroth K., Carlsten A. Do policy changes in the pharmaceutical reimbursement schedule alter drug expenditures? Interrupted time series analysis of cost, volume and cost per volume trends in Sweden 1986-2002. Health Policy 2006, 76:231-243.
51. Kwon H.Y., Yang B.M. Do generics really create savings on drug expenditures?. Korean Journal of Health Economics and Policy 2011, 17(4):23-42.
52. Schweitzer S.O. Pharmaceutical Economics and Policy 2007, Oxford University Press, New York. 2nd ed.
53. Jacobzone S. Pharmaceutical policies in OECD countries: reconciling social and industrial goals 2000, Organisation for Economic Cooperation and Development, Paris.
54. Kanavos P., Costa-Font J., Seeley E. Competition in off-patent drug markets: issues, regulation and evidence. Economic Policy 2008, 23(55):499-544.
55. Seeley E., Kanavos P. Generic medicines from a societal perspective: savings for health care systems. Eurohealth 2008, 14(2):18-22.