Abstract
South Korean healthcare system has experienced an unprecedented growth and transformation in the span 15 years. The landmarks were the unification of insurance funds, and the separation of prescribing and dispensing of drugs (SPD). Several pricing policies have been introduced, revised and abolished to attempt to address unexpected increases in pharmaceutical expenditure which followed the separation of prescribing and dispensing of medicines. This chapter outlines the health care and pharmaceutical systems in South Korea, details pricing policies in the latest decade and reviews the effectiveness of these policies. While having a long-lasting history in pharmaceutical price control, South Korea has often introduced policies with a weak scientific basis and then abolished them without proper assessment and evaluation. Some evidence suggests that price controls have reduced pharmaceutical costs in the short-term, but evidence on the long-term impacts are largely absent. Given the cause of current cost inflation, i.e., increased use of pharmaceuticals and an ageing population, society needs a policy consensus to control prices and encourage rational prescribing.
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Notes
- 1.
Values adjusted by purchasing power parity (PPP) to eliminate price level differences in inter-country comparisons, equalising currencies by using a basket of goods and services.
- 2.
US$1 = 1,100 KRW in 2014.
- 3.
France, Germany, Italy, Japan, Switzerland, the UK and the US.
- 4.
The first to fifth generic drug is set at less than 80 % of cost for its off-patent alternative. The sixth and later product is set at the 90 % price of the least expensive alternative (MOHW Official Instructions 2005–14; provision 8).
- 5.
For instance, ‘GenericA’, a generic product of the ‘OriginalA’ (price 100) was priced at the maximum of 80 (i.e. 0.8 × 100) in the previous system. Now, it is priced at maximum 64 (i.e. 0.8 × 0.8 × 100) because the price of ‘OriginalA’ is reduced to 80 in the new system.
References
Andersson K, Bergstrom G, Petzold MG, Carlsten A (2007) Impact of a generic substitution reform on patients’ and society’s expenditure for pharmaceuticals. Health Policy 81(2–3):376–384
Bae E-Y, Kim J-H (2001) Pharmaceutical price regulation in Korea. Korea Institute for Health and Social Affairs, Seoul
Cho J-G, Lee E-K, Kim J-Y, Jang S-M, Bae E-Y, Park H-K, Lee S-J, Kim J-K, Lee Y-H (2001) Evaluation and policy implication of the separation of prescribing and dispensing drugs. Korea Institute for Health and Social Affairs, Seoul
Cho J-G, Choi S-H, Lee S-Y, Yoon K-J (2003) Achievements and policy implication of the separation of prescribing and dispensing drugs. Korea Institute for Health and Social Affairs, Seoul
Choi YJ (2007) Analysis of factors attributing to pharmaceutical expenditure. Health Insurance Review & Assessment Service, Seoul
Choi S-E (2008) Current state and challenges of pharmacoeconomic evaluation in Korea. J Prev Med Public Health 41(2):74–79
Choi S-J, Kim J-H, Lee S-Y (2005) Intensify public share in the National Health Insurance: definition, plan and practice. Health Insur Forum 4(4):2–13
Chung WJ (2002) The political economy of health policy decision-making: Korea’s drug pricing policy reform. Korean Assoc Policy Stud 11(4):99–133
Chung WJ, Kim HJ (2005) Interest groups’ influence over drug pricing policy reform in South Korea. Yonsei Med J 46(3):321–330
DailyPharm (1999a) Doctors prefer original drugs in case of the introduction of the separation policy. DailyPharm, 8 June 1999
DailyPharm (1999b) Putting the actual acquisition price system into effect in October; 30% price cut. DailyPharm, 1 Sept 1999
DailyPharm (2000) Abolishment of a fund requirement in drug wholesalers. DailyPharm, 12 March 2000
DailyPharm (2004a) Public health organisations, call for abolishing “A7 average pricing”. DailyPharm, 11 Feb 2004
DailyPharm (2004b) Urgent needs to provide the information of healthcare utilization. DailyPharm, 12 April 2004
DailyPharm (2006) NCEs, spending 132 days for benefit listing. DailyPharm, 11 Feb 2006
DailyPharm (2007) Four NCEs out of ten registered on the positive list. DailyPharm, 12 Oct 2007
Ha D, Choi Y, Kim DU, Chung KH, Lee EK (2011) A comparative analysis of the impact of a positive list system on new chemical entity drugs and incrementally modified drugs in South Korea. Clin Ther 33(7):926–932
HIRA (2012) Statistics for drug products distribution 2011. Health Insurance Review & Assessment Service, Korea Pharmaceutical Information Service, Seoul
HIRA (2013) About the drug-related group payment. Health Insurance Review & Assessment Service. http://www.hira.or.kr/dummy.do?pgmid=HIRAA030066010000. Accessed 10 May 2014
Huh S-I, Jung J-C, Lee H-Y (2006) A strategy for rationalising pharmaceutical expenditure. National Health Insurance Corporation, Seoul
Hwang G-J (2006) National health insurance: from segmentation to greater equality. In: Pathways to state welfare in Korea: interests, ideas and institutions. Ashgate Publishing, Aldershot, pp 80–111
Jang S-M, Lee E-K, Kim Y, Han E-A, Bae E-Y, Kim J-Y, Lee Y-H, Shin C-W, Song Y-M, Kang Y-H, Hwang K-H (2001) Pharmaceutical utilisation before and after the separation of prescribing and dispensing of drugs; focusing on changes in prescribing behaviour. Korea Institute for Health and Social Affairs, Seoul
Jang S, Park CM, Bae G, Lee HJ, Kim HS (2010) Analysis of factors affecting the change of pharmaceutical expenditure. Health Insurance Review & Assessment Service, Seoul
Jeong H-S, Lee EK, Kim EJ, Ryu G-C, Song YM, Kim SJ (2005) Impact of the purchasing price reimbursement system for insurance drugs upon the health insurer’s financial situation. Korean J Health Policy Adm 15(3):40–59
Jung S-W, Lee T-J, Cho B-H (2008) Market competition structure after original drug patent expiry. Korean J Health Econ Policy 14(2):1–25
KHIDI (2004) Health industry year book 2003. Korea Health Industry Development Institute, Seoul
KHIDI (2007) Health industry year book 2006. Korea Health Industry Development Institute, Seoul
KHIDI (2013) Health industry year book 2013. Korea Health Industry Development Institute, Osong
KIDS (2013) About KIDS. Korea Institute of Drug Safety & Risk Management. https://www.drugsafe.or.kr/iwt/ds/en/introduction/EgovGreeting.do. Accessed 10 May 2014
Kim J-H (2002) History of Korean pharmaceutical pricing and challenges. Monthly Consumers. http://www.consumer.or.kr/magazine/mz_view.html?num=41
Kim S-O (2005) Realities in expensive drug prescribing and its determinants. Health Insur Forum 4(4):57–83
Kim S-O, Choi S-E (2011) Improving price-volume arrangement system by linking expenditure target with pharmaceutical price negotiation. Korean J Health Econ Policy 17(3):1–21
Kim J-H, Jung J-C (2005) Survey of out-of-pocket in the National Health Insurance system. Health Insur Forum 4(1):74–88
Kim J-H, Lee H-Y (2006) Survey of out-of-pocket in the National Health Insurance system 2005. Health Insur Forum 5(4):42–58
Kim W, Lee K (2008) Drug price policy under national health insurance: a win-win strategy. Korean Soc Secur Stud 24(4):65–88
Kim S-J, Kwon S-M, Jung Y, Heo J-H (2010) International comparison of generic medicine prices. Korean J Health Econ Policy 16(3):41–62
Korean Pharmacists for Democratic Society (2006) Introduce a proper positive list system to remove drug price premium. Korean Pharmacists for Democratic Society, Korea
Korean Statistical Information Services (2014) Health expenditure. National Statistical Office. http://kosis.kr/statisticsList/statisticsList_03List.jsp?vwcd=MT_RTITLE&parmTabId=M_03_01#SubCont. Accessed 30 June 2014
Kwon S (2003) Pharmaceutical reform and physician strikes in Korea: separation of drug prescribing and dispensing. Soc Sci Med 57(3):529–538
Kwon S, Reich MR (2005) The changing process and politics of health policy in Korea. J Health Polit Policy Law 30(6):1003–1026
Kwon H-Y, Yang B-M (2011) Fixed budget for pharmaceuticals. Korean J Health Econ Policy 17(1):25–45
Kwon H-Y, Hong J-M, Godman B, Yang B-M (2013) Price cuts and drug spending in South Korea: the case of antihyperlipidemic agents. Health Policy 112(3):217–226. doi:10.1016/j.healthpol.2013.08.011
Lee S-Y (2005) Reforms of the health care delivery system in transition. Health Insur Forum 4(2):16–34
Lee E-K (2006) Reimbursement pricing and some policy implications. Health Insur Forum 5(2):2–14
Lee I-H (2010) Evaluating pharmaceutical policy in South Korea. University of York, York
Lee I-H (2013a) Evidence-based pharmaceutical policy-making; a challenging task? Vivid voices from Korean experts. Korean J Clin Pharm 23(3):185–195
Lee JH (2013b) The review of market-based Actual Transaction Price system. SungKyunKwan University, Suwon
Lee H-J, Lee T-J (2013) Impact of price control on drug expenditure and factors associated with the drug switch among statins: analysis of HIRA-NPS data. Health Policy Manage 23(2):112–123
Lee EK, Malone DC (2003) Comparison of peptic-ulcer drug use and expenditures before and after the implementation of a government policy to separate prescribing and dispensing practices in South Korea. Clin Ther 25(2):578–592
Lee I-H, Bloor K, Hewitt C, Maynard A (2012) The effects of new pricing and copayment schemes for pharmaceuticals in South Korea. Health Policy 104(1):40–49. doi:10.1016/j.healthpol.2011.09.003
Lee JY, Park JH, Shin HH, Ko SK (2013) Reference pricing; case study and implication. Korean Assoc Policy Stud 29(4):201–219
Lee I-H, Park S, Lee EK (2014) Generic utilization in the Korean National Health Insurance market; cost, volume and influencing factors. Yakhak Hoeji 58(2):99–106
MOHW (2006) [MOHW report to the National Assembly 2006]. Ministry of Health & Welfare, Gwacheon
Newsmp (2012) M.P. NamYoon insists the abolishment of market-based Actual Transaction Price system. Newsmp, 8 Oct 2012
NHIC, HIRA (2007) Statistical booklet on 30 year-history of Korean National Health Insurance. National Health Insurance Corporation, Health Insurance Review & Assessment Service, Seoul
NHIS, HIRA (2012) National Health Insurance statistical yearbook. National Health Insurance Service, Health Insurance Review & Assessment Service, Seoul
OECD (2007) How does Korea compare OECD Health Data 2007. Organisation for Economic Co-operation and Development, Paris
OECD (2013a) Health expenditure OECD Factbook 2013: economic, environmental and social statistics. OECD Publishing, Paris
OECD (2013b) Life expectancy at birth, total population. Health: key tables from OECD, no. 11. doi:10.1787/lifexpy-total-table-2013-2-en
OECD (2013c) Pharmaceutical expenditure. Health: key tables from OECD. doi:10.1787/pharmexpcap-table-2013-2-en; 10.1787/pharmexp-table-2013-2-en
OECD.Stat (2014) Organisation for Economic Cooperation and Development. http://www.oecd-ilibrary.org/statistics. Accessed 12 June 2014
Park S (2010) Risk-sharing agreement on the pricing and reimbursement of new drugs. Korean J Health Econ Policy 16(2):125–153
Park S, Jang Y-S, Chae S-M, Park E-J, Kim N-S, Lee EK, Lee I-H (2011) An indepth study of the utilization and costs of pharmaceuticals in South Korea, 2010. Ministry of Health & Welfare, Korea Institute for Health and Social Affairs, Seoul
Park S, Jang Y-S, Park E-J, Chae S-M, Lee Y-S, Ko S-K, Lee EK, Lee I-H (2012) An indepth study of the utilization and costs of pharmaceuticals in South Korea, 2012. Ministry of Health & Welfare, Korea Institute for Health and Social Affairs, Seoul
People’s Solidarity for Participatory Democracy (1998) Overestimated drug prices causes more than a trillion won financial loss in the National Health Insurance. Committee on Social Welfare, People’s Solidarity for Participatory Democracy, Seoul
People’s Solidarity for Participatory Democracy (1999) MOHW should disclosure real transaction prices for pharmaceuticals. Committee on Social Welfare, People’s Solidarity for Participatory Democracy, Seoul
Shin J-Y, Choi S-E (2008) The volume and the price of generic drug consumption in Korean prescription drug market. Korean J Health Econ Policy 14(1):103–125
Simoens S, De Coster S (2006) Sustaining generic medicines markets in Europe. Research Centre for Pharmaceutical Care and Pharmaco-economics, Katholieke Universiteit, Leuven
Yang C-Y (2002) A critical analysis of drug pricing and reimburse schemes in Korean medical insurance system. Kukje Kyungje Yongu 8(3):249–265
Yonhapnews (2011) Number of public beds, staying the same for 10 years. Yonhapnews, 18 Oct 2011
Yoon H-S (2008) National Insurance reimbursement pricing scheme: challenges and a strategy for improvement. Korea Development Institute, Seoul
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Lee, IH., Bloor, K. (2015). Pharmaceutical Pricing Policies in South Korea. In: Babar, ZUD. (eds) Pharmaceutical Prices in the 21st Century. Adis, Cham. https://doi.org/10.1007/978-3-319-12169-7_9
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