Lee Tae-Jin
School of Public Health, Seoul National University, Korea.
J Prev Med Public Health. 2008 Mar;41(2):69-73. doi: 10.3961/jpmph.2008.41.2.69.
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.
为抑制药品支出的快速增长，韩国政府于2006年底引入了药品正面清单制度和药品价格谈判程序。药品经济评估已开始在韩国国民健康保险药品的上市和定价中发挥关键作用。在韩国的体系背景下，关于在上市和定价中使用经济评估，有一些要点需要讨论。首先，上市和定价过程已经碎片化，引发了制药公司的抱怨，并推迟了新药惠及患者的时间。其次，有人担心正面清单制度可能会限制患者可选择用于治疗的药品范围和可得性。第三，现有药品退市的时间表可能不现实。第四，由于缺乏资料，提供可靠的成本效益证据并非总是容易。第五，对于韩国社会可接受的增量成本效益比（ICER）范围，尚未达成共识。总之，在不久的将来，有必要评估经济评估为韩国社会带来的成果。
