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韩国的药品降价与药品支出:以降血脂药物为例。

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

机构信息

Institute of Health and Environment, Seoul National University, Seoul, South Korea.

出版信息

Health Policy. 2013 Oct;112(3):217-26. doi: 10.1016/j.healthpol.2013.08.011. Epub 2013 Sep 12.

Abstract

OBJECTIVE

To identify the effect of price control policies on drug expenditure in South Korea.

METHODS

We retrospectively examined the effects of price-reduction policies on drug expenditures, in particular regarding anti-hyperlipidemic drugs. The National Health Insurance claims data for a 60-month period between 2006 and 2010 were analysed. A segmented regression analysis was conducted with three intervention variables: July 2008, April 2009, and January 2010.

RESULTS

Despite three rounds of price cuts, monthly drug expenditures increased by KRW 599.67 million (USD 523,726) after the third intervention (p=0.0781). The trend in volume increased consistently, but not significantly. The unit prices showed a steady downward trend over time, but rebounded after the third price cut. The number of patients with hyperlipidemia more than doubled to 3729 (p=0.0801) per month after the entry of generics for atorvastatin in July 2008.

CONCLUSION

Extensive price controls did not effectively suppress the growth of pharmaceutical expenditures. The increased number of patients, attributable to the newly launched generic drug atorvastatin, and the increased use of expensive drugs were major factors affecting the increase in drug spending. Policies that regulate both drug prices and utilisation, and that reduce financial burdens via enhanced use of generics need to be introduced.

摘要

目的

明确价格控制政策对韩国药品支出的影响。

方法

我们回顾性分析了降价政策对药品支出的影响,尤其是针对降脂药物。我们分析了 2006 年至 2010 年 60 个月的国家健康保险索赔数据。采用分段回归分析了三个干预变量:2008 年 7 月、2009 年 4 月和 2010 年 1 月。

结果

尽管进行了三轮降价,第三次干预后(p=0.0781),每月药品支出增加了 599670 韩元(523726 美元)。尽管数量持续增加,但没有显著增加。单位价格随着时间的推移呈稳步下降趋势,但第三次降价后出现反弹。自 2008 年 7 月阿托伐他汀仿制药上市以来,每月的高血脂患者人数增加了一倍多,达到 3729 人(p=0.0801)。

结论

广泛的价格控制并未有效抑制药品支出的增长。患者人数的增加,归因于新推出的阿托伐他汀仿制药,以及昂贵药物的使用增加,是导致药品支出增加的主要因素。需要引入既控制药品价格又控制使用量、通过增加仿制药使用来减轻财政负担的政策。

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