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降价改革对韩国抗糖尿病药物成本及使用情况的影响:一项基于国家健康保险数据库的研究

Effects of a price cut reform on the cost and utilization of antidiabetic drugs in Korea: a national health insurance database study.

作者信息

Suh Hae Sun, Kim Jee-Ae, Lee Iyn-Hyang

机构信息

College of Pharmacy, Pusan National University, Busan, South Korea.

Health Insurance Review & Assessment Service, Wonju, South Korea.

出版信息

BMC Health Serv Res. 2018 Jun 8;18(1):429. doi: 10.1186/s12913-018-3255-y.

Abstract

BACKGROUND

Despite the potential widespread application and a significant need, the policy effectiveness of prescribed medications price controls has not been studied extensively. We aimed to explore the effects of a price cut introduced in April 1st of 2012 on the cost and utilization of antidiabetics in South Korea.

METHODS

We identified approximately four million outpatients who filed at least one diabetes-related claim during the index period (January 2010 to December 2012) using the National Health Insurance claims data. We performed interrupted time series analyses for cost and utilization of "overall," "reduced price," and "constant price" antidiabetics between January 2009 and June 2013, and measured the growth rate for incidents of medical and surgical procedures for diabetes-induced complications.

RESULTS

The segmented regression suggests that spending on overall and reduced price antidiabetics would drop by 6 and 23%, respectively; spending on constant price antidiabetics would rise by 16% in a year after the new pricing compared to if the policy were not in existence. There were a few immediate changes in utilization, and its trend indicated a significant decrease in reduced price antidiabetics and an increase in constant price antidiabetics. Incidents of medical and surgical procedures relating to diabetic complications were unaffected.

CONCLUSIONS

The Korean price cut program contained costs by immediately reducing the cost of pharmaceuticals without any major signals associated with compromised clinical conditions in diabetic patients.

摘要

背景

尽管处方药价格管制政策有广泛应用的潜力且有很大需求,但尚未得到广泛研究。我们旨在探讨2012年4月1日实施的降价措施对韩国抗糖尿病药物成本和使用情况的影响。

方法

我们使用国民健康保险理赔数据,确定了在索引期(2010年1月至2012年12月)至少提交过一项糖尿病相关理赔的约400万门诊患者。我们对2009年1月至2013年6月期间“总体”、“降价”和“原价”抗糖尿病药物的成本和使用情况进行了间断时间序列分析,并测量了糖尿病并发症医疗和外科手术事件的增长率。

结果

分段回归表明,总体和降价抗糖尿病药物的支出将分别下降6%和23%;与政策未实施相比,新定价后一年内原价抗糖尿病药物的支出将增长16%。使用情况有一些即时变化,其趋势表明降价抗糖尿病药物显著减少,原价抗糖尿病药物增加。与糖尿病并发症相关的医疗和外科手术事件未受影响。

结论

韩国的降价计划通过立即降低药品成本控制了费用,且没有任何与糖尿病患者临床状况受损相关的重大信号。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06a8/5992837/282bbc7f0774/12913_2018_3255_Fig1_HTML.jpg

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