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轻易削减,轻易反弹:韩国大幅降价药物的支出。

Easy cuts, easy rebound: Drug expenditures with massive price cuts in Korea.

机构信息

Division of Biology & Public Health, Mokwon University, Daejeon, Republic of Korea.

College of Pharmacy, Ewha Women's University, Seoul, Republic of Korea.

出版信息

Health Policy. 2019 Apr;123(4):388-392. doi: 10.1016/j.healthpol.2018.11.002. Epub 2018 Nov 20.

Abstract

BACKGROUNDS

Since 2012, the Korean government has introduced 46.5% price cut for off-patent medicines in order to reign everescalating drug expenditure. This study sought to appraise the impact of the price cut measure (in the context of Korean National Health Insurance system).

METHODS

We employed Korean National Health Insurance database from January 2007 until December 2016 for 120 month period. An interrupted time series analysis with segmented regression analysis was conducted to estimate the impact of price cut on overall drug spending.

RESULTS

Drug spending significantly dropped with the price cut by 186.22 billlion Korean Won (KRW) (p < 0.0001) and the trend after the price cut has also significantly decreased by 1.33 billion KRW (p = 0.002). However, it was predicted that total expenditures showed an increasing trend and bounced back to the original level. Quantity prescribed had no significance with the price cut. Unit price had a substantial drop (β = -41.68, p < 0.0001) with the price-cut, but the trend after the intervention has increased (β = 0.16, p = 0.656) with no significance.

CONCLUSIONS

Although the price cut has successfully countered the everescalating pharmaceutical expenditures in Korea, the impact was temporary. A lack of demand-side measures resulted in an ineffectiveness and unsustainability of policy effect. Thus, more aggressive demand-side measures should be introduced in the Korean context,and both the demand and supply-sides should be balanced.

摘要

背景

自 2012 年以来,韩国政府为了控制不断攀升的药品支出,将非专利药品的价格降低了 46.5%。本研究旨在评估该降价措施(在韩国国家健康保险制度的背景下)的影响。

方法

我们使用了 2007 年 1 月至 2016 年 12 月为期 120 个月的韩国国家健康保险数据库。采用分段回归分析的中断时间序列分析来估计降价对总体药品支出的影响。

结果

药品支出随着降价显著下降了 1862.2 亿韩元(KRW)(p<0.0001),降价后的趋势也显著下降了 13.3 亿韩元(p=0.002)。然而,预计总支出呈上升趋势,并反弹至原有水平。处方数量与降价无关。降价后,单位价格大幅下降(β=-41.68,p<0.0001),但干预后的趋势有所上升(β=0.16,p=0.656),没有显著性。

结论

尽管降价成功地遏制了韩国不断攀升的药品支出,但这种影响是暂时的。缺乏需求方措施导致政策效果无效且不可持续。因此,在韩国背景下应引入更积极的需求方措施,平衡供需双方。

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