Yu Seung-Rae, Choi Sooyoung
College of Pharmacy, Dong-Duk Women's University, Seoul 02748, Republic of Korea.
Department of Biostatistics, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32611, USA.
Healthcare (Basel). 2025 Feb 21;13(5):468. doi: 10.3390/healthcare13050468.
Pharmaceutical expenditures serve as key indicators of healthcare system efficiency, innovation, and sustainability. South Korea has implemented policies such as the economic evaluation exemption (EEE) and risk-sharing agreements (RSAs) to balance cost control and access to innovative therapies. However, discrepancies persist in the distribution of expenditures across therapeutic areas, raising concerns about alignment with public health needs. This retrospective observational study analyzed pharmaceutical expenditures in South Korea from 2007 to 2022, focusing on new chemical entities (NCEs). Data sources included the IQVIA MIDAS Global Database, the WHO Global Burden of Disease (GBD) database, and South Korea's national health insurance records. Expenditure patterns were benchmarked against OECD and A8 countries using disability-adjusted life years (DALYs) and other healthcare metrics to assess the relationship between spending and disease burden. By 2022, South Korea had introduced 276 NCEs, demonstrating progress, but still lagging the OECD average. NCE expenditure increased from 10.0% to 16.0% of total pharmaceutical spending between 2017 and 2022, whereas A8 countries' share rose from 26.2% to 48.1%. While oncology expenditures were proportionate to disease burden, spending on chronic diseases such as musculoskeletal and cardiovascular conditions remained relatively low compared to their DALY contributions. Although South Korea has strengthened its investment in pharmaceutical innovation, disparities in expenditure distribution persist. Refining policies to enhance resource allocation for chronic diseases and expanding the RSA framework beyond oncology could improve equity and sustainability. Adopting international best practices-such as indication-based pricing and funding mechanisms for high-cost therapies-may further support optimal pharmaceutical expenditure management.
药品支出是医疗体系效率、创新和可持续性的关键指标。韩国实施了经济评估豁免（EEE）和风险分担协议（RSA）等政策，以平衡成本控制与创新疗法的可及性。然而，各治疗领域的支出分布仍存在差异，引发了对其与公共卫生需求匹配度的担忧。这项回顾性观察研究分析了2007年至2022年韩国的药品支出情况，重点关注新化学实体（NCE）。数据来源包括艾昆纬MIDAS全球数据库、世界卫生组织全球疾病负担（GBD）数据库以及韩国的国民健康保险记录。使用伤残调整生命年（DALY）和其他医疗指标，将支出模式与经合组织（OECD）和A8国家进行基准对比，以评估支出与疾病负担之间的关系。到2022年，韩国已引入276种新化学实体，虽有进展，但仍落后于经合组织平均水平。2017年至2022年期间，新化学实体支出占药品总支出的比例从10.0%增至16.0%，而A8国家的这一比例则从26.2%升至48.1%。虽然肿瘤学支出与疾病负担相称，但与伤残调整生命年贡献相比，肌肉骨骼和心血管疾病等慢性病的支出仍然相对较低。尽管韩国加强了对药品创新的投资，但支出分布的差异依然存在。完善政策以加强对慢性病的资源分配，并将风险分担协议框架扩展至肿瘤学以外领域，可能会改善公平性和可持续性。采用国际最佳实践，如基于适应症的定价和高成本疗法的资助机制，可能会进一步支持优化药品支出管理。
