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KMID : 0861020120270020001
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Korea Journal of Herbology
2012 Volume.27 No. 2 p.1 ~ p.16
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A Study on the Current Status of Prescribed Drugs in Oriental Health Insurance and their Improvement
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Kwon Yong-Chan
Yoo Wang-Keun
Seo Bu-Il
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Abstract
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Objective: To investigate the current status of prescription drugs in Oriental medical institutes and to draw up
a future plan for the revitalization of Oriental medical health insurance, this survey has been performed.
Method: The survey has been made with 321 doctors working at Oriental medical institutes in Daegu and
Kyungbuk areas for a period of 3 month from June 1, 2010 until September 1, 2010.
Result: 1. When it comes to the current status of the use of herbal drugs in Oriental Health insurance, most
of doctors surveyed prescribe insurance drugs, and they prescribe insurance drugs to patients, who are less
than 20% of total patients visiting their clinics.
2. The awareness of Herbal Health Care Drugs is investigated. When it comes to the understanding of the
difference between insurance drugs(powder type drugs) and granular type drugs, doctors admit that they differ
only in one aspect, whether or not their being covered by health insurance. Based on the survey results on the
understanding of insurance coverage of granular type drugs, doctors, even though they long for granular type
drugs to be accepted as insurance drugs, are worrying whether the number of outpatients might dwindle due to
increased insurance co-payments. They also point out that the biggest obstacles in the expansion of the
granular type drugs as insurance drugs are the lack of understanding of the government and the objection of
the Health Insurance Review and Assesment service (HIRA) for fear of increased insurance claims.
3. Upon investigation on Oriental medicine doctors’ understandings of herbal pharmaceutical industry, it is
found that doctors’ responses on pharmaceutical industry are not all positive ones(’new product development and
neglect of R&D infrastructure’ and ’smallness of industry’). When it is investigated what area needs the greatest
improvement in herbal pharmaceutical industry, ’securing sufficient capital, good manufacturing, and
strengthening quality control’, is the highest.
4. When it is asked what are the most needed in order to improve herbal health insurance medicine, responses
such as ’the increase in the accessibility to and the utilization of Oriental medical clinics through the
diversification of the means of prescriptions’, ’the improvement of insurance benefits(cap adjustments)’, ’increase
the proportion of high quality medicinal plants’, ’the ceiling of co-payments(deductible) at 20,000 won or more’,
’expansion of the choices of formulations’, ’formulational expansions of tablets and pills’, and finally ’admittance
and expansion of granular type drug as insurance drug’ are the highest.
5. Upon investigating the general characteristics of the current status of the usage of Oriental health care
herbal drugs, the followings are observed. First, the frequency of use of health insurance drugs by the doctors
who use health insurance with general characteristics shows similar differences in case of total monthly sales
amount (p<0.001), average number of daily patients (p<0.05). Secondly, as to the willingness of the expanded
usage of insurance drugs, similar differences are observed in case of total monthly sales amount (p<0.05).
6. Upon investigating the general characteristics of the perception of Herbal health care drugs, the followings
are observed. First, inspecting general characteristics and insurance claims due to increased
co-payments(deductible amount) reveals similar differences in case of working period (p<0.01) and in case of
total monthly sales amount (p <0.01). Secondly, inspecting general characteristics and the obstacles that hinder
granular type drugs from being accepted as health care insurance drugs shows similar differences in case of
working period (p<0.05).
7. Upon investigating the general characteristics of the understanding of Oriental Herbal pharmaceutical
companies, the followings are observed. First, opinions on the general characteristics of pharmaceutical
companies, when examined with variance analysis, shows similar differences in case of total monthly sales
amount (p<0.05). Secondly, when opinions are examined on general characteristics and the problems of herbal
pharmaceutical companies, similar differences are found in case of working period (p<0.01) and in case of total
monthly sales amount (p<0.001). Lastly, opinions on the general characteristics and reforms of pharmaceutical
companies, similar differences are observed in case of working period (p<0.001).
8. Upon investigating the general characteristics of the improvement of insurance Herbal drugs, the followings
are observed. First, regarding general characteristics and insurance benefits, similar differences are observed
in case of working period (p<0.05), in case of total monthly sales amount (p<0.05), and in case of average
number of daily patients (p<0.01). Secondly, opinions on the general characteristics and the needs for the
improvement of Herbal insurance drugs are examined in 5 different aspects, which are the approval of granular
type drugs as insurance drugs, the expanded practices of the number of prescription insurance drugs, the needs
of a variety of formulations, the needs of TFT of which numbers of Oriental medical doctors are members for
the revision of the existing system, and the needs of adjusting the current ceiling of the fixed amount and the
fixed rate. When processed by the analysis of variance, the results show similar differences in case of average
number of daily patients (p<0.01).
Conclusion: From the results of this study the first measures to take are, to reform overall insurance benefit
system, including insurance co-payment system(fixed rate cap adjustment), to expand the number of the herbal
drugs to be prescribed matching with insurance benefit accordingly, and to revitalize herbal medicine insurance
system through the change of various formulations. In addition, it is recommended to improve the effectiveness
of herbal medicine by making plans to enhance the efficacy of herbal medicine and by enabling small
pharmaceutical companies to outgrow themselves.
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KEYWORD
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Prescribed Drugs, Oriental Health Insurance, herbal drugs, herbal medicine insurance
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