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KMID : 1122920090010010021
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2009 Volume.1 No. 1 p.21 ~ p.27
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Positive Drug Formulary System in Korea from a Managed Care Pharmacy Perspective
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Sohn Hyun-Soon
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Abstract
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Formulary list that defines available drugs for use is developed to help physicians to select the most appropriate medication within a specific class of drugs under a specific health plan circumstances. Pharmaceuticals value can be
maximized through sound formulary management. A positive list as a closed formulary type includes limited number of
drugs reimbursed for preferred drugs only. Health plan is moving to more restrictive formulary system that has more strong
power to control due to rising costs. In Korea, a positive list was implemented in Dec 2006, aiming at the appropriateness
of pharmaceutical expenditure, under the drug expenditure rationalization plan. With the worldwide comparison of listing
status for several products, Australia and New Zealand that implement a positive system have lower level in coverage than
UK that has a negative system. At the point in time of UKyears with positive system, it is necessary to identify concerns
and create possible solutions for its successful settlement. Formulary-based price control can be one of strategies to control drug expenditure, but it may jeopardize R&D of new drug, result in increased utilization of more costly alternatives, and not guarantee long-term savings to society. In a viewpoint of balancing of clinical effectiveness and cost-effectiveness as criteria for listing, economic evaluation is recommended to be used as a primary reference for optimal price to assure costeffectiveness when a drug is decided to include in the formulary list, rather than primary decision criteria for listing. Based on ultimate goal of positive system for efficient use of healthcare resource rather than reduction of drug expenditure itself, a range of effective mechanisms in the managed care pharmacy perspective that promote quality and optimal results such as drug utilization review and medical treatment guidelines should be considered to overcome the limitation of this system.
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KEYWORD
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Formulary list, Positive system, Negative system, Managed care pharmacy
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FullTexts / Linksout information
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Listed journal information
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