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KMID : 1146320130010010086
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Journal of Health Technology Assessment
2013 Volume.1 No. 1 p.86 ~ p.92
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Health Technology Assessment and Decision Making: Art of Scientific Interpretation
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Kim Hyo-Jin
Park Hye-Jin
Ko Su-Kyoung
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Abstract
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Objectives: Health technology assessment (HTA) has a fundamental basis of the sciences which means the drug is priced in terms of its relative value. However, after a drug is listed, this value is continuously challenged solely by price changes resulted by drug pricing policy without full appreciation of its worth. This study was executed to demonstrate the changes in drugs’ cost-effectiveness value exclusively due to price changes. This was done by analyzing the example of hyperlipidemia drug which has been sharply fluctuating as a result of drug price policy in Korea since 2007.
Methods: Comparators were set by hyperlipidemia drugs [Atorvastatin (A) 10/20/40/80 mg, Rosuvastatin (R) 10/20 mg, and Simvastatin (S) 20/40/80 mg]. LDL-C reduction rate (%) was used as effectiveness. The drug cost of each treatment was calculated using the data from published website of the Health Insurance Review and Assessment Service. The analysis period was from 2007 to 2012 to reflect price policy impact. The average cost-effectiveness ratio (ACER), the cost per 1% LDL-C reduction, was used as cost-effectiveness parameter.
Results: There have been constant price-cut in accordance with drug pricing policies which were the re-evaluation of listed drugs (rearrangement plan) and pricecut policy in April 2012. The ACER level of all hyperlipidemia treatments changed irregularly every year. The most cost-effective treatment was not constant every year (using drug list price, 2007; R10, 2008-2009; A20, 2011-2011; S40, 2012; A20).
Conclusion: Without changes in effectiveness, due to the drug price reduction based on political decisions, the level of ACER has been inconsistently changing. This study suggests that HTA should include supplementary implementation strategies to overcome external influences and improve current HTA methods and processes. This will mean that the actual drug’s value is appropriately taken into consideration without undermining the accomplishment of HTA.
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KEYWORD
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Health technology assessment, HTA, Cost-effectiveness, Average cost-effectiveness ratio, ACER
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