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KMID : 1146320160040020058
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Journal of Health Technology Assessment
2016 Volume.4 No. 2 p.58 ~ p.66
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A Roadmap to Contain Pharmaceutical Expenditures under the National Health Insurance System
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Kim Seong-Ok
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Abstract
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The growth rate of pharmaceutical expenditures covered by the National Health Insurance had been rapidly growing and also its proportion among the health expenditures had been comparatively high (29.15% in 2011). This study presented a roadmap to contain pharmaceutical expenditures under the National Health Insurance System composed of five agenda, which were initiated by the National Health Insurance Service (NHIS) in the perspective of insurer in 2012. Five agenda composed of strengthening of the negotiation power of the insurer and diversification of risk sharing arrangement, global pharmaceutical budget system, reference pricing system, pharmaceutical tendering system, and public fund for orphan drugs, which were selected from the discussion among the staff in the NHIS. Then expert opinion survey were conducted to investigate stakeholers’ anticipated impact of each 5 agenda with the criteria of pharmaceutical expenditure control, sustainablity and equity, efficiency, availability, accessibility, quality and health outcomes, satisfaction of consumer and patient, and objective of pharmaceutical company (R&D and innovation). And anticipated introduction time of these agenda, policy compliance of stakeholders. 19 experts from academic, government, pharmaceutical company, doctors, pharmacist and consumer and patient group. The roadmap to control pharmaceutical expenditures composed of 5 agenda initiated by the NHIS were presented in detail as result of experts’ opinion.
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KEYWORD
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Pharmaceutical exmpenditure, Pharmaceutical tendering system, Orphan drug fund, Reference pricing system, Pharmaceutical budget, Risk sharing arrangement
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