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KMID : 1170320230290030001
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Korean Journal of Health Economics and Policy
2023 Volume.29 No. 3 p.1 ~ p.16
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Status of Orphan Drug Prescription Volume and Health Insurance Spending
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Yun Ji-Eun
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Abstract
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This study aimed to build data on the use and spending of orphan drugs by linking the Ministry of Food and Drug Safety's Orphan Drugs Designation List with the National Health Insurance Service’s claim data. Then, this study identified the number of prescriptions, drug expenditures, and expenditures per patient by ATC (Anatomic Therapeutics Chemical) groups to confirm the characteristics of orphan drugs. As a result, 197 of the 289 items designated as orphan drugs were used for beneficiaries of the Korean National Health Insurance (NHI) and Medicaid Program, accounting for about 4.5% of the total drug spending. Among them, the number of prescriptions and drug expenditures for "L: Antineoplastic and immunomodulating agents" were the largest, reflecting that R&D of anticancer drugs has been substantial. In addition, the subgroup analysis results by individual ingredients found that orphan drugs include both high-priced drugs with a low number of prescriptions but a large amount of expenditure, and low-priced drugs with a high number of prescriptions but a small amount of expenditure. This suggests that different management approaches are needed even within orphan drugs. To this end, data that can systematically monitor the use and expenditure status of orphan drugs should be supported.
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KEYWORD
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Orphan Drug, Rare Diseases, Health Expenditure, Drug Cost
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