Determinants of Growth in Prescription Drug Spending Using 2010–2019 Health Insurance Claims Data

Lee, Hye Yeong; Park, Dahye; Kim, Dong‐Sook

doi:10.3389/fphar.2021.681492

Cited by 14 publications

(5 citation statements)

References 14 publications

(15 reference statements)

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“…Several previous studies reported that the reason for this continued increase of PE in Korea is the adoption of a fee-for-service system, which is vulnerable to supplier-induced demand [ 15 ]. In addition, other causes of increasing PE include an increase in chronic diseases due to an aging population; increase in medicine use; increased use of new and expensive drugs; and expansion of health insurance benefit coverage [ 16 17 18 ]. According to HIRA statistics for reimbursed medicine, PE for elderly patients increased by 5.4% over a 5-year period between 2017 and 2021, and the share in PE compared to the overall population was 45.5% in 2021 [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Trends in National Pharmaceutical Expenditure in Korea during 2011 - 2020

et al. 2023

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Background This study aimed to identify the trends in pharmaceutical expenditure (PE), share of PE in health expenditure (HE), and trends in expenditure by pharmacological groups (ATC level 1 classification) in Korea for a 10-year period (2011 - 2020) and compare the data with those of other Organisation for Economic Co-operation and Development (OECD) countries. Using the findings, we determined the current status of pharmaceutical expenditure (PE) management in Korea and derived the implications for establishing future macroscopic policies on PE. Materials and Methods We analyzed the OECD Health Statistics and the Korean national health insurance claims database from January 2011 through December 2020. The outcome measures were HE, PE, and pharmaceutical sales data for ATC level 1 medicines from OECD Health Statistics data during 2011 - 2020. As OECD collects limited ATC level 1 data, we used the HIRA health insurance claims data for PEs of ATC level-1 classification, including D, L, P, and S. Results PE in Korea increased by 38.5% from 19.9 billion USD in 2011 to 27.6 billion USD in 2020, whereas the share of PE in HE decreased by 6.3%p from 26.4% in 2011 to 20.1% in 2020. In 2020, Korea ranked third in PE per capita (760.9 USD PPP) and had the highest share of PE (20.1%) among the 19 OECD countries studied. By ATC level 1 class, the highest PE was A (alimentary tract and metabolism) at 4.3 billion USD, and L (antineoplastic and immunomodulating agents) had the highest increase at 13.4%; in contrast, J (anti-infectives for systemic use) had the lowest increase in annual average PE at −0.2% in 2020 relative to 2011. Among the 17 OECD countries, Korea had the highest and the third-highest expenditures for ATC codes A and J, respectively. Conclusion PE in Korea has continued to increase between 2011 and 2020, indicating the need for macroscopic management of PE. Our results on PE by ATC code may help health authorities in establishing future policies on PE.

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Section: Discussionmentioning

confidence: 99%

Trends in National Pharmaceutical Expenditure in Korea during 2011 - 2020

et al. 2023

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“…Although the cognitive bene ts of choline alfoscerate are widely acknowledged, the lack of robust clinical trials and de nitive evidence of its e cacy has limited its use. Interestingly, it is commonly used as a dietary supplement in many countries, including the US, but the Korean healthcare system has taken a distinct approach by including it in its insurance coverage system [10].…”

Section: Introductionmentioning

confidence: 99%

Use of choline alfoscerate for newly diagnosed patients with Alzheimer’s disease in Korea

Kim,

Jeon,

2023

Preprint

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Purpose: Choline alfoscerate, a cholinergic precursor in the brain, improves dementia-related symptoms. Although it is widely available as a dietary supplement in several countries, including the U.S., the Korean healthcare system has incorporated it into its insurance coverage. Therefore, in this study, we aimed to investigate the utilization status of choline alfoscerate and factors influencing it in patients newly diagnosed with Alzheimer’s disease (AD) using real-world data.Methods: We analyzed the Health Insurance Review and Assessment Service research dataset to identify patients ≥ 60 years old who were newly diagnosed with AD. We determined whether the study population was prescribed choline alfoscerate in addition to AD medications (donepezil, rivastigmine, galantamine, and memantine) within 60 d of the initial diagnosis. Moreover, the Cochran–Armitage test was used to confirm the statistical differences in the annual drug utilization trends.Results: Among the 330,326 study participants, 99,845 (33.08%) were consuming choline alfoscerate. Its use increased from 15.96% in 2012 to 47.65% in 2019. Factors that positively influenced the use of choline alfoscerate included male sex, MedAid insurance, and osteoarthritis. However, its use tended to decrease in the presence of certain comorbidities (hypertension, congestive heart failure, stroke/transient ischemic attack, chronic kidney disease, and depression).Conclusion: Utilization of choline alfoscerate has gradually increased in Korea, in part due to the absence of a disease-modifying therapy for AD and its inclusion in the country’s insurance coverage system. However, its use should be monitored due to the unclear efficacy and risk profile of this drug.

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“…In the United States, total drug expenditure was $535.3 billion in 2020 ( Tichy et al, 2020 ). In Korea, total drug expenditure in 2019 grew by 53.98% compared with 2010 ( Lee et al, 2021 ). Drug expenditure demonstrated a greater growth rate while providing universal health coverage achieved success in China ( Yip et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

A quasi-experimental study of the volume-based procurement (VBP) effect on antiviral medications of hepatitis B virus in China

Wen,

Xu,

Chen

et al. 2023

Front. Pharmacol.

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Background: The Pilot Plan of National Centralized Volume-Based Procurement (NCVBP) was adopted to cope with the rapid increase in drug expenditures. This research aimed to quantitatively evaluate the impact of the NCVBP on antiviral medications for the hepatitis B virus.Methods: Data on nucleoside analogs (NAs) medications of hepatitis B virus monthly procurement records in the pilot cities from January 2018 to December 2019 were extracted from the China Drug Supply Information Platform (CDSIP). The impacts of the NCVBP on purchased volumes, expenditures, and pre-defined daily dose costs were evaluated by interrupted time-series (ITS) analysis using Stata 16.0. We constructed two segments with one interruptive point (March 2019).Results: Compared to the same period between pre-and post-intervention, the purchased volume of NAs medications were increased by 92.85%, and selected medications were increased by 119.09%. Analysis of changes in the level of NAs medication followed a decrease in purchased expenditure (coefficient: 5364.88, p < 0.001), meanwhile, the purchased volume was increased with statistical significance (coefficient:605.49, p < 0.001). The Defined Daily Dose cost (DDDc) of NAs medication followed a decrease (coefficient: 8.90, p < 0.001). The NCVBP reform was followed by an increase of 618.41 ten thousand Defined Daily Dose (DDD) (p < 0.001) in purchased volume and a reduction of 5273.84 ten thousand Chinese Yuan (CNY) (p < 0.001) in the purchased expenditure of selected medications in the level. The DDDc of selected medications decreased in the level (coefficient: 9.87, p < 0.001), while the DDDc of alternative medications increased in the slope (coefficient:0.07, p = 0.030). The purchased volume and expenditure of bid-winning products increased by 964.08 ten thousand DDD and 637.36 ten thousand CNY in the level (p < 0.001). An increase of 633.46 ten thousand DDD (p < 0.001) in purchased volume and a reduction of 4285.32 ten thousand CNY (p < 0.001) in the purchased expenditure of generic drugs in the level was observed.Conclusion: The NCVBP reduced the DDDc of NAs medication, improved the utilization of the selected medications, and promoted the usage of generic products.

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Determinants of Growth in Prescription Drug Spending Using 2010–2019 Health Insurance Claims Data

Cited by 14 publications

References 14 publications

Trends in National Pharmaceutical Expenditure in Korea during 2011 - 2020

Trends in National Pharmaceutical Expenditure in Korea during 2011 - 2020

Use of choline alfoscerate for newly diagnosed patients with Alzheimer’s disease in Korea

A quasi-experimental study of the volume-based procurement (VBP) effect on antiviral medications of hepatitis B virus in China

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