Trends in National Pharmaceutical Expenditure in Korea during 2011 - 2020

Abstract

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.

Principles and practices of antimicrobial stewardship programs in Korea

“…Initiated in 2019, the Korea National Antimicrobial Use Analysis System (KONAS) enables healthcare facilities to gain insights into their antibiotic usage patterns, including usage by antibiotic class and application [ 23 ]. This system motivates and facilities the engagement in stewardship activities aimed at guiding appropriate use [ 24 ].…”

“…This system motivates and facilities the engagement in stewardship activities aimed at guiding appropriate use [ 24 ]. KONAS nationally monitors the quantitative use of antibiotics by individual medical facilities and aims to expand participation through institutional support [ 23 , 24 ].…”

Quantitative and qualitative evaluation of antimicrobial usage: the first step for antimicrobial stewardship

“…In 2023, 110 institutions, comprising 42 tertiary care hospitals and 68 secondary care hospitals, voluntarily joined the KONAS initiative [ 23 , 36 ]. While currently limited to tertiary and general hospitals, there are plans to progressively expand the program to include standard hospitals, long-term care hospitals, and clinics [ 37 ].…”

“…Non-insured prescriptions are not included in claims data, and the drugs prescribed at the time of discharge are classified as drugs prescribed to inpatients, leading to overestimation of the use of some drug classes. Additionally, the timing of an insurance claim can impact the pattern of monthly antimicrobial prescriptions [ 37 ]. Notably, there is a temporal gap between data collection and distribution, as data are typically compiled for review with a latency of about 1.5–2 years, leading to delays in data availability [ 23 ].…”

Incidence of Clostridioides difficile Infections in Republic of Korea: A Prospective Study With Active Surveillance vs. National Data From Health Insurance Review & Assessment Service

“… 10 Despite experiencing a decrease of −0.3% in expenditure from 2011 to 2020, Korea still ranks third among the 17 Organisation for Economic Co-operation and Development (OECD) countries in terms of expenditure on the Anatomical Therapeutic Chemical Classification System (ATC code J, which are anti-infectives for systemic use. 11 Furthermore, by 2025, Korea is expected to enter a super-aged society, with a rapid increase in the older person population, accounting for 20.6% of the total population. 12 Therefore, the incidence of CDI is expected to continue to increase.…”