TY - JOUR
T1 - The effects of new pricing and copayment schemes for pharmaceuticals in South Korea
AU - Lee, Iyn-Hyang
AU - Bloor, Karen
AU - Hewitt, Catherine
AU - Maynard, Alan
N1 - Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
PY - 2012/1
Y1 - 2012/1
N2 - OBJECTIVES: This study examined the effect of new Korean pricing and copayment schemes for pharmaceuticals (1) on per patient drug expenditure, utilisation and unit prices of overall pharmaceuticals; (2) on the utilisation of essential medications and (3) on the utilisation of less costly alternatives to the study medication. METHODS: Interrupted time series analysis using retrospective observational data. RESULTS: The increasing trend of per patient drug expenditure fell gradually after the introduction of a new copayment scheme. The segmented regression model suggested that per patient drug expenditure might decrease by about 12% 1 year after the copayment increase, compared with the absence of such a policy, with few changes in overall utilisation and unit prices. The level of savings was much smaller when the new price scheme was included, while the effects of a price cut were inconclusive due to the short time period before an additional policy change. Based on the segmented regression models, we estimate that the number of patients filling their antihyperlipidemics prescriptions decreased by 18% in the corresponding period. Those prescribed generic and brand-named antihyperlipidemics declined by around 16 and 19%, respectively, indicating little evidence of generic substitution resulting from the copayment increase. Few changes were found in the use of antihypertensives. CONCLUSIONS: The policies under consideration appear to contain costs not by the intended mechanisms, such as substituting generics for brand name products, but by reducing patients' access to costly therapies regardless of clinical necessity. Thus, concerns were raised about potentially compromising overall health and loss of equity in pharmaceutical utilisation.
AB - OBJECTIVES: This study examined the effect of new Korean pricing and copayment schemes for pharmaceuticals (1) on per patient drug expenditure, utilisation and unit prices of overall pharmaceuticals; (2) on the utilisation of essential medications and (3) on the utilisation of less costly alternatives to the study medication. METHODS: Interrupted time series analysis using retrospective observational data. RESULTS: The increasing trend of per patient drug expenditure fell gradually after the introduction of a new copayment scheme. The segmented regression model suggested that per patient drug expenditure might decrease by about 12% 1 year after the copayment increase, compared with the absence of such a policy, with few changes in overall utilisation and unit prices. The level of savings was much smaller when the new price scheme was included, while the effects of a price cut were inconclusive due to the short time period before an additional policy change. Based on the segmented regression models, we estimate that the number of patients filling their antihyperlipidemics prescriptions decreased by 18% in the corresponding period. Those prescribed generic and brand-named antihyperlipidemics declined by around 16 and 19%, respectively, indicating little evidence of generic substitution resulting from the copayment increase. Few changes were found in the use of antihypertensives. CONCLUSIONS: The policies under consideration appear to contain costs not by the intended mechanisms, such as substituting generics for brand name products, but by reducing patients' access to costly therapies regardless of clinical necessity. Thus, concerns were raised about potentially compromising overall health and loss of equity in pharmaceutical utilisation.
UR - http://www.scopus.com/inward/record.url?scp=83555172298&partnerID=8YFLogxK
U2 - 10.1016/j.healthpol.2011.09.003
DO - 10.1016/j.healthpol.2011.09.003
M3 - Article
C2 - 22000599
SN - 0168-8510
VL - 104
SP - 40
EP - 49
JO - Health Policy
JF - Health Policy
IS - 1
ER -