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Effective policy initiatives to constrain lipid-lowering drug expenditure growth in South Korea

机译：限制韩国降低血脂药物支出增长的有效政策措施

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Background The rapid growth of prescription drug expenditures is a major problem in South Korea. Accordingly, the South Korean government introduced a positive listing system in 2006. They also adopted various price reduction policies. Nevertheless, the total expenditure for lipid-lowering drugs have steadily increased throughout South Korea. The present study explores the factors that have influenced the increased expenditures of lipid-lowering drugs with a particular focus on the effects of statins in this process. Methods This paper investigates the National Health Insurance claims data for prescribed lipid-lowering drugs collected between January 1, 2005 and December 31, 2009. We specifically focused on statins and assessed the yearly variation of statin expenditure by calculating the increased rate of paired pharmaceutical expenditures over a 2 year period. Our study classified statins into three categories: new entrants, core medicines and exiting medicines. For core medicines, we further examined influencing factors such as price, amount of drugs consumed by volume, and prescription changes (substitutes for other drug). Results Statin expenditure showed an average annual increase of 25.7% between 2005 and 2009. Among the different statins, the expenditure of atorvastatin showed a 36.6% annual increase rate, which was the most dramatic among all statins. Also we divided expenditure for core medicines by the price factor, volume factor, and prescription change. The result showed that annual weighted average prices of individual drug decreased each year, which clearly showed that price influenced statin expenditure in a negative direction. The use of generic drugs containing the same active ingredient as name-brand drugs increased and negatively affected statin expenditure (Generic Mix effect). However, the use of relatively expensive ingredients within statin increase, Ingredient Mix effect contributed to increased statin expenditure (Ingredient Mix effect). In particular, the volume effect was found to be critical for increasing statin expenditure as the amount of statin consumed increased steadily throughout the study period. Conclusions The recent rapid increase in statin expenditure can largely be attributed to an increase in consumption volume. In order to check drug expenditures effectively in our current situation, in which chronic diseases remain steadily on the rise, it is necessary to not only have supply-side initiatives such as price reduction, but also demand-side initiatives that could control drug consumption volume, for example: educational programs for rational prescription, generic drug promotional policies, and policies providing prescription targets.
机译：背景技术处方药支出的快速增长是韩国的一个主要问题。因此，韩国政府于2006年推出了积极的上市制度。他们还采取了各种降价政策。尽管如此，降脂药物的总支出在整个韩国稳定增长。本研究探讨了影响降脂药物支出增加的因素，特别是他汀类药物在此过程中的作用。方法本研究调查了2005年1月1日至2009年12月31日期间收集的处方降脂药物的国家健康保险索赔数据。我们特别关注他汀类药物，并通过计算配对药物支出的增长率来评估他汀类药物支出的年度变化。在2年的时间内。我们的研究将他汀类药物分为三类：新进入者，核心药物和现有药物。对于核心药物，我们进一步检查了影响因素，例如价格，按体积消费的药物数量和处方变更（替代其他药物）。结果2005年至2009年间，他汀类药物的支出年均增长25.7％。在不同他汀类药物中，阿托伐他汀的支出年增长率为36.6％，在所有他汀类药物中增幅最大。同样，我们将核心药品的支出除以价格因素，数量因素和处方变更。结果表明，每种药物的年度加权平均价格逐年下降，这清楚地表明，价格对他汀类药物的消费有负面影响。使用与名牌药物具有相同活性成分的非专利药物会增加他汀类药物的消费，并对其产生负面影响（Generic Mix效应）。然而，他汀类药物中相对昂贵的成分的使用增加了，成分混合效应导致了他汀类药物支出的增加（成分混合效应）。特别是，发现体积效应对于增加他汀类药物的支出至关重要，因为他汀类药物的消费量在整个研究期间一直稳定增长。结论最近他汀类药物支出的快速增长在很大程度上归因于消费量的增加。为了在慢性病持续增长的当前形势下有效地检查药品支出，不仅需要采取降价等供应方举措，而且还需要可以控制毒品消费量的需求方举措，例如：有关合理处方的教育计划，仿制药促销政策以及提供处方目标的政策。

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