Improving Patient Access to New Drugs in South Korea: Evaluation of the National Drug Formulary System

Seung-Lai Yoo, Dae-Jung Kim, Seung-Mi Lee, Won-Gu Kang, Sang-Yoon Kim, Jong Hyuk Lee and Dong-Churl Suh
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Seung-Lai Yoo: College of Pharmacy, Chung-Ang University, Seoul 06974, Korea
Dae-Jung Kim: College of Pharmacy, Chung-Ang University, Seoul 06974, Korea
Seung-Mi Lee: College of Pharmacy, Chung-Ang University, Seoul 06974, Korea
Won-Gu Kang: College of Pharmacy, Chung-Ang University, Seoul 06974, Korea
Sang-Yoon Kim: College of Pharmacy, Chung-Ang University, Seoul 06974, Korea
Jong Hyuk Lee: Department of Pharmaceutical Engineering, Hoseo University, Asan 31499, Korea
Dong-Churl Suh: College of Pharmacy, Chung-Ang University, Seoul 06974, Korea

IJERPH, 2019, vol. 16, issue 2, 1-15

Abstract: This study reviews and evaluates the national drug formulary system used to improve patient access to new drugs by making reimbursement decisions for new drugs as part of the South Korean national health insurance system. The national health insurance utilizes three methods for improving patient access to costly drugs: risk-sharing agreements, designation of essential drugs, and a waiver of cost-effectiveness analysis. Patients want reimbursement for new drugs to be processed quickly to improve their access to these drugs, whereas payers are careful about listing them given the associated financial burden and the uncertainty in cost-effectiveness. However, pharmaceutical companies are advocating for drug prices above certain thresholds to maintain global pricing strategies, cover the costs of drug development, and fund future investments into research and development. The South Korean government is expected to develop policies that will improve patient access to drugs with unmet needs for broadening health insurance coverage. Simultaneously, the designing of post-listing management methods is warranted for effectively managing the financial resources of the national health insurance system.

Keywords: patient access; reimbursement; risk-sharing agreement; cost-effectiveness analysis; national health insurance (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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