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Review of Programs for Improving Patient’s Access to Medicines
Korean J Clin Pharm 2018;28(1):40-50
Published online March 31, 2018
© 2018 Korean College of Clinical Pharmacy.

EuGene Kim1,2 and Younhee Kim2,3*

1Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
2Institute of Health and Environment, School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
3Social Cost Estimates Division, National Assembly Budget Office, 1 Uisadang-daero Yeongdeungpo-gu, Seoul 07233, Republic of Korea
Correspondence to: Younhee Kim, Institute of Health and Environment, School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
Tel: +82-2-880-2741, Fax: +82-2-762-9105
E-mail: jio02@naver.com
Received September 15, 2017; Revised December 6, 2017; Accepted December 6, 2017.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Objective: This study presented the analysis period, the complexity of combined therapy and comparator choice as the key limitations in the economic evaluation of new drugs, and discussed programs for coping with these limitations.
Methods: This study evaluated the post-evaluation, risk-sharing agreement, extra funding program, and flexible incremental cost-effectiveness ratio (ICER) threshold as actions or programs that would increase accessibility to costly new drugs. The study also presented the cases of other countries. The application of the post-evaluation was considered to deal with high uncertainty regarding new drugs.
Results: The risk-sharing agreement was introduced in European countries as well as South Korea and has been responsible for the shift from using the financial schemes to outcome-based schemes. The drug funding program has had troubled in securing stable extra funds. The application of higher ICER in the economic evaluation of expensive and innovative oncology drugs was criticized because of the inequity between oncology patients and patients with other diseases.
Conclusion: Therefore, introducing and applying actions that would increase the accessibility to costly new drugs in South Korea have been deemed necessary after careful reviews and discussions with various stakeholders (insurer, policy makers, pharmaceutical companies and patients).
Keywords : Cost-effectiveness, uncertainty, access to medicine, post-evaluation, risk-sharing, ICER(incremental cost-effectiveness
ratio)


March 2018, 28 (1)
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