우리나라 건강보험의 위험분담제도가 재정 및 환자접근성에 미친 영향

Abstract

Objective: This study examined the Risk Sharing Agreement (RSA) on pharmaceutical pricing system in Korean national healthinsurance. Through RSA, the insurer was able to maintain the principles in the price listing process while managing the budgeteffectively and improving patient access to new drugs. Despite these positive effects, there are still issues raised by somestakeholders, such as lack of transparency in the listing process and doubts about its effectiveness. Therefore, we investigated theimpacts of RSA on national health insurance financing and patient access to analyze the effects of RSA. Methods: The impact ofRSA was investigated by analyzing the health insurance claims data for 2014∼2016. The degree of improvement in patient accesswas determined by the decreased amount of patients’ payment. Results: Results showed that the financial impact of RSA was notsignificant and patients’ access to the new drug greatly improved. Conclusion: These results show that RSA is a good system forimproving patient access to new drugs without additional expense on insurance.