우리나라 건강보험의 위험분담제도가 재정 및 환자접근성에 미친 영향
An Overview of the Risk Sharing Management in Korean National Health Insurance, Focused on the Effect of the Patient Access and Insurance Finance
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초록

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.

키워드

Risk sharing agreementpharmaceutical pricingpatient accessinsurance financenational health insurance
제목
우리나라 건강보험의 위험분담제도가 재정 및 환자접근성에 미친 영향
제목 (타언어)
An Overview of the Risk Sharing Management in Korean National Health Insurance, Focused on the Effect of the Patient Access and Insurance Finance
저자
이종혁방준석
DOI
10.24304/kjcp.2018.28.2.81
발행일
2018-06
저널명
한국임상약학회지
28
2
페이지
124 ~ 130