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
Objective: This study examined the Risk Sharing Agreement (RSA) on pharmaceutical pricing system in Korean national health insurance. Through RSA, the insurer was able to maintain the principles in the price listing process while managing the budget effectively and improving patient access to new drugs. Despite these positive effects, there are still issues raised by some stakeholders, such as lack of transparency in the listing process and doubts about its effectiveness. Therefore, we investigated the impacts of RSA on national health insurance financing and patient access to analyze the effects of RSA. Methods: The impact of RSA was investigated by analyzing the health insurance claims data for 2014∼2016. The degree of improvement in patient access was determined by the decreased amount of patients’ payment. Results: Results showed that the financial impact of RSA was not significant and patients’ access to the new drug greatly improved. Conclusion: These results show that RSA is a good system for improving patient access to new drugs without additional expense on insurance.
목차
ABSTRACT 연구 방법 연구대상 및 연구 자료의 수집 자료 분석 연구 결과 우리나라의 위험분담제도 운영 현황 위험분담제도의 건강보험 재정에 대한 영향 위험분담제도의 환자접근성에 대한 영향 외국의 위험분담제도 현황 고찰 결론 감사의 말씀 참고문헌
키워드
Risk sharing agreementpharmaceutical pricingpatient accessinsurance financenational health insurance
저자
이종혁 [ Jong Hyuk Lee | 호서대학교 생명보건과학대학 제약공학전공 ]
Co-Correspondence to