Pharmaceutical spending structure needs to be reorganized

Discussion about social value of new medicine , Limited Health insurance finance and Dilemma of access expansion

Recognized ?reorganization of generic drug price, innovation signal of expenditure structure�

We need to increase the expenditure of new drugs in drug costs far more than now.

 

Patent expiration drugs must be left out of the market and replaced by generics for health insurance to be kept.

 

However, since the structure could not be broken, the reform of the generic drug price system, which is a transitional measure, has started.

 

It is solved only by redrawing the spending structure itself.

 

There is often a conflict between estimating drug pricing and increasing reimbursement reflecting the social value of expensive innovative new drugs and the rational expenditure and management of limited health insurance financing.

 

The government is trying to come up with a variety of tools to evaluate the value of innovative new drugs, but it is not easy to close the gap between regulators and profit-generating companies.

 

Eventually, it was the government and experts' view that a massive restructuring of the financial spending structure in health insurance would be necessary to resolve this conflicting agenda.

 

At the National Assembly Library on Nov 7, experts from the government, industry, and patients organization gathered in an open policy debate to solve the difficult task of balancing new drug?s social values ​​and health finances.

 

A panel discussion was held after the presentation of JiHong Bu, senior vice president of IQVIA Korea, which aims to increase the supply of new drugs by regulating the excessive use of chronic disease drugs.

 

The discussion was attended by Myungseop Kwak, Director of insurance and pharmaceutical affairs at MOHW, Jinok Byun, director of the Center for Institutional Finance Research, Korea Institute for Health Insurance Policy, Prof.Lee, Wonbok, Graduate School of Law, Ewha Womans University, Sungjoo Kim, a member of Lee & Ko, and Representative Kijong Ahn , Korea alliance of patients organization

▲ Professor Wonbok Lee (left), Director of Jinok Byun

he discussion was based on whether it would be reasonable to create a health budget for new drug benefits by regulating the use of mild and chronic disease drugs, and how to improve the expenditure structure of drugs cost.

 

Prof.

 

Lee, Wonbok, school of law of Ewha Womans University pointed to the lack of statistical or objective evidence that reducing the use of mild and chronic diseases and increasing new drug benefits would contribute to health and financial health.

 

In particular, he introduced many cases where the cost-effectiveness of treatment for severe rare diseases was low and mentioned the risk of unconditional expansion of new drug benefits.

 

Prof.

 

Lee said, "Because the high-income countries except Japan and Korea are spending aggressively on new drugs, there is no justification for the expansion of new drug benefits." Prof.

 

Lee said, "It must be accompanied by practical evidence.

 

We need to provide quantitative indicators of what will help us in terms of health finance and public health." In particular, if the new cap expenditures are unconditionally increased due to the fiscal cap, there is a need for a solution to the backlash against the decrease in stakes in other sectors.

 

� Jinok Byun, head of the Korea Institute for Health Policy Research, said people should not misunderstand that the government will not save or use health finances.

 

Health insurance finances, after all, exist in order to be well spent, explaining that they are doing their best to meet the characteristics of medicines.

 

In particular, the initial drug pricing negotiation of the original new drug is important in terms of financial financing.

 

"The chronic leukemia drug Gleevec was the first targeted drug, called magic bullet because of its superior effect.

 

When it was first introduced, the number of patients was 500," she said.

 

"We have tens of thousands of patients a year and the Gleevec market is still active.� "This is the hallmark of the innovative new drug market.

 

It is the case that Gleevec?s reimbursement was not stopped even after the Novatis?s rebate is caught." "If the new drug lie Gleevec is not managed by the government, it becomes a problem.

 

It is the decision or adjustment process on drugs to agree on a reasonable basis for price in terms of overall price management."

▲ Sungjoo Kim (left) and Myungseop Kwak

Sung-Joo Kim, Expert in Lee & Ko , said that the level of drug prices in Korea is not high compared to overseas, and that the application of innovative new drugs should be expanded quickly.

 

"I agree with the significant improvement in the new drug registration rate, but the reimbursement approval is still limited.

 

Cancer immunotherapy is a good example of this, we need to increase reimbursement level and expand the reimbursement drugs" said Kim.

 

Mr.

 

Kim said, ?In particular, we have to worry about creating surplus in financial fields other than pharmaceutical expenses.

 

According to the analysis of the Health Insurance Review & Assessment Service bill data, The number of visits by the most visited clinics in Korea for one year was 300 times.

 

It means that the patient went to clinics more than once per day, so we need to improve the efficiency of health finance.

 

" Myungseop Kwak, the ministry's director of welfare, said that the drug expenditure structure should be redesigned for the social value of new drugs and sustainable health finance.

 

The purpose of this study is to analyze the current spending structure and to rationalize as soon as possible to spend more on new drugs and to reduce the amount of money spent on patent expiration drugs and generics to secure sustainability of health and financial finance.

 

However, since it is virtually impossible to break the spending structure at once, it is implementing measures that can be reformed, such as the reform of the generic drug system, which is a transitional stage.

 

He said, ?Patients and the industry do not require reimubursement for patent expiring drugs.

 

We pay only for new drugs.??We have established a rationalization plan and started research on expenditure structure analysis.

 

We initiated expenditure structure analysis research, results will be released in the first half of next year.� He also said, "If you don't change the expenditure structure in the end, the answer will be microscopic.

 

It's difficult to solve it without drawing a new macroscopic cost chart and digging into the details one by one." Sustainability can only be achieved if the patent expiry is released from the market and generics are replaced.

 

" ?We started with the reorganization of the generic drug pricing system, which is a transitional measure because it is difficult to realize in the five-year health insurance guarantee plan.

 

We plan to use the resources obtained through the reevaluation of patent expired drugs and non-payment drugs for high-cost anticancer drugs, rare incurable diseases treatments, and serious treatments."