title: Evaluation on the first 2 years of the positive list system in South Korea.
abstract: OBJECTIVE
  The South Korean positive list system in pharmaceutical reimbursement was introduced by the Health Care System Reform Act implemented in December 2006. This study introduces this positive list system (PLS), and reports on an evaluation of two years of operation. In addition, decision-making factors are evaluated and current issues and solutions discussed.
  
  
  METHODS
  We analyzed 91 submissions with reimbursement decisions completed by December 31, 2008. Submission characteristics and relevant factors related to decision criteria were identified by the decision outcomes (recommended/rejected).
  
  
  RESULTS
  Under the new system, Health Insurance Review and Assessment service (HIRA) recommended 64 submissions for reimbursement and rejected 27 submissions. For recommended submissions, 59 met all criteria and 5 were recommended based on the rule of rescue. The primary reason for rejection was unacceptable cost-effectiveness. The likelihood of recommendation was found to be significantly elevated if a drug was superior to its comparator, if treatment cost was not greater than that of its comparator, or if the number of recommended decisions made by other committees increased.
  
  
  CONCLUSIONS
  The South Korean PLS has stabilized during the 2 years after its introduction. The recommended submissions were qualified in all decision-making criteria used. Among the various decision criteria, clinical benefit and cost-effectiveness were the main drivers of reimbursement decisions. In addition, there is a certain degree of consistency between the reimbursement decisions of HIRA and other countries.
authors: Health Insurance Review and Assessment Services, Secho-Gu, Seoul, Republic of Korea.
authors: Sung Eun
authors: SE
authors: Park
authors: Sang Hee
authors: SH
authors: Lim
authors: Hyun Woong
authors: HW
authors: Choi
authors: Seung Min
authors: SM
authors: Lee
authors: Dong Won
authors: DW
authors: Kim
authors: Eun Young
authors: EY
authors: Yim
authors: Kook Hee
authors: KH
authors: Kim
authors: So Young
authors: SY
authors: Yi
mesh_terms: D003362:Cost-Benefit Analysis / Q000331:legislation & jurisprudence / Q000592:standards; D003657:Decision Making; D004608:Eligibility Determination; D018166:Health Care Reform / Q000331:legislation & jurisprudence; D006291:Health Policy / Q000191:economics* / Q000331:legislation & jurisprudence*; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000191:economics* / Q000331:legislation & jurisprudence*; D007356:Insurance, Pharmaceutical Services / Q000191:economics* / Q000331:legislation & jurisprudence*; D009313:National Health Programs / Q000191:economics* / Q000331:legislation & jurisprudence*; D015397:Program Evaluation; D056910:Republic of Korea