title: The effects of new pricing and copayment schemes for pharmaceuticals in South Korea.
abstract: OBJECTIVE
  This study examined the effect of new Korean pricing and copayment schemes for pharmaceuticals (1) on per patient drug expenditure, utilisation and unit prices of overall pharmaceuticals; (2) on the utilisation of essential medications and (3) on the utilisation of less costly alternatives to the study medication.
  
  
  METHODS
  Interrupted time series analysis using retrospective observational data.
  
  
  RESULTS
  The increasing trend of per patient drug expenditure fell gradually after the introduction of a new copayment scheme. The segmented regression model suggested that per patient drug expenditure might decrease by about 12% 1 year after the copayment increase, compared with the absence of such a policy, with few changes in overall utilisation and unit prices. The level of savings was much smaller when the new price scheme was included, while the effects of a price cut were inconclusive due to the short time period before an additional policy change. Based on the segmented regression models, we estimate that the number of patients filling their antihyperlipidemics prescriptions decreased by 18% in the corresponding period. Those prescribed generic and brand-named antihyperlipidemics declined by around 16 and 19%, respectively, indicating little evidence of generic substitution resulting from the copayment increase. Few changes were found in the use of antihypertensives.
  
  
  CONCLUSIONS
  The policies under consideration appear to contain costs not by the intended mechanisms, such as substituting generics for brand name products, but by reducing patients' access to costly therapies regardless of clinical necessity. Thus, concerns were raised about potentially compromising overall health and loss of equity in pharmaceutical utilisation.
authors: College of Pharmacy, Ajou University, Republic of Korea.
authors: Iyn-Hyang
authors: IH
authors: Lee
authors: Karen
authors: K
authors: Bloor
authors: Catherine
authors: C
authors: Hewitt
authors: Alan
authors: A
authors: Maynard
mesh_terms: D003363:Cost Control; D017047:Cost Sharing / Q000191:economics*; D016527:Drug Costs; D004335:Drug and Narcotic Control; D017850:Economics, Pharmaceutical; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006291:Health Policy; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000191:economics; D012044:Regression Analysis; D056910:Republic of Korea; D012189:Retrospective Studies