title: The effect of new drug pricing systems and new reimbursement guidelines on pharmaceutical expenditures and prescribing behavior among hypertensive patients in Korea.
abstract: OBJECTIVE
  The purpose of this study was to determine the effects of a new drug-pricing system (January 2012) and new prescription and reimbursement guidelines (January 2013) on hypertension-related pharmaceutical expenditures and prescribing behaviors in Korea.
  
  
  METHODS
  In all, 11,298 clinics and 2,667,132 patients with hypertension were included in our study. As dependent variables, we used the drug cost per patient, drug cost per prescribed day, number of drugs per prescription, number of prescribed days per visit, number of visits, number of original (vs. generic) drugs prescribed, and the percentage of original drug cost. Clinic characteristics and patients' age and sex were used as independent variables. Multi-level mixed-effect regression models were used.
  
  
  RESULTS
  The drug cost per patient decreased by -1446 KRW$ (-7.4%; p<0.001) in Q4 2012 and by -1833 (-9.3%; p<0.001) in Q2 2013 compared with Q4 2011. Number of drugs per prescription decreased significantly. The percentage of original drug cost and the number of original drugs also declined.
  
  
  CONCLUSIONS
  Reforms to the drug pricing policy and the new guidelines may reduce pharmaceutical expenditures without increasing number of drugs per prescription and the number of original drug used. Policy makers should consider the comprehensive effects of implementing new policies on both drug prices and consumption.
authors: Health Insurance Review and Assessment Service, Republic of Korea.
authors: Mee-Hyun
authors: MH
authors: Cho
authors: Department of Healthcare Management, Eulji University, Republic of Korea.
authors: Ki-Bong
authors: KB
authors: Yoo
authors: Department of Social Medicine, Dankook University, Republic of Korea.
authors: Hoo-Yeon
authors: HY
authors: Lee
authors: Department of Public Health, Graduate School, Yonsei University, Republic of Korea; Institute of Health Services Research, Yonsei University, Republic of Korea.
authors: Kwang-Sig
authors: KS
authors: Lee
authors: National Cancer Control Institute, National Cancer Center, Republic of Korea.
authors: Jeoung A
authors: JA
authors: Kwon
authors: Department of Public Health, Graduate School, Yonsei University, Republic of Korea; Institute of Health Services Research, Yonsei University, Republic of Korea.
authors: Kyu-Tae
authors: KT
authors: Han
authors: Department of Public Health, Graduate School, Yonsei University, Republic of Korea; Institute of Health Services Research, Yonsei University, Republic of Korea.
authors: Jae-Hyun
authors: JH
authors: Kim
authors: Institute of Health Services Research, Yonsei University, Republic of Korea; Department of Preventive Medicine, College of Medicine Yonsei University, Republic of Korea. Electronic address: ecpark@yuhs.ac.
authors: Eun-Cheol
authors: EC
authors: Park
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000191:economics*; D016527:Drug Costs / Q000639:trends*; D016568:Drugs, Generic; D017850:Economics, Pharmaceutical; D005260:Female; D005102:Health Expenditures / Q000639:trends*; D006801:Humans; D006973:Hypertension; D007349:Insurance, Health, Reimbursement; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D056910:Republic of Korea
chemical_list: D000959:Antihypertensive Agents; D016568:Drugs, Generic
keywords: Antihypertensive drugs; Drug pricing system; Pharmaceutical expenditures; Pharmaceutical policy