title: Effects of drug price reduction and prescribing restrictions on expenditures and utilisation of antihypertensive drugs in Korea.
abstract: OBJECTIVE
  To evaluate the quantitative effects of the drug price reduction on pharmaceutical expenditures and the new guidelines to restrict prescribing on drug utilisation for antihypertensive drugs.
  
  
  METHODS
  We used an interrupted time series design with the National patient sample data of Health Insurance Review and Assessment Service in South Korea.
  
  
  METHODS
  54,295 participants who were with primary hypertension from the National patient sample data of Health Insurance Review and Assessment Service were included. The study period was from March 2011 to December 2013. The dependent variables were antihypertensive drug costs, antihypertensive drug cost per prescribing day, daily drug utilisation, average number of drugs per month, percentage of original drugs per prescription, drug overutilisation and prohibited combinations. Segmented regression analysis was used.
  
  
  RESULTS
  The drug price reduction reduced expenditure (US$-1.51, -10.2%), and the new guidelines reduced expenditures even more (US$-2.13; -16.2%). These policies saved US$4.22 (28%) of antihypertensive drug costs per patient in December 2013 compared to March 2012. Drug price reduction policy was introduced in April 2012. We established the policy effect by comparing it before (March 2012) with after(21 months later-December 2012). The effects of the guidelines decreased expenditures, daily drug utilisation and the average number of drugs per month more than did the drug price reduction.
  
  
  CONCLUSIONS
  Both policies saved money. The guidelines were more effective over time and had fewer side effects such as increasing daily drug utilisation and number of drugs than the effects of drug price reduction.
authors.affiliation: Department of Healthcare Management, Eulji University, Sungnam, South Korea.
authors.forename: Ki-Bong
authors.identifier: http://orcid.org/0000-0001-7073-8586
authors.initials: KB
authors.lastname: Yoo
authors.affiliation: Institute of Health Services Research, Yonsei University, Seoul, South Korea Graduate School of Public Health, Yonsei University, Seoul, South Korea.
authors.forename: Sang Gyu
authors.initials: SG
authors.lastname: Lee
authors.affiliation: Institute of Health Services Research, Yonsei University, Seoul, South Korea Graduate School of Public Health, Yonsei University, Seoul, South Korea.
authors.forename: Sohee
authors.initials: S
authors.lastname: Park
authors.affiliation: Institute of Health Services Research, Yonsei University, Seoul, South Korea Graduate School of Public Health, Yonsei University, Seoul, South Korea.
authors.forename: Tae Hyun
authors.initials: TH
authors.lastname: Kim
authors.affiliation: National Evidence-based Healthcare Collaborating Agency, Seoul, South Korea.
authors.forename: Jeonghoon
authors.initials: J
authors.lastname: Ahn
authors.affiliation: Health Insurance Review and Assessment Service, Seoul, South Korea.
authors.forename: Mee-Hyun
authors.initials: MH
authors.lastname: Cho
authors.affiliation: Institute of Health Services Research, Yonsei University, Seoul, South Korea Department of Preventive Medicine, College of Medicine, Yonsei University, Seoul, South Korea.
authors.forename: Eun-Cheol
authors.initials: EC
authors.lastname: Park
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000191:economics*; D016527:Drug Costs / Q000639:trends*; D005260:Female; D005102:Health Expenditures / Q000639:trends*; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000331:legislation & jurisprudence*; D065186:Interrupted Time Series Analysis; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic / Q000592:standards*; D012044:Regression Analysis; D056910:Republic of Korea
chemical_list: D000959:Antihypertensive Agents
keywords: antihypertensive drug; direct price control; drug utilization; pharmaceutical expenditures; reimbursement restriction