HIRA

저가구매 장려금 효과 분석을 통한 제도 개선 방안 연구

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Type
Research report
Author(s)
윤은지신서희조호진조가영
Issued Date
2023-01
Keyword
PharmaceuticalIncentive for the purchase of low-priced drugsEffect evaluation
Abstract
The purpose of this study is to analyze the status and effects of the incentive for the purchase of low-priced drugs, suggest improvements to the system, and provide research for the financial management of pharmaceuticals in Korea.
The method of this study is quantitative and qualitative analyses. The main data for quantitative research was the incentive for the purchase of low-priced drugs data of the Health Insurance Review and Assessment Service(HIRA) from 2014 to 2021. In addition, qualitative research was conducted through in-depth interviews with medical institutions participating and non-participating in this system.
The first results of the study were that the pharmaceutical cost was reduced by 6% to 7% compared with the upper limit of the drug price through the low-cost purchase incentive system. Tertiary general hospitals had the highest proportion of cost savings due to the high pharmaceutical cost, but the lowest savings rate. In clinics, the savings effect was higher. Public hospitals had higher cost savings than private hospitals and an increased savings effect. Conversely, most private hospitals were tertiary general hospitals with very low savings rates. Second, the interview results showed that tertiary general hospitals evaluated the system negatively compared with its high reputation. Most general hospitals and clinics also evaluated it negatively due to a lack of administrative power. However, clinics had similar proportions of positive and negative opinions, and pharmacies could not evaluate the system. Third, it was shown that the effect of saving will continue if the incentive system operates continuously, but the ability to achieve an effect above the current level is limited.
As improvements for this system, this study suggests identifying real problems, devising ways to promote participation in the system, and adjusting the relationship between the drug pricing reduction system.
Publisher
건강보험심사평가원
URI
https://repository.hira.or.kr/handle/2019.oak/3089
Alternative Title
A Study on System Improvement through Effect Analysis of the Incentive for the purchase of low-priced drugs
Table Of Contents
제1장 서론 ················································································ 1
1. 연구 배경 및 목적 ················································································ 1
2. 연구 내용 및 방법 ·················································································· 4

제2장 국내·외 문헌 고찰 ················································································ 9
1. 저가구매 장려금 제도 소개 ······································································ 9
가. 개요 ·········································································································· 9
나. 저가구매 장려금 제도 관련 법적 기준 ························································ 15
2. 의약품 구매·계약·구입약가 산정 구조 ······················································ 23
가. 의약품 구매 구조 ····················································································· 23
나. 의약품 계약 구조 ····················································································· 27
다. 의약품 구입약가 산정 구조 ········································································ 30
3. 제도관련 국내·외 문헌 고찰 ··································································· 32
가. 의료공급자 인센티브 개념 ·········································································· 32
나. 의약품 구매 및 가격 관리 정책 ································································ 36
4. 소결 ···································································································· 63

제3장 제도 현황 및 특성 분석 ················································································ 67
1. 차수별 현황 ························································································· 67
가. 차수별 전체 현황 ····················································································· 67
나. 차수별·의료기관 종별 세부 현황 ································································· 68
다. 차수별·설립구분별 세부 현황 ····································································· 73
라. 의사(약사) 1인당 절감액·장려금 현황 ························································ 75
2. 저가구매 의약품 현황 ··········································································· 77
가. 차수별 저가구매 의약품 현황 ····································································· 77
나. 의료기관 종별 상위 절감 의약품 현황 ························································ 83
3. 제도 관련 영향요인 분석 ····································································· 89
가. 기관 특성 분석 ························································································ 89
나. 의약품 특성 분석 ···················································································· 105
4. 소결 ·································································································· 117

제4장 제도 효과 분석 ··········································································· 120
1. 재정 절감 효과 분석 ··········································································· 121
가. 분석 개요 ···························································································· 121
나. 분석 결과 ···························································································· 123
2. 제도 확산 및 참여지속성 분석 ····························································· 134
가. 분석 개요 ···························································································· 134
나. 분석 결과 ······························································································ 135
3. 의약품 단위 효과 분석 ········································································ 139
가. 분석 개요 ······························································································ 139
나. 분석 결과 ······························································································ 141
4. 소결 ·································································································· 145

제5장 의료기관·전문가 심층인터뷰 ··········································································· 149
1. 개요 ·································································································· 149
가. 분석 개요 ······························································································ 149
나. 분석 방법 ······························································································ 151
2. 인터뷰 결과 ······················································································· 152
가. 의약품 관리 현황 ···················································································· 152
나. 의약품 구매 및 저가구매 관련 요인 ·························································· 157
다. 제도 인지도 및 관심도 ············································································ 169
라. 제도 진단 및 평가 ·················································································· 171
마. 제도 개선방안에 대한 의견 ······································································ 174
바. 기타 의견 ······························································································ 180
3. 소결 ·································································································· 182

제6장 제도 개선(안) 제안 및 결론 ································································································ 189
1. 개요 ································································································ 189
2. 제도 개선(안) ··················································································· 190
가. 제도의 실질적인 문제 파악 필요 ···························································· 190
나. 제도 참여 유인책 마련 ············································································ 193
다. 제도 주요 취지 명확화 필요 ·································································· 200
3. 결론 ································································································ 202

◾ 참고 문헌 ····················································································· 204
◾ 부록 ····························································································· 212
Publisher
건강보험심사평가원
Location
KOR
Citation
윤은지. (2023-01). 저가구매 장려금 효과 분석을 통한 제도 개선 방안 연구.
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