Korean J Clin Pharm.  2017 Dec;27(4):250-257. 10.24304/kjcp.2017.27.4.250.

Prescribing Pattern and Safety Analysis of Nonsteroidal Anti-inflammatory Drug and Gastro- Protective Agent following Reimbursement Guidelines Relaxation

• Han MH
• Noh E
• Nam JH
• Lee SW
• Lee EK

• KMID: 2403330
• DOI: http://doi.org/10.24304/kjcp.2017.27.4.250

Abstract

OBJECTIVE
The prevalence rate of osteoarthritis in Koreans aged 50 years or older is 14.3%, and the total amount of medical costs is more than KRW 1 trillion. Recently, the reimbursement guidelines for osteoarthritis treatment have changed.
METHODS
In this study, we sought to describe prescription patterns of nonsteroidal anti-inflammatory drugs (NSAIDs) and gastro-protective agent (GPA) and analyze the clinical and economic impacts of the new policy using the national health insurance claims data. The incidence of upper gastrointestinal adverse event by policy change was identified through the odds ratio, and changes in medicine and medical costs related to osteoarthritis through mean and median.
RESULTS
There were 204,552 patients before the reimbursement guidelines relaxation and 239,710 after it, a 17.2% rise. The prescription ratio was 3.3% for the patients prescribed with COX-2 selective NSAIDs alone and 1.3% for those with both COX-2 selective NSAIDs and GPA combination before the reimbursement guidelines relaxation. The reimbursement guidelines relaxation significantly increased their ratios to 6.9% and 2.8%, respectively. Gastrointestinal adverse events significantly reduced by 1.21%p after reimbursement guidelines relaxation. The average medicine cost per person increased significantly to KRW 140,291 from KRW 137,323 after the reimbursement guidelines relaxation, while the average medical cost per person slightly decreased from KRW 311,605 to KRW 310,755 after the relaxation, showing no meaningful difference.
CONCLUSION
The reimbursement guidelines relaxation may influence on decreasing the upper gastrointestinal adverse event, increasing the medicine costs and maintaining the medical costs for osteoarthritis.

Keyword

Osteoarthritis; reimbursement guidelines; NSAIDs; gastro-protective agent; gastrointestinal adverse event; medical cost