What's the HIRA's solution to the drug price?

The drug price file will be provided in advance on the first day of deliberation by the Deliberation Committee

Care should be taken when applying the billing program

Measures have been prepared to improve administrative and economic losses caused by drug returns in hospitals, clinics, and pharmacies following the revision of the monthly drug benefit list and upper limit table.

 

The HIRA has decided to provide a revision of the drug benefit list in advance starting this month.

 

Until now, drug price files have been provided since the revision of the notice after deliberation and resolution by the Health Insurance Policy Deliberation Committee of the MOHW.

 

However, in the future, even before the issuance of the notice, after the Health Policy Review Committee is over, the drug price file will be provided in advance from the first day of the review.

 

The final contents of the drug price file provided in advance can be changed depending on the results of the deliberation, so it seems that it takes time to apply the billing program.

 

It is inconvenient to use the pre-provided drug price file to check the actual transaction price when returning and settling drugs at pharmacies and to apply the final drug price file to the billing program after issuance of the notice.

 

The reason why the HIRA came up with such an early provision of drug price files seems to be the main reason for the monthly drug price, but the suspension of execution occurs when the upper limit of the drug is adjusted due to the reduction of the benefit range.

 

Hospitals, clinics, and pharmacies will suffer from administrative tasks such as settlement of differences in drug prices.

 

In particular, in the case of pharmacies, if the weighted average price is incorrectly calculated due to drug price reduction or increase, it may lead to on-site investigation and administrative disposition due to inconsistency in claims.