주요국의 의약품 급여관리를 위한 수평탐색 현황 비교

• Published in: HIRA Research Vol. 4; no. 1; pp. 20 - 33
• Main Authors: 조쌍은, Ssangeun Jo, 변지혜, Ji-hye Byun
• Format: Journal Article
• Language: Korean
• Published: 건강보험심사평가원 심사평가정책연구소 31.05.2024; 건강보험심사평가원
• Subjects: Decision support systems; Emerging therapeutics; Horizon scanning; Insurance; pharmaceutical; Pharmaceutical policy; services; 사회학
• ISSN: 2765-6764; 2765-7353
• DOI: 10.52937/hira.24.4.1.e6

With the recent development of innovative medical technology, the market entry of high-priced drugs, such as Kymriah, Zolgensma, and Luxturna injections, is increasing. Accordingly, there is a growing need to effectively manage benefits by reviewing the characteristics of drugs, significant adverse reactions, and treatment effects in advance through horizon scanning. This study conducts a literature review of the status and methodology of domestic and foreign horizon scanning and proposes horizon scanning methods for pharmaceutical benefits management. The review results indicate that horizon scanning in Europe had different operational plans, such as the scope and duration of the search by country. However, the implementation typically aimed to reflect horizon scanning in policy decisions, such as determining benefits directions or establishing a regulatory agency management plan. Meanwhile, the results of horizon scanning in the United States and Korea were provided as reference materials to major stakeholders rather than directly reflecting them in the policy. Although listing high-priced drugs with uncertain long-term treatment effects and financial impact is expected to increase, periodic horizon scanning activities for pharmaceutical benefits management have not been conducted in Korea. Therefore, as a horizon scanning procedure for pharmaceutical benefits management, this study proposes the following four steps, namely, (step 1) define target indications and drug efficacy groups; (step 2) establish the purpose of horizon scanning; (step 3) review the extant literature; (step 4) summarize and discuss the results; (step 5) deliberate potential decision-making.