In 2023, the expenditure on health insurance-covered pharmaceuticals increased by approximately 2 trillion won compared to the previous year, surpassing 26 trillion won.
The analysis indicates that the health insurance financial burden is increasing due to the inclusion of expensive anticancer drugs and new treatments for rare diseases, along with rising expenditures for chronic disease medications such as those for hyperlipidemia, hypertension, and diabetes, influenced by an aging population and Western dietary habits.
The National Health Insurance Service released the '2023 Analysis of Pharmaceutical Expenditure' on the 16th. The total amount spent on pharmaceuticals from health insurance funding for the year 2023 was 26.1966 trillion won, an 8.5% increase from the previous year (24.1542 trillion won). The overall treatment cost for the same year was 110.8029 trillion won, which was a 4.7% increase from the previous year. The increase in pharmaceutical expenditure is approximately twice as large.
As expensive new drugs have entered the health insurance coverage system, the expenditure is also increasing.
Health authorities have continued to cover pharmaceuticals to reduce the burden on patients with cancer and rare intractable diseases. In 2023, coverage was applied to 24 drugs, including the treatment for spinal muscular atrophy, Evrysdi. The scope of use was expanded for eight drugs, including a severe atopic dermatitis treatment. In 2022, 22 drugs, including the treatment for acute lymphoblastic leukemia, 'Kymriah', were covered, and the scope of use was expanded for seven drugs, including immune checkpoint inhibitors.
As a result, the expenditure on covered pharmaceuticals for treating cancer and rare intractable diseases increased by 10.8% and 9.7%, respectively, reaching 3.8402 trillion won for cancer and 2.5492 trillion won for rare intractable diseases, surpassing the overall pharmaceutical expenditure growth rate of 8.5%.
Chronic disease medications that need to be continuously taken due to difficulties in fundamental treatment accounted for a significant portion of the expenditures.
When examining the expenditures by efficacy group, the expenditure on antiplatelet drugs for treating hyperlipidemia was the largest at 2.849 trillion won. Next were anticancer drugs at 2.7336 trillion won and antihypertensive medications at 2 trillion won. Following them were the treatment for peptic ulcers at 1.3904 trillion won and the diabetes medication at 1.3667 trillion won.
By ingredient group, the expenditure on the 'Ezetimibe + Rosuvastatin combination' for hyperlipidemia ranked first at 605.8 billion won. Following it were the brain function enhancer 'Choline Alfoscerate' (563 billion won), hyperlipidemia medication 'Atorvastatin' (558.7 billion won), antithrombotic agent 'Clopidogrel' (417.9 billion won), and hyperlipidemia medication 'Rosuvastatin' (337.7 billion won).
By age group, the expenditure on pharmaceuticals for patients in their 60s was the highest. The expenditure for patients in their 60s was 6.6 trillion won, accounting for 25.2% of the total. This was followed by those in their 70s (5.2 trillion won), 50s (4.4 trillion won), and 80s (3.1 trillion won). The percentage of total pharmaceutical expenditure accounted for by those aged 60 and older was also the highest at 58.1%.
The proportion of pharmaceutical expenditure within the total treatment cost was 23.6%, an increase of 0.8 percentage points from the previous year. By type of medical institution, pharmacy claims were the highest at 18 trillion won (68.9%). This was followed by tertiary hospitals (3.8 trillion won), general hospitals (2.2 trillion won), and clinics (1.1 trillion won).
According to the latest health statistics released by the Organisation for Economic Co-operation and Development (OECD) in August last year, the ratio of pharmaceutical expenditure to current healthcare costs in South Korea was 18% as of 2022, surpassing the OECD average of 14.2%, ranking South Korea 7th among OECD member countries.
A representative from the National Health Insurance Service noted, "The continuous increase in pharmaceutical expenditure is due to the inclusion of high-cost anticancer drugs and gene therapies in coverage and the rise in chronic diseases due to an aging population." They added, "While enhancing coverage to ensure that citizens can use necessary medications on time, we will expand the analysis of medications that may be abused or prescribed unnecessarily and establish management strategies to protect health insurance finances while promoting public health."