34 research outputs found

    Table1_Introduction of managed entry agreements in Korea: Problem, policy, and politics.docx

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    Objectives: This study aimed to understand Managed Entry Agreements (MEAs) in Korea through the framework of three streams of the policy window model and its practical management and impact on pricing and reimbursement scheme.Methods: An extensive literature review based on Kingdon’s model was conducted. We also performed descriptive analyses of MEA implementation using data on medicines listed in Korea and compared its MEA scheme with four different countries.Results: As per problem streams, patients with rare disease or cancers have considerable difficulties in affording their medicines and this has challenged the drug benefit system and raised an issue of patient’s access. Policy streams highlighted that MEAs were introduced as a benefit enhancement plan for four major diseases since January 2014. MEAs have also been strengthened as a bypass mechanism to expand the insurance coverage especially for new premium-priced medicines under Moon Care (Listing all non-listed services). In descriptive analysis of MEAs, a total of 48 medicines were contracted as MEAs from January 2014 to December 2020, accounting for 73.4% of listed medicines for cancer or rare diseases and 97.9% of the cases were finance-based contracts. Meanwhile, outcome-based contracts such as CED accounted for only 2.1%. The application of MEAs differs across countries, resulting in a kappa coefficient of 0.00–0.14 (United Kingdom 0.03, Italy 0.00, Australia 0.14), indicating a lack of consistency compared to South Korea.Conclusion: MEAs, which were introduced as a bypass mechanism, have now superseded the standard process for anticancer agents or orphan drugs. Further studies are needed to evaluate the impact of the confidential agreements and effectiveness of new high-priced medicines with limited clinical data at launch.</p

    Integration of results from different outcomes for signal identification.

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    <p><sup><i>1</i></sup><i>less than 3 cases without AZCERT drugs or CV drugs</i>; QTs = symptomatic QT prolongation, QTa = asymptomatic QT prolongation.</p><p><sup>2</sup> stronger signal was not reached only due to lack of 3 cases without <i>AZCERT drugs or CV drugs</i></p><p>Integration of results from different outcomes for signal identification.</p

    Disproportionality analysis for antihistamines with cases of ventricular arrhythmia.

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    <p>NOTES: in italic, not statistically significant ROR; na = number of cases <3;VF = ventricular fibrillation; fatVT = fatal or life-threatening ventricular fibrillation; non-fatVT = other VT cases.</p><p>Disproportionality analysis for antihistamines with cases of ventricular arrhythmia.</p

    Disproportionality analysis for antihistamines with cases of cardiac arrest (CA) or sudden cardiac death (SCD).

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    <p>NOTES: in italic, not statistically significant ROR; na = number of cases <3</p><p>Disproportionality analysis for antihistamines with cases of cardiac arrest (CA) or sudden cardiac death (SCD).</p

    Trends in antipsychotic utilization according to data availability.

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    <p>AUT: Austria; CRO: Croatia; EST: Estonia; FRA: France; ITA: Italy; LIT: Lithuania; NOR: Norway; SPA: Spain (Catalonia); SCO: Scotland; SER: Serbia; SLO: Slovenia; SWE: Sweden; EMA: European Medicines Agency; FDA: Food and Drug Administration; FGA: first-generation antipsychotics; SGA: second-generation antipsychotics; TdP: Torsades de Pointes. Boxes indicate regulatory safety warnings on cardiovascular risk. </p

    Country-by-Country Comparison in antipsychotic utilization included in Group A: 2005 <i>versus</i> 2010.

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    <p>Abscissa: DID. OLA: olanzapine; ZIP: ziprasidone; RIS: risperidone; QUE: quetiapine; HAL: haloperidol; CLO: clozapine; CHL: chlorpromazine; AMI: amisulpride; CYA: cyamemazine (shown only in France). </p
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