[LETTERS to the editor]Don’t rush ― prepare for ‘positive drug plan’In May, the Ministry of Health and Welfare proposed a new drug reimbursement plan called “the positive list” to replace the existing “negative list.” The government’s plan to adopt the positive list has brought strong opposition from multinational pharmaceutical companies. The United States ambassador to Korea, Alexander Vershbow, requested Seoul reconsider this plan. I do not agree with the views of the multinational drug firms and the U.S. ambassador. However, I believe that it is too early for Korea to enforce the positive list. There are three main reasons to reconsider this new plan in the interest of the Korean government, consumers and domestic pharmaceutical corporations.
To begin with, the Korean government lacks the infrastructure required to put this plan in operation. Unlike other developed countries which have enough specialists, research institutions and related facilities, Korea does not yet meet the requirements of such a system. To be specific, the proportion of public medical institutions in the health system here is just 14.3 percent,which is remarkably lower than developed countries such as Britain, 96 percent; France, 65 percent; the United States, 33 percent; and Japan, 36 percent. Public medical institutions are a crucial factor needed to enforce a positive list system. In addition, we have a thin supply of professionals who are trained in the evaluation of data for economies of scale and few training institutions to produce such experts in the field.
Also, this plan can cause inconvenience to consumers, because generally it will make it hard to switch prescription medicines, thereby reducing patients’ access to diverse drugs for treatment. Also, if there are some medical products that are not registered in the national health insurance system but are essential for treating certain diseases, the high prices of those drugs can make them inaccessible to the people who need them. Accordingly, patients’ complaints would greatly increase.
Furthermore, domestic pharmaceutical companies would be at a disadvantage and are likely to lose in the fierce competition with multinational drug firms due to the latter’s rich data resources and economies of scale that can easily adjust to the positive list system.
I am not opposed to the government’s decision to install a universal system which gives public health insurers the right to decide which drugs are reimbursed by public funds. Multinational pharmaceutical companies have no right to intervene in national policies.
However, in my view the Korean government should first fully prepare for the positive list system before carrying it out by constructing enough public medical institutions, establishing research organizations and training facilities to raise our own experts, making efficient laws to protect consumers’ rights to be treated properly, and sharpening domestic drug corporations’ competitiveness. The Korean government should not cross this bridge until it has the appropriate conditions.
by Song Ka-Young