<div class="gmail_quote">From: <b class="gmail_sendername">Ruggiero, Mrs. Ana Lucia (WDC)</b> <a href="mailto:ruglucia@paho.org">ruglucia@paho.org</a><br><br><br>
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<p style="MARGIN-LEFT: 0.5in"><b><font face="Arial" color="maroon" size="2"><span style="FONT-WEIGHT: bold; FONT-SIZE: 11pt; COLOR: maroon; FONT-FAMILY: Arial">South Korean Pharmaceutical Reforms Failed To Reduce Costs</span></font></b></p>

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<p style="MARGIN-LEFT: 0.5in"><em><i><font face="Arial" color="navy" size="2"><span style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">The reform's implementation, although well-intentioned and successful in some respects, was imperfect from the start.</span></font></i></em><font face="Arial" color="navy"><span style="COLOR: navy; FONT-FAMILY: Arial"><br>
<br>Hak-Ju Kim and Jennifer Prah Ruger</span></font></p>
<p style="MARGIN-LEFT: 0.5in"><em><b><i><font face="Arial" color="navy" size="2"><span style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; COLOR: navy; FONT-STYLE: normal; FONT-FAMILY: Arial">Health Affairs, 28 May 2008</span></font></i></b></em><b><i><font face="Arial" color="navy"><span style="FONT-WEIGHT: bold; COLOR: navy; FONT-STYLE: italic; FONT-FAMILY: Arial"></span></font></i></b></p>

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<p style="MARGIN-LEFT: 0.5in"><font face="Arial" color="navy" size="1"><span style="FONT-SIZE: 9pt; COLOR: navy; FONT-FAMILY: Arial">Available at: <a href="http://content.healthaffairs.org/cgi/content/abstract/hlthaff.27.4.w260" target="_blank"><font color="navy"><span style="COLOR: navy">http://content.healthaffairs.org/cgi/content/abstract/hlthaff.27.4.w260</span></font></a> </span></font></p>

<p style="MARGIN-LEFT: 0.5in"><b><font face="Arial" color="maroon" size="2"><span style="FONT-WEIGHT: bold; FONT-SIZE: 11pt; COLOR: maroon; FONT-FAMILY: Arial"> </span></font></b></p>
<p style="MARGIN-LEFT: 0.5in"><font face="Arial" color="navy" size="2"><span style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">"….The pharmaceutical reforms instituted by South Korea in 2000 have cut down on the abuse of antibiotics and other prescription drugs, according to a new study published today on the Health Affairs Web site. However, the reforms have also had unintended consequences, such as the increased use of high-price brand-name drugs and an acceleration in the rate of increase of South Korea's national health spending, say the study's authors, <i><span style="FONT-STYLE: italic">Hak-Ju Kim of Dongguk University in Seoul and Jennifer Prah Ruger of the Yale University School of Medicine. </span></i>They observe that overall South Korean health care spending has actually increased more rapidly after the reforms than before they were implemented…."</span></font></p>

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<p style="MARGIN-LEFT: 0.5in"><font face="Arial" color="navy" size="2"><span style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">"…Despite its lofty aims, the pharmaceutical reform has resulted in unintended distortions in the supply of medical services and expenditures, increasing the use of uninsured services and high-price drugs, and expanding market share for multinational companies. It also is resulting in the full separation of medical institutions and pharmacies for outpatient care.^{<a href="http://content.healthaffairs.org/cgi/content/full/hlthaff.27.4.w260/DC1#48%2348" target="_blank"><font color="navy"><span style="COLOR: navy">48</span></font></a>} Further reform bills are needed to reduce these unintended adverse effects. Introducing recommended drug formularies and restricting insurance benefits for those not on the list may help restrict unnecessary growth in medical spending. Thoughtful consideration of evidence-based incentives and disincentives for health care providers will be crucial in future reforms…."</span></font></p>

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<p style="MARGIN-LEFT: 0.5in"><font face="Arial" color="navy" size="2"><span style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">Health Affairs is pleased to make this article freely accessible to listserv recipients for two weeks. </span></font><i><font face="Arial" color="navy" size="1"><span style="FONT-SIZE: 8pt; COLOR: navy; FONT-STYLE: italic; FONT-FAMILY: Arial">-----From: Ford, Kathleen Project Hope<br>
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