Utilization Trends and Concentration Ratio of Korean Medicine: Based on the National Health Insurance Data

Although Korean Medicine (KM) subsidized by the National Health Insurance (NHI) has been used for a long time, there has been no active analysis using claims data . Therefore, the purpose of this study was to examine the NHI KM utilization trend using NHI statistics and to measure the level of market concentration by year.

By restructuring the contents of NHI Statistics for Pharmaceuticals for 2010-2019, the claim cases, costs, and annual growth rates of KM were demonstrated by year, sex, age group, region, therapeutic group, and KM treatment. The proportion of highly used k treatments in cost was calculated as the concentration ratio (CR) k and its trend by year was investigated.

In 2019, the NHI cost on KM amounted to ₩38.2 billion KRW, increasing by 11.6% per year on average in 2010-2019. Notably, KM was used more frequently among women and patients aged ≥ 65 years, and the mixed formulation accounted for 95% of the total cost of KM. The CR of the simple formulation increased rapidly, whereas that of the mixed formulation remained constant. In 2019, three simple formulation treatments-peony, licorice, and ginseng- accounted for 93.8% of the total cost for KM (CR3 = 93.8%).

NHI KM is rapidly increasing. Investigating the CR of KM confirmed that KM prescriptions have been concentrated in small numbers over the past 10 years.