우리나라와 일본의 지역약국 약사서비스 관련 공적보험급여의 범위 및 수가 비교

A Comparative Study on Health Insurance Fees Related to Community Pharmacists’ Services in Korea and Japan

In Korea, the service fee reimbursed to community pharmacists by national health insurance (NHI) is limited to traditional dispensing and managing of medication. On the contrary, health insurance fees for various pharmaceutical care services are reimbursed in Japan, which has a similar healthcare system to that of Korea. This study aims to compare the fees and types of reimbursable activities covered by NHI between Korea and Japan. The unit prices and coverage conditions for each medical fee-related community pharmacist were examined and extracted from the reimbursement schedule tables from NHI. The Japanese fee was converted into Korean won by the Purchasing-Power-Parities exchange rate. We compared the dispensing fees according to change of prescription days and several additional payment conditions such as night-time, narcotics prescriptions, and medication for infant/child. In Japan, various fees for pharmacists’ advanced pharmaceutical care activities were reimbursed comprehensively, not merely for traditional dispensing. The average fee dispensed for a 3-day prescription in Korea was about 60.8% of that in Japan and estimated to 33.6~60.5% under various additional payment conditions. Therefore, this study suggests that Japan s cases need to be reviewed and benchmarked and that we need to consider how to reflect them in Korea’s reimbursement scheme.