‘Drug innovation is concentrated around specific diseases’

HIRA studies Revised OECD Health System Performance Assessment framework

Sustainability of public finance highlighted as a core issue, warning on rising drug prices

The OECD has raised concerns that pharmaceutical innovation is increasingly concentrated in specific disease areas, while placing healthcare financial sustainability at the center of policy debate.

It has stressed that the price increases of new drugs must be reviewed to determine if they actually lead to meaningful health gains, and that a comprehensive evaluation is necessary when assessing access to medicines.

On the 15th, the Health Insurance Review and Assessment Service (HIRA) announced the results of its research on the Revised OECD Health System Performance Assessment framework indicators.

The OECD HSPA framework is designed to compare how effectively national healthcare systems are functioning across countries.

According to HIRA’s analysis, pharmaceuticals and medical technologies were newly positioned as core foundational elements determining system performance in the 2024 revised OECD HSPA framework.

The revision reflects lessons from the COVID-19 pandemic, during which vulnerabilities in global supply chains for essential medicines and medical devices, as well as shortages in intensive care capacity and healthcare infrastructure, were exposed.

Sustainability perspectives were particularly strengthened. The HIRA research team explained, “(The revised framework) critically questions whether rising prices of new drugs translate into actual improvements in health value and addresses the sustainability of health finances as a key policy challenge.”

They added, “The OECD also points out the imbalance created by innovation being concentrated in specific disease areas, and calls for a fundamental review of the pharmaceutical incentive structure and the rationality of current pricing models.”

Changes were also made to concretize the concept of drug accessibility. This signifies that accessibility should be evaluated as a multidimensional, people-centered concept, not merely based on a product's availability.

The research team stated, " The revised framework defines access to medicines as a multidimensional concept encompassing availability, affordability, geographic accessibility, acceptability, and quality. This implies the need for a comprehensive assessment of barriers across the entire medicine lifecycle, including regulatory approval, health technology assessment, reimbursement listing, and prescribing and dispensing practices.”

They further noted, ”The OECD has published a report that serves as a foundation for developing indicators to monitor such complex dimensions of access."