(P-089) Clinical and Cost-saving Effects of the Drug Utilization Review Modernization Pilot Project in Inpatient and Outpatient Settings in Korea

Background: Korea’s national health insurance authority introduced a DUR modernization pilot project in which health professionals provided follow up services to monitor adverse events after prescribing of drugs. The project was operated for 20 medical institutions between August and December 2019.

Objectives: To evaluate the clinical and economic effects of the implemented project.

Methods: We conducted difference-in-differences (DID) statistical methods using National Health Insurance claims data from the Health Insurance Review and Assessment Service (HIRA). We calculated the number of drug-related adverse events and allergic drug reactions as a clinical indicator and medical costs incurred to manage these events as an economic indicator. Each outcome measure was calculated for the 5-months period from August to December in 2018 and the same months in 2019 to consider the impact of seasonality. To select the control group, we considered institutional characteristics, such as region, type of medical care institution, number of beds, and number of physicians employed. We, then, calculated absolute and relative differences in each outcome measure. DID was defined as a difference in absolute differences between the intervention group and the control group.

Results: Overall, the monthly number of drug-related adverse events and allergic reactions and corresponding medical costs showed parallel trends between the intervention group and the control group before and after implementation of the pilot project. DID was -43 and -826 for the number of drug-related adverse events and allergic reactions and -$198,700 and $53,318 for medical costs in the inpatient and outpatient settings, respectively. For outpatients, the monthly number of drug-related adverse events and allergic drug reactions has grown higher for the control group than for the intervention group after implementation of the pilot project.

Conclusions: Implementation of the DUR modernization pilot project with follow-up service lowered the number of drug-related adverse events and allergic drug reactions in the in- and outpatient setting. The project lowered medical costs incurred to manage these events in the inpatient setting only.