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1、ARTICLE IN PRESSSocial Science & Medicine 57 (2003) 529–538Pharmaceutical reform and physician strikes in Korea:separation of drug prescribing and dispensingSoonman Kwon*Department of Health Policy and Management, School of Public Health, Seoul National University, 28 Yonkon-dong,Cho
2、ngno-gu, Seoul 110-799, Republic of KoreaAbstractBefore the recent pharmaceutical reform in Korea that mandates the separation of drug prescribing and dispensing,physicians and pharmacists both prescribed and dispensed drugs, resulting in the overuse and misuse of drugs. Thepharmaceu
3、tical reform attempts to change the provider’s economic incentives by eliminating the providers’ profit fromdrugs that have been a major source of their income. It also influences the pharmaceutical industry that has thrived onoffering high margins to physicians rather than on producin
4、g high-quality drugs. However, physician strikes forced thegovernment to modify some critical elements of the reform package and to raise medical fees substantially tocompensate for the income loss of physicians. Lack of a strategic plan of implementation, failure to appreciate thech
5、ange in the paradigm of health policy process, and failure to convince consumers of the benefits of the reform, are themajor reasons that the historic reform of the separation of drug prescribing and dispensing has resulted in greater socialcost than expected.r 2003 Elsevier Science L
6、td. All rights reserved.Keywords: Separation of prescribing and dispensing; Pharmaceuticals; Physician strike; KoreaIntroductionAging of the population, growth of popular accep-tance of drugs, and removal of financial barriers to usehave led to the growth of drug consumption (Davis,19
7、97). Consequently, pharmaceutical expenditure is animportant contributor to overall health care costescalation, and health care policy in many countriesnow targets the pharmaceutical sector for cost contain-ment (Mossialos & Abel-Smith, 1996; Saltman &Figueras, 1997). Korea faced eve
8、n worse prob
