“2010년도 의약품 소비량 및 판매액 통계 심층분석”

주관연구기관명 : 한국보건사회연구원
연 구 책 임 자 : 박 실비아
연 구 원 : 장 영 식
연 구 원 : 채 수 미
연 구 원 : 박 은 자
연 구 원 : 김 남 순
연 구 원 : 이 의 경
연 구 원 : 이 인 향

요 약 ·········································································································· 1
제1장 서론 ································································································· 11
제1절 연구 배경 및 목적 ················································································ 11
제2절 연구내용 ····························································································· 13
제3절 연구방법 ······························································································· 16
제2장 인구집단 및 기관 유형별 의약품 사용량과 약품비의 심층 분석 ········ 29
제1절 인구학적 특성별 의약품 사용량과 약품비 ·············································· 29
제2절 지역별 의약품 사용량과 약품비 ····························································· 64
제3절 의료기관 종별 의약품 사용량과 약품비 ················································· 69
제3장 의약품 사용 인구집단 및 기관의 특성별 분포 ·································· 75
제1절 의약품 사용 인구집단의 특성별 분포 ···················································· 75
제4장 의약품 적정사용을 위한 주요 의약품의 사용량과 약품비 분석 ········ 109
제1절 항생제 사용 현황 분석 ······································································· 109
제2절 노인에게 잠재적으로 부적절한 의약품(potentially inappropriate drugs,
PID) 사용 현황 분석 ········································································· 142
제3절 고가의약품 사용 현황 분석 ································································· 155
제5장 비급여 의약품의 사용량과 약품비 분석 ·········································· 175
제1절 2010년 비급여 의약품 비용 및 사용량 ············································ 175
제2절 비급여비용 상위의약품 ········································································ 178
제6장 1일 사용량 기준 약품비 분석 ························································ 185
제1절 국내 의약품의 1일 사용량 기준 약품비 ·············································· 185
제2절 OECD 국가별 비교 ··········································································· 192
제7장 고찰 및 결론 ·················································································· 203
참고문헌 ··································································································· 207
부 록 ···································································································· 211
〔부록 1〕 외래 감기(상병코드 J00~J06)에서 항생제 사용 ························· 211
〔부록 2〕 고가의약품 사용 분석 포함 약품 ················································ 214
〔부록 3〕 의료기관 종별 항생제 사용량 ····················································· 216

표 목 차
〈표 1-1〉 분석 대상 의약품 분류·······································································14
〈표 1-2〉 ATC 계열별 DDD가 있는 약물 현황················································18
〈표 1-3〉 2010년 비급여의약품 표본 자료수집 의료기관 현황 ························19
〈표 1-4〉 2010년 비급여의약품 및 일반의약품 표본 자료수집 약국 현황 ········19
〈표 2-1〉 성별 연령별 의약품 사용량·································································30
〈표 2-2〉 주요 일부 의약품의 사용량 ·······························································37
〈표 2-3〉 주요 일부 의약품의 사용량 (고혈압 치료제) ·······································38
〈표 2-4〉 ATC 대분류에서 성별 연령별 약품비·················································48
〈표 2-5〉 주요 일부 의약품의 성별 연령별 약품비··············································55
〈표 2-6〉 고혈압 치료제의 성별 연령별 약품비··················································56
〈표 2-7〉 지역별 의약품 계열별 총 사용량·························································65
〈표 2-8〉 지역별 의약품 계열별 의사수 대비 의약품 사용량·······························66
〈표 2-9〉 지역별 의약품 계열별 총 약품비·························································67
〈표 2-10〉 지역별 의약품 계열별 의사수 대비 약품비········································69
〈표 2-11〉 의료기관 종별 의약품 계열별 의약품 총 사용량································70
〈표 2-12〉 의료기관 종별 의약품 계열별 의사수 대비 의약품 사용량·················70
〈표 2-13〉 의료기관 종별 의약품 계열별 약품비················································71
〈표 2-14〉 의료기관 종별 의약품 계열별 의사수 대비 약품비····························72
〈표 4-1〉 연도별 항생제 사용량 ·····································································112
〈표 4-2〉 연도별 연령별 항생제 사용량 및 구성비 ·········································113
〈표 4-3〉 연도별 연령별 항생제 사용량 ··························································114
〈표 4-4〉 연도별 성별 항생제 사용량 및 구성비 ·············································114
〈표 4-5〉 연도별 성별 항생제 사용량 ·····························································115
〈표 4-6〉 의료기관 종별 항생제 사용량 및 약품비 ·········································117
〈표 4-7〉 ATC 3단위별 항생제 사용량 연도별 비교·······································119
〈표 4-8〉 ATC 4단위 별 항생제 사용량 연도별 비교·····································122
〈표 4-9〉 성분명별 항생제 사용량 연도별 비교················································125
〈표 4-10〉 OECD 국가의 항생제 소비량·······················································130
〈표 4-11〉 분석 대상 노인에게 잠재적으로 부적절한 의약품 성분명 ··········145
〈표 4-12〉 65세 이상 노인에게 잠재적으로 부적절한 약물의 사용량과 약품비(외래) 146
〈표 4-13〉 65세 이상 노인에게 잠재적으로 부적절한 약물의 사용량과 약품비(입원) 147
〈표 4-14〉 65세 이상 노인에게 잠재적으로 부적절한 약물의 성별 사용량과 약품비
(외래) ··························································································148
〈표 4-15〉 65세 이상 노인에게 잠재적으로 부적절한 약물의 성별 사용량과 약품비
(입원) ··························································································149
〈표 4-16〉 65세 이상 노인에게 잠재적으로 부적절한 약물의 연령별 사용량과 약품
비(외래) ·······················································································151
〈표 4-17〉 65세 이상 노인에게 잠재적으로 부적절한 약물의 연령별 사용량과 약품
비(입원) ·······················································································152
〈표 4-18〉 고가의약품 분석 대상 의약품군 및 ATC코드································157
〈표 4-19〉 분석포함 주성분코드의 개수 및 약제급여목록상 평균제품수···········159
〈표 4-20〉 분석에 포함된 약품군의 자료빈도, 사용량 및 사용금액··················162
〈표 4-21〉 약품군 및 가격그룹별 사용량과 사용금액 점유율(%) ····················164
〈표 4-22〉 고혈압치료제에서 각 요인들의 고가약 처방에 대한 Odds Ratios 166
〈표 4-23〉 위궤양치료제/해열진통제에서 각 요인들의 고가약 처방에 대한 Odds
Ratios ······················································································167
〈표 4-24〉 약품그룹별 연감절감액 추정··························································168
〈표 5-1〉 2010년 입원 및 의료기관 원내조제 의약품의 급여 및 비급여 비용·176
〈표 5-2〉 2010년 입원 및 의료기관 원내조제 의약품의 급여 및 비급여 사용량 177
〈표 5-3〉 2010년 표본조사된 입원 및 외래 원내조제 비급여의약품비용 상위 10%
약효군 현황·····················································································178
〈표 5-4〉 2010년 표본조사된 외래 원외조제 비급여의약품비용 상위 10% 약효군
현황································································································179
〈표 5-5〉 주요 비급여비용 상위약효군의 상세 의약품비용································180
그림 목차
〔그림 2-1〕 ATC 대분류별 성별 의약품 사용량·················································31
〔그림 2-2〕 성별 연령별 의약품 사용량(A: 소화기관 및 신진대사용 의약품) ·····32
〔그림 2-3〕 성별 연령별 의약품 사용량(C: 심혈관계용 의약품) ························32
〔그림 2-4〕 성별 연령별 의약품 사용량(G: 비뇨생식기계 및 성호르몬 의약품) ··33
〔그림 2-5〕 성별 연령별 의약품 사용량(H: 전신성 호르몬제) ····························34
〔그림 2-6〕 성별 연령별 의약품 사용량(J: 전신성 항감염약) ····························34
〔그림 2-7〕 성별 연령별 의약품 사용량(M: 근골격계용 의약품) ························35
〔그림 2-8〕 성별 연령별 의약품 사용량(N: 신경계용 의약품) ····························36
〔그림 2-9〕 고혈압 치료제의 계열별 성별 의약품 사용량····································39
〔그림 2-10〕 성별 연령별 의약품 사용량(소화기관용 의약품) ····························40
〔그림 2-11〕 성별 연령별 의약품 사용량(A02B: 위궤양 및 위식도 역류질환 치료
제) ······························································································40
〔그림 2-12〕 성별 연령별 의약품 사용량(A10: 당뇨병 치료제) ·······················41
〔그림 2-13〕 성별 연령별 의약품 사용량(C10: 지질완화약물) ·························42
〔그림 2-14〕 성별 연령별 의약품 사용량(N05B: 불안제거약) ··························42
〔그림 2-15〕 성별 연령별 의약품 사용량(N06A: 항우울제) ·····························43
〔그림 2-16〕 성별 연령별 의약품 사용량(고혈압 치료제: C03, C07, C08,
C09) ························································································44
〔그림 2-17〕 성별 연령별 의약품 사용량(C03: 이뇨제) ···································44
〔그림 2-18〕 성별 연령별 의약품 사용량(C07: 베타차단제) ····························45
〔그림 2-19〕 성별 연령별 의약품 사용량(C08: 칼슘차단제) ····························46
〔그림 2-20〕 성별 연령별 의약품 사용량(C09: 레닌안지오텐신약) ···················46
〔그림 2-21〕 ATC 대분류별 성별 약품비·························································49
〔그림 2-22〕 성별 연령별 약품비(A: 소화기관 및 신진대사용 의약품) ··············50
〔그림 2-23〕 성별 연령별 약품비(C: 심혈관계용 의약품) ·································51
〔그림 2-24〕 성별 연령별 약품비(G: 비뇨생식기계 및 성호르몬 의약품) ··········51
〔그림 2-25〕 성별 연령별 약품비(H: 전신성 호르몬제) ·····································52
〔그림 2-26〕 성별 연령별 약품비(J: 전신성 항감염약) ·····································53
〔그림 2-27〕 성별 연령별 약품비(M: 근골격계용 의약품) ·································53
〔그림 2-28〕 성별 연령별 약품비(N: 신경계용 의약품) ·····································54
〔그림 2-29〕 고혈압치료제의 계열별 성별 약품비··············································57
〔그림 2-30〕 성별 연령별 약품비(소화기관용 의약품) ·······································57
〔그림 2-31〕 성별 연령별 약품비(A02B: 위궤양 및 위식도 역류질환 치료제) ·58
〔그림 2-32〕 성별 연령별 약품비(A10: 당뇨병 치료제) ···································59
〔그림 2-33〕 성별 연령별 약품비(C10: 지질완화제) ········································59
〔그림 2-34〕 성별 연령별 약품비(N05B: 불안제거약) ·····································60
〔그림 2-35〕 성별 연령별 약품비(N06A: 항우울제) ········································61
〔그림 2-36〕 성별 연령별 약품비(고혈압 치료제: C03, C07, C08, C09) ·61
〔그림 2-37〕 성별 연령별 약품비(C03: 이뇨제) ··············································62
〔그림 2-38〕 성별 연령별 약품비(C07: 베타차단제) ········································63
〔그림 2-39〕 성별 연령별 약품비(C08: 칼슘차단제) ········································63
〔그림 2-40〕 성별 연령별 약품비(C09: 레닌안지오텐신약) ······························64
〔그림 2-41〕 의료기관 종별 의약품 계열별 의사수 대비 의약품 사용량··············71
〔그림 2-42〕 의료기관 종별 의약품 계열별 의사수 대비 약품비·························72
〔그림 3-1〕 ATC 대분류별 사용량의 성별 분포 ···············································76
〔그림 3-2〕 A계열(소화기관 및 신진대사용 의약품) 사용량의 연령별 분포········76
〔그림 3-3〕 C계열(심혈관계용 의약품) 사용량의 연령별 분포····························77
〔그림 3-4〕 G계열(비뇨생식기계 및 성호르몬 의약품) 사용량의 연령별 분포·····78
〔그림 3-5〕 H계열(전신성 호르몬제) 사용량의 연령별 분포·······························78
〔그림 3-6〕 J계열(전신성 항감염약) 사용량의 연령별 분포·······························79
〔그림 3-7〕 M계열(근골격계용 의약품) 사용량의 연령별 분포···························80
〔그림 3-8〕 N계열(신경계용 의약품) 사용량의 연령별 분포·······························80
〔그림 3-9〕 주요 일부 의약품 사용량의 성별 분포··············································81
〔그림 3-10〕 소화기관용 의약품 사용량의 연령별 분포······································82
〔그림 3-11〕 A02B(위궤양 및 위식도 역류질환 치료제) 사용량의 연령별 분포 82
〔그림 3-12〕 A10(당뇨병 치료제) 사용량의 연령별 분포·································83
〔그림 3-13〕 C10(지질완화제) 사용량의 연령별 분포······································83
〔그림 3-14〕 N05B(불안제거약) 사용량의 연령별 분포···································84
〔그림 3-15〕 N06A(항우울제) 사용량의 연령별 분포······································85
〔그림 3-16〕 고혈압 치료제 전체 및 세부 약품군 사용량의 성별 분포···············85
〔그림 3-17〕 고혈압 치료제 전체 사용량의 연령별 분포·····································86
〔그림 3-18〕 C03(이뇨제) 사용량의 연령별 분포············································87
〔그림 3-19〕 C07(베타차단제) 사용량의 연령별 분포······································87
〔그림 3-20〕 C08(칼슘차단제) 사용량의 연령별 분포······································88
〔그림 3-21〕 C09(레닌안지오텐신약) 사용량의 연령별 분포····························89
〔그림 3-22〕 ATC 대분류별 약품비의 성별 분포··············································90
〔그림 3-23〕 A계열(소화기관 및 신진대사용 의약품) 약품비의 연령별 분포······90
〔그림 3-24〕 C계열(심혈관계용 의약품) 약품비의 연령별 분포·························91
〔그림 3-25〕 G계열(비뇨생식기계 및 성호르몬 의약품) 약품비의 연령별 분포··92
〔그림 3-26〕 H계열(전신성 호르몬제) 약품비의 연령별 분포····························92
〔그림 3-27〕 J계열(전신성 항감염약) 약품비의 연령별 분포·····························93
〔그림 3-28〕 M계열(근골격계용 의약품) 약품비의 연령별 분포·························94
〔그림 3-29〕 N계열(신경계용 의약품) 약품비의 연령별 분포····························94
〔그림 3-30〕 주요 일부 의약품 약품비의 성별 분포···········································95
〔그림 3-31〕 소화기관용 의약품 약품비의 연령별 분포······································96
〔그림 3-32〕 A02B(위궤양 및 위식도 역류질환 치료제) 약품비의 연령별 분포 96
〔그림 3-33〕 A10(당뇨병 치료제) 약품비의 연령별 분포·································97
〔그림 3-34〕 C10(지질완화제) 약품비의 연령별 분포······································98
〔그림 3-35〕 N05B(불안제거약) 약품비의 연령별 분포···································98
〔그림 3-36〕 N06A(항우울제) 약품비의 연령별 분포······································99
〔그림 3-37〕 고혈압 치료제 전체 및 계열별 약품비의 성별 분포·····················100
〔그림 3-38〕 고혈압 치료제 전체 약품비의 연령별 분포··································100
〔그림 3-39〕 C03(이뇨제) 약품비의 연령별 분포··········································101
〔그림 3-40〕 C07(베타차단제) 약품비의 연령별 분포···································102
〔그림 3-41〕 C08(칼슘차단제) 약품비의 연령별 분포···································103
〔그림 3-42〕 C09(레닌안지오텐신약) 약품비의 연령별 분포··························103
〔그림 3-43〕 의약품 계열별 사용량의 의료기관 종별 분포·······························104
〔그림 3-44〕 의약품 계열별 약품비의 의료기관 종별 분포·······························105
〔그림 4-1〕 연령별 항생제 사용량···································································113
〔그림 4-2〕 성별 항생제 사용량·······································································115
〔그림 4-3〕 성, 연령별 항생제 사용량·····························································115
〔그림 4-4〕 연령별 항생제 약품비···································································116
〔그림 4-5〕 성별 항생제 약품비·······································································116
〔그림 4-6〕 성, 연령별 항생제 약품비·····························································117
〔그림 4-7〕 ATC 3단위별 항생제 사용량·······················································118
〔그림 4-8〕 ATC 3단위별 항생제 사용량 연도별 추이···································120
〔그림 4-9〕 ATC 3단위별 항생제 약품비·······················································120
〔그림 4-10〕 ATC 4단위별 항생제 사용량····················································121
〔그림 4-11〕 ATC 4단위별 항생제 사용량 연도별 추이·································123
〔그림 4-12〕 ATC 4단위별 항생제 약품비····················································124
〔그림 4-13〕 OECD 국가의 항생제 소비량(2009년) ···································131
〔그림 4-14〕 외래 감기에서 연령집단별 항생제 사용량····································132
〔그림 4-15〕 외래 감기에서 연령집단별 항생제 약품비····································133
〔그림 4-16〕 외래 감기에서 성별 항생제 사용량·············································133
〔그림 4-17〕 외래 감기에서 성별 항생제 약품비·············································134
〔그림 4-18〕 외래 감기에서 항생제 사용량의 의료기관 종별 분포···················135
〔그림 4-19〕 외래 감기에서 항생제 약품비의 의료기관 종별 분포···················135
〔그림 4-20〕 분석약품의 가격그룹··································································159
〔그림 4-21〕 분석약품 전체의 가격그룹별 점유율············································163
〔그림 4-22〕 주요 요양기관구분에 따른 항고혈압약제의 가격그룹별 총사용량··167
〔그림 6-1〕 입원 부문 1일 사용량 기준 약품비의 의료기관 종별 현황(A02B) 186
〔그림 6-2〕 외래 부문 1일 사용량 기준 약품비의 의료기관 종별 현황(A02B) 186
〔그림 6-3〕 입원 부문 1일 사용량 기준 약품비의 의료기관 종별 현황(C10) ·187
〔그림 6-4〕 외래 부문 1일 사용량 기준 약품비의 의료기관 종별 현황(C10) ·187
〔그림 6-5〕 입원 부문 1일 사용량 기준 약품비의 의료기관 종별 현황(C03) ·188
〔그림 6-6〕 외래 부문 1일 사용량 기준 약품비의 의료기관 종별 현황(C03) ·188
〔그림 6-7〕 입원 부문 1일 사용량 기준 약품비의 의료기관 종별 현황(C07) ·189
〔그림 6-8〕 외래 부문 1일 사용량 기준 약품비의 의료기관 종별 현황(C07) ·189
〔그림 6-9〕 입원 부문 1일 사용량 기준 약품비의 의료기관 종별 현황(C08) ·190
〔그림 6-10〕 외래 부문 1일 사용량 기준 약품비의 의료기관 종별 현황(C08) 190
〔그림 6-11〕 입원 부문 1일 사용량 기준 약품비의 의료기관 종별 현황(C09) 191
〔그림 6-12〕 외래 부문 1일 사용량 기준 약품비의 의료기관 종별 현황(C09) 191
〔그림 6-13〕 A02B(위궤양 및 위식도 역류질환 치료제)의 1일 사용량기준 약품비
(환율 기준, 2009) ··································································193
〔그림 6-14〕 C03(이뇨제)의 1일 사용량기준 약품비(환율 기준, 2009) ·····194
〔그림 6-15〕 C07(베타 차단제)의 1일 사용량기준 약품비(환율 기준, 2009)194
〔그림 6-16〕 C08(칼슘 차단제)의 1일 사용량기준 약품비(환율 기준, 2009)195
〔그림 6-17〕 C09(레닌 안지오텐신약물)의 1일 사용량기준 약품비(환율 기준,
2009) ···················································································195
〔그림 6-18〕 C10(지질완화 약물)의 1일 사용량기준 약품비(환율 기준, 2009)196
〔그림 6-19〕 A02B(위궤양 및 위식도 역류질환 치료제)의 1일 사용량기준 약품비
(구매력 기준, 2009) ······························································197
〔그림 6-20〕 C03(이뇨제)의 1일 사용량기준 약품비(구매력 기준, 2009) ·197
〔그림 6-21〕 C07(베타 차단제)의 1일 사용량기준 약품비(구매력 기준, 2009)198
〔그림 6-22〕 C08(칼슘 차단제)의 1일 사용량기준 약품비(구매력 기준, 2009)198
〔그림 6-23〕 C09(레닌 안지오텐신약물)의 1일 사용량기준 약품비(구매력 기준,
2009) ····················································································199
〔그림 6-24〕 C10(지질완화 약물)의 1일 사용량기준 약품비(구매력 기준, 2009)199