Background: In September 2019, ranitidine, the largest share in the gastric acid secretion inhibitor market, was identified as a carcinogen, and sales were banned. The purpose of this study was to investigate how the gastric acid secretion inhibitor market changed after ranitidine withdrawal. Methods: From January 2010 to December 2021, the prescription dose and cost of gastric acid secretion inhibitors were calculated monthly. To investigate the effect of ranitidine withdrawal on the gastric acid secretion inhibitor market, we developed a time-series autoregressive model using data from January 2010 to October 2019. In addition, the P-value was calculated by interrupted time series analysis using the data dating between 2010 and 2021 (interrupted time: October 2019). Results: Since 2010, proton pump inhibitors have increased their market share in terms of prescription volume and drug costs. This trend accelerated since ranitidine was withdrawn from the market in September 2019. In 2021, it was estimated that ranitidine prescriptions would be transferred as follows: famotidine's increased prescription volume was estimated at 323 million (pharmaceutical cost, 53.2 billion won), proton pump inhibitors (PPIs) at 223 million (89.9 billion won), and lafutidine at 137 million (20.5 billion won). Conclusions The market share expansion of PPIs accelerated due to the withdrawal of ranitidine. The ranitidine prescription was partially transferred to the same H 2 blockers, such as famotidine and lafutidine, and there was also a significant transfer to PPIs.

PURPOSE: The purpose of this study was to categorize adult's subjectivity of their attitudes towards life sustaining treatment, and thereby understand the differences among these life sustaining treatment types using Q methodology. METHODS: Q-methodology, which provides a method of analyzing the subjectivity of each item, was used. Thirty selected Q-statements received from 52 adults were classified into a shape of normal distribution using a 7 point scale. The collected data was analyzed using a QUANL pc program. RESULT: Four types of attitudes toward life sustaining treatment were identified. Type I is called one's autonomy type. Type II is called potentiality of resuscitation type. Type III is called DNR (Do not resuscitation) type. Type IV is calledone's effort type. CONCLUSION: The results of the study indicate that different approaches of life support care programs are recommended based on the four types of life sustaining treatment attitudes among Korean adults.
Adult ; *Attitude to Death ; Humans ; *Life Support Care/psychology ; Middle Aged ; Q-Sort ; Terminal Care/psychology ; Withholding Treatment

Objectives: This study aims to assess the current status of diabetes management among residents in 11 administrative regions (Si and Gun) of Chungcheongbuk-do, using data from the 2023 Community Health Survey, and to analyze variations according to the types of local governments. Methods: A total of 12,033 residents of Chungcheongbuk-do, aged 19 and older, were selected as study participants through the 2023 Korean Community Health Survey by Korea Centers for Disease Control and Prevention. Diabetes management indicators, including blood glucose awareness, treatment adherence, and complication prevention, were analyzed using SAS Enterprise Guide version 8.3, focusing on regional differences and patterns according to local government classifications. Results: Less than half of the residents of Chungcheongbuk-do were aware of their blood glucose levels, with considerable variation observed across regions. The overall proportion of individuals receiving appropriate diabetes management in Chungcheongbuk-do was 9.6%, but the rates differed significantly between regions. For instance, Yeongdong had the highest rate of diabetes self-management education (57.5%), while Chungju had the lowest (4.3%). The frequency of regular diabetic complication screenings, such as eye and kidney exams, remained suboptimal in most regions, with many falling below 50%. Even among regions with similar local government characteristics, substantial disparities in diabetes management were identified. Conclusions There is a pressing need for Chungcheongbuk-do and its local governments to enhance blood glucose awareness among residents and integrate comprehensive diabetes education into local health care strategies. Tailored health initiatives must be developed at the local level to improve diabetes management outcomes and reduce regional disparities, ultimately aiming to improve the quality of life for individuals with diabetes.

Background: This study investigated trends in national expenditures on anticancer and immunomodulating agents from 2013 to 2022. Methods: Information was obtained from the National Health Insurance claims data spanning a period of 10 years, from 2013 to 2022. The subjects of this study are patients diagnosed with cancer who used anticancer agents between January 1, 2013, and December 31, 2022. Trends were examined across various categories, including sex, age groups, routes of healthcare use, and types of healthcare institutions. We calculated the compound annual growth rate in both the number of patients and expenditures by year. Results: In 2013, pharmaceutical expenditures amounted to USD 11,984 million, representing 25.5% of the total healthcare expenditures, which were USD 46,984 million.Within this pharmaceutical expenditure, anticancer medications constituted USD 584 million, or 4.9%. By 2022, pharmaceutical expenditures had risen to USD 22,093 million, accounting for 22.8% of the total healthcare expenditures of USD 96,904 million. Of this amount, USD 1,566 million was allocated to anticancer drugs, which represented 7.1% of the total pharmaceutical expenditures. Between 2013 and 2022, total healthcare expenditures experienced a significant increase of 106.2%, reaching USD 49,920 million. Concurrently, pharmaceutical expenditures rose by 91.1% to USD 10,919 million, while expenditures on anticancer drugs surged by 168.2% to USD 982 million. In 2022, the category with the highest expenditures was ATC L01FF, which includes programmed cell death protein 1/death ligand 1 inhibitors such as nivolumab, totaling USD 266.2 million. This was followed by L01FD at USD 198.8 million and L01EA at USD 140.4 million. Since 2018, however, spending on immune checkpoint blockers targeting cell death proteins or ligands has continued to rise and currently ranks first. Conclusion The number of patients using anticancer drugs and the associated drug expenditures have risen between 2013 and 2022. As the share of anticancer drugs in total drug expenditures grows, so too do the overall expenditures. This escalating financial burden highlights the necessity for policymakers to thoroughly understand the appropriate and costeffective usage of anticancer drugs, as it directly influences the affordability and accessibility of healthcare services.

Background: This study investigated trends in national expenditures on anticancer and immunomodulating agents from 2013 to 2022. Methods: Information was obtained from the National Health Insurance claims data spanning a period of 10 years, from 2013 to 2022. The subjects of this study are patients diagnosed with cancer who used anticancer agents between January 1, 2013, and December 31, 2022. Trends were examined across various categories, including sex, age groups, routes of healthcare use, and types of healthcare institutions. We calculated the compound annual growth rate in both the number of patients and expenditures by year. Results: In 2013, pharmaceutical expenditures amounted to USD 11,984 million, representing 25.5% of the total healthcare expenditures, which were USD 46,984 million.Within this pharmaceutical expenditure, anticancer medications constituted USD 584 million, or 4.9%. By 2022, pharmaceutical expenditures had risen to USD 22,093 million, accounting for 22.8% of the total healthcare expenditures of USD 96,904 million. Of this amount, USD 1,566 million was allocated to anticancer drugs, which represented 7.1% of the total pharmaceutical expenditures. Between 2013 and 2022, total healthcare expenditures experienced a significant increase of 106.2%, reaching USD 49,920 million. Concurrently, pharmaceutical expenditures rose by 91.1% to USD 10,919 million, while expenditures on anticancer drugs surged by 168.2% to USD 982 million. In 2022, the category with the highest expenditures was ATC L01FF, which includes programmed cell death protein 1/death ligand 1 inhibitors such as nivolumab, totaling USD 266.2 million. This was followed by L01FD at USD 198.8 million and L01EA at USD 140.4 million. Since 2018, however, spending on immune checkpoint blockers targeting cell death proteins or ligands has continued to rise and currently ranks first. Conclusion The number of patients using anticancer drugs and the associated drug expenditures have risen between 2013 and 2022. As the share of anticancer drugs in total drug expenditures grows, so too do the overall expenditures. This escalating financial burden highlights the necessity for policymakers to thoroughly understand the appropriate and costeffective usage of anticancer drugs, as it directly influences the affordability and accessibility of healthcare services.

Objectives: This study aims to assess the current status of diabetes management among residents in 11 administrative regions (Si and Gun) of Chungcheongbuk-do, using data from the 2023 Community Health Survey, and to analyze variations according to the types of local governments. Methods: A total of 12,033 residents of Chungcheongbuk-do, aged 19 and older, were selected as study participants through the 2023 Korean Community Health Survey by Korea Centers for Disease Control and Prevention. Diabetes management indicators, including blood glucose awareness, treatment adherence, and complication prevention, were analyzed using SAS Enterprise Guide version 8.3, focusing on regional differences and patterns according to local government classifications. Results: Less than half of the residents of Chungcheongbuk-do were aware of their blood glucose levels, with considerable variation observed across regions. The overall proportion of individuals receiving appropriate diabetes management in Chungcheongbuk-do was 9.6%, but the rates differed significantly between regions. For instance, Yeongdong had the highest rate of diabetes self-management education (57.5%), while Chungju had the lowest (4.3%). The frequency of regular diabetic complication screenings, such as eye and kidney exams, remained suboptimal in most regions, with many falling below 50%. Even among regions with similar local government characteristics, substantial disparities in diabetes management were identified. Conclusions There is a pressing need for Chungcheongbuk-do and its local governments to enhance blood glucose awareness among residents and integrate comprehensive diabetes education into local health care strategies. Tailored health initiatives must be developed at the local level to improve diabetes management outcomes and reduce regional disparities, ultimately aiming to improve the quality of life for individuals with diabetes.

Background: This study investigated trends in national expenditures on anticancer and immunomodulating agents from 2013 to 2022. Methods: Information was obtained from the National Health Insurance claims data spanning a period of 10 years, from 2013 to 2022. The subjects of this study are patients diagnosed with cancer who used anticancer agents between January 1, 2013, and December 31, 2022. Trends were examined across various categories, including sex, age groups, routes of healthcare use, and types of healthcare institutions. We calculated the compound annual growth rate in both the number of patients and expenditures by year. Results: In 2013, pharmaceutical expenditures amounted to USD 11,984 million, representing 25.5% of the total healthcare expenditures, which were USD 46,984 million.Within this pharmaceutical expenditure, anticancer medications constituted USD 584 million, or 4.9%. By 2022, pharmaceutical expenditures had risen to USD 22,093 million, accounting for 22.8% of the total healthcare expenditures of USD 96,904 million. Of this amount, USD 1,566 million was allocated to anticancer drugs, which represented 7.1% of the total pharmaceutical expenditures. Between 2013 and 2022, total healthcare expenditures experienced a significant increase of 106.2%, reaching USD 49,920 million. Concurrently, pharmaceutical expenditures rose by 91.1% to USD 10,919 million, while expenditures on anticancer drugs surged by 168.2% to USD 982 million. In 2022, the category with the highest expenditures was ATC L01FF, which includes programmed cell death protein 1/death ligand 1 inhibitors such as nivolumab, totaling USD 266.2 million. This was followed by L01FD at USD 198.8 million and L01EA at USD 140.4 million. Since 2018, however, spending on immune checkpoint blockers targeting cell death proteins or ligands has continued to rise and currently ranks first. Conclusion The number of patients using anticancer drugs and the associated drug expenditures have risen between 2013 and 2022. As the share of anticancer drugs in total drug expenditures grows, so too do the overall expenditures. This escalating financial burden highlights the necessity for policymakers to thoroughly understand the appropriate and costeffective usage of anticancer drugs, as it directly influences the affordability and accessibility of healthcare services.

Objectives: This study aims to assess the current status of diabetes management among residents in 11 administrative regions (Si and Gun) of Chungcheongbuk-do, using data from the 2023 Community Health Survey, and to analyze variations according to the types of local governments. Methods: A total of 12,033 residents of Chungcheongbuk-do, aged 19 and older, were selected as study participants through the 2023 Korean Community Health Survey by Korea Centers for Disease Control and Prevention. Diabetes management indicators, including blood glucose awareness, treatment adherence, and complication prevention, were analyzed using SAS Enterprise Guide version 8.3, focusing on regional differences and patterns according to local government classifications. Results: Less than half of the residents of Chungcheongbuk-do were aware of their blood glucose levels, with considerable variation observed across regions. The overall proportion of individuals receiving appropriate diabetes management in Chungcheongbuk-do was 9.6%, but the rates differed significantly between regions. For instance, Yeongdong had the highest rate of diabetes self-management education (57.5%), while Chungju had the lowest (4.3%). The frequency of regular diabetic complication screenings, such as eye and kidney exams, remained suboptimal in most regions, with many falling below 50%. Even among regions with similar local government characteristics, substantial disparities in diabetes management were identified. Conclusions There is a pressing need for Chungcheongbuk-do and its local governments to enhance blood glucose awareness among residents and integrate comprehensive diabetes education into local health care strategies. Tailored health initiatives must be developed at the local level to improve diabetes management outcomes and reduce regional disparities, ultimately aiming to improve the quality of life for individuals with diabetes.