Abstract
Background Herbal medicine is widely used for the treatment of functional dyspepsia (FD) in East Asian countries. We aimed to analyze the prescription patterns of herbal medicine for patients with FD in Korean medicine clinical settings through the analysis of national health insurance claims data over the past 10 years and to check how herbal medicine has been used for FD within the scope of national health insurance. Methods All prescription data claimed to the Health Insurance Review and Assessment Service with the diagnosis of FD and herbal medicine prescriptions in 2010–2019 were reviewed. We estimated the demographics, clinical characteristics, and annual prescription amount and cost of each herbal medicine. Frequent comorbidities of FD were investigated by analyzing the frequency of the Korean standard classification of diseases codes used together with FD. Results In total, 19,388,248 herbal medicine prescriptions were identified. Herbal medicine prescriptions were mostly claimed by women, the elderly, outpatients at Korean medicine clinics, and national health insurance; the number increased every year. The most frequently prescribed herbal medicine was Pingwei-san (Pyeongwi-san) (31.12%), followed by Xiangshapingwei-san (Hyangsapyeongwi-san) (23.20%), Qiongxia-tang (Gungha-tang) (6.31%), and Banxiaxiexin-tang (Banhasasim-tang) (6.25%). The total cost of herbal medicine prescriptions increased every year, and it was highest for Xiangshapingwei-san (Hyangsapyeongwi-san) (19.37%), followed by Banxiaxiexin-tang (Banhasasim-tang) (17.50%) and then Pingwei-san (Pyeongwi-san) (15.63%). Musculoskeletal and connective tissue diseases including low back pain and myalgia were the commonest comorbidities associated with FD. Conclusion This is the first study to investigate the disease burden and actual prescription pattern of herbal medicine for FD using claim data. Future clinical research and related healthcare policies should be established based on our study.
Highlights
Functional dyspepsia (FD) comprises troublesome upper gastrointestinal chronic symptoms, including early satiety, postprandial fullness, and epigastric pain or burning sensation [1]. e pathophysiology of functional dyspepsia (FD) has not been clearly elucidated and FD has a worldwide prevalence of 5–11% [2, 3]
Statistical data of the Health Insurance Review and Assessment Service (HIRA) in the Republic of Korea indicate that FD ranked 8th among the causes of outpatient consultations at Korean medical institutions in 2020 [9], which indicates that many patients receive traditional Korean medical treatments—such as herbal medicine—for FD. e HIRA, a public institution established in July 2000 in the Republic of Korea, conducts healthcare cost–benefit reviews and adequacy assessments
We identified all claims data containing a diagnosis of FD (Korean Standard Classification of Disease [KCD] code: K30 in the primary or first secondary diagnosis, determined with reference to the “Korean Medicine Clinical Practice Guideline for FD”) [11] and herbal medicine prescriptions from Korean medical institutions from January 2010–December 2019, regardless of the subjects’ age, sex, episodic order, and types of Korean medical institution
Summary
Functional dyspepsia (FD) comprises troublesome upper gastrointestinal chronic symptoms, including early satiety, postprandial fullness, and epigastric pain or burning sensation [1]. e pathophysiology of FD has not been clearly elucidated and FD has a worldwide prevalence of 5–11% [2, 3]. Statistical data of the Health Insurance Review and Assessment Service (HIRA) in the Republic of Korea indicate that FD ranked 8th among the causes of outpatient consultations at Korean medical institutions in 2020 [9], which indicates that many patients receive traditional Korean medical treatments—such as herbal medicine—for FD. All prescription data claimed to the Health Insurance Review and Assessment Service with the diagnosis of FD and herbal medicine prescriptions in 2010–2019 were reviewed. Herbal medicine prescriptions were mostly claimed by women, the elderly, outpatients at Korean medicine clinics, and national health insurance; the number increased every year. E total cost of herbal medicine prescriptions increased every year, and it was highest for Xiangshapingwei-san (Hyangsapyeongwi-san) (19.37%), followed by Banxiaxiexin-tang (Banhasasim-tang) (17.50%) and Pingwei-san (Pyeongwi-san) (15.63%). Is is the first study to investigate the disease burden and actual prescription pattern of herbal medicine for FD using claim data. Future clinical research and related healthcare policies should be established based on our study
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