1. What is DUR?
Drug utilization review (DUR) is defined as an authorized, structured, and continuing program that reviews, analyzes, and interprets patterns of drug usage in a given health care delivery system against predetermined standards. DUR play a key role in improving the quality of pharmaceutical care by striving to prevent inappropriate drug use and adverse drug reactions. DUR programs provide prescribers and pharmacists with feedback on their performance and prescribing behaviors. DUR information allows the health care practitioners to provide safe and effective care to the patients.
2. History of DUR in Korea
In Korea, the concept of DUR was first introduced in the late 1980’s. Lists of drugs that are contraindicated in pregnant women, drugs with drug-drug interactions, and drugs with age-limits have been developed and announced by the Ministry of Food and Drug Safety (MFDS). As DUR criteria have been developed, the Korea Health Insurance Review & Assessment Service (HIRA) has set up a concurrent DUR system that provides real-time information on contraindicated drugs to physicians and pharmacists. In April 2012, the KIDS was established to develop DUR criteria for rational drug use, to investigate the drug utilization pattern, and to distribute educational resources for health care professionals.
3. Related Organizations
Drug Safety Related Governmental Organizations
In Korea, there are six governmental organizations related to drug safety as shown below. Ministry of Health and Welfare (MOHW) and Ministry of Food and Drug Safety (MFDS) are central governmental agencies, which oversee other organizations. MOHW has been overseeing public health and safety in general since 1948. MFDS and Korea Center for Disease Control and Prevention (KCDC) manage approvals of drugs and vaccines respectively. The Health Insurance Review and Assessment Service (HIRA) evaluates the appropriateness of medical care and the National Evidence-based Healthcare Collaborating Agency (NECA) provides scientific evidence for policy decision-making.
DUR Collaborative System
Korean DUR collaborative system is supported by the following organizations.
4. Nationwide DUR System in Korea
DUR criteria are developed by KIDS, announced by MFDS, and then embedded in the DUR system by HIRA. Hospital and pharmacy computer systems are linked to HIRA’s system for real-time transmission of prescribing and dispensing information.