South Korea health insurance sees 4.2 trillion won in overpayments

South Korea's National Health Insurance Service (NHIS) has reported significant financial shifts regarding health insurance premiums and drug pricing. Data submitted to the National Assembly reveals that over the past five years, approximately 4.2477 trillion won in health insurance premiums were overcharged or incorrectly paid, totaling roughly 15.46 million cases.

Of these overpayments, 45.5 billion won has not yet been returned to subscribers, with 38.2 billion won remaining unpaid. Notably, the amount of overpayments increased by nearly 30% in 2024 compared to 2021. Lawmaker Baek Jong-heon emphasized the need for fundamental measures to minimize errors during the assessment stage rather than relying solely on post-hoc refunds.

In a separate development, the NHIS has implemented price reductions for 80 pharmaceutical products following negotiations with manufacturers. This volume-price linkage system resulted in an average price reduction of 4.6%, expected to save approximately 33.9 billion won in national health insurance funds. The reductions primarily affect treatments for chronic conditions such as hypertension and hyperlipidemia, which accounted for 43.2% of the adjusted drugs, aiming to reduce the long-term medication costs for patients.