Sustainable Immunization Financing: Korea Country Brief

Executive Summary

Changing Demographics

• The Korean middle class is shrinking, requiring more assistance from the government in covering healthcare costs and focusing conversation in the sector around the national insurance mechanism.
• The fertility rate is the lowest of the OECD countries, propelling Korea towards being the second most aged population by 2050. This demographic shift will require strong investments in healthcare and welfare programs and may push health services towards those that benefit the aged.

Strong Immunization Performance

• The immunization program currently includes coverage for 17 different vaccine preventable diseases, including a number of new and underutilized vaccines as well as vaccines along the life course for adults.
• Vaccines in the national program are available to all Koreans free of charge in all public and private facilities, though 90% of delivery is done in the private sector. Facilities procure vaccines accepted in the national program and are reimbursed by provinces at a set rate upon delivery.
• Provinces play a major role in the immunization program as managers and co-financiers with the national government.
• Coverage of the national immunization program is nearly 100% across vaccines, with some exceptions for new and underutilized vaccines which continue to grow over time.
• Though Korea has a national insurance mechanism with universal coverage, the immunization program remains a vertical program under the Korean CDC.

Future Considerations

• Korea’s main interest is security of supply, which drives the decision-making and financials of the Korean immunization program. To push this agenda, Korea accepts and procures multiple brands in the national immunization program and focuses on private market performance of vaccines prior to their inclusion into the NIP in efforts to assure product security. There is also a national push to increase local production of vaccines through the Vision 2020 policy, both for economic growth as well as the supply security benefits – a move that encourages multinational companies to partner locally, but may have limited impact on product choice at the facility level.
• Korea is working to further expand coverage of services under its national health insurance system, growth that could affect the immunization budget, though it functions as a separate program. The focus of public spending on healthcare could open opportunities for public health programs as more money flows into system and the national health insurance purchaser works to create efficiencies by promoting preventive services.