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The aging population and increasing demand have threatened the sustainability of the National Health Insurance(NHI) system. Although spending efficiency is crucial, few studies exist on the method of setting pharmaceuticalexpenditure budgets. As this study reviewed drug spending prediction and control measures, it attempted to deriveimplications from domestic policy. We conducted a report review of the Organisation for Economic Cooperation andDevelopment (OECD). Further, we conducted interviews with seven experts in pharmaceutical policy-related academia andHealth Insurance Review & Assessment Service (HIRA) practitioners. The results showed that 13 out of 22 countriesregularly set public pharmaceutical spending budgets. Additionally, to control pharmaceutical expenditures, numerousforeign countries have implemented policies on pricing and reimbursements. The results of the interview on the domesticdrug spending control policy highlighted the necessity of a demand-based policy targeting physicians and patients. Basedon the review of foreign policies and the interview results, we suggest the necessity of projecting future expenditures andusing the soft drug expenditure limit.
