Prescriptive Trends of Hyaluronic Acid Eye Drops: Analysis of Korean Health Insurance Claims Database

Purpose: Hyaluronic acid (HA) eye drops are widely prescribed in South Korea, where they are available only by prescription and reimbursed by the National Health Insurance Service, yet recent evidence on prescribing patterns is limited. This study described HA eye drop prescription trends using National Health Insurance claims data from 2017 to 2021. Methods: This retrospective descriptive study used serial annual cross-sectional claims data from a proportionally stratified 8.5% sample of HA eye drop users, extrapolated to national estimates. Prescriptions were analyzed by demographics, formulation, and annual prescription duration. Annual percentage changes (APCs) with 95% confidence intervals (CIs) were estimated using log-linear regression, confirmed by the exact Mann-Kendall trend test. Results: The number of patients increased from 7,434,447 in 2017 to 7,929,058 in 2021 (+6.7%; APC 1.10%, 95% CI -2.26 to 4.59), and prescriptions by 6.3% (APC 1.06%, 95% CI -2.01 to 4.22); neither trend was significant. Total prescription quantity increased 75.4%, to 44,885,574 standardized units (APC 15.24%, 95% CI 9.09 to 21.73). Multi-dose quantity declined (APC -3.35%, 95% CI -4.78 to -1.90) while unit-dose quantity increased by 162% (APC 27.54%, 95% CI 16.76 to 39.30). Patients with cumulative annual supply exceeding 180 day-equivalents increased from 12.9% to 24.2%, accounting for 62.8% of total quantity in 2021. Mean annual quantity per patient increased by 64.4% (3.44 to 5.66 units). These long-term users had higher recorded prevalences of retinal and choroidal disease (18.8% versus 8.5%) and glaucoma (12.5% versus 5.1%) as the principal diagnosis than short-term users. Conclusions: The number of patients receiving HA eye drops increased without significant trend, whereas total prescription quantity rose by three-quarters, with increased supply per patient, marked shift toward unit-dose formulations, and growth concentrated among long-term users. These findings illustrate recent prescribing patterns of HA eye drops in South Korea and indicate that patient counts alone understate HA eye drop utilization growth.