Tuberculosis drugs, antibiotics, economic evaluation are exempted.
Pre-announcement of the revised standards for evaluation of the Health Insurance Review & Assessment Service and whether or not the medical care benefits are eligible
The exemption from economic evaluation, which is limited to anti-cancer drugs and rare disease treatments, has been expanded to tuberculosis treatment, antibiotics and emergency detoxification.
The Health Insurance Review and Assessment Service (hereinafter referred to as the Health Insurance Review and Assessment Service) recently announced a revision of the "Regulations on Evaluation Criteria and Procedures for Drug Care Benefits, etc."
The special economic evaluation system was introduced in 2015 to enhance patients' accessibility to rare disease treatments.
Since then, it has been difficult to carry out an economic assessment, although it has not been applied to the special economic assessment system, and at the same time, there have been continuous calls for expanding the scope of drugs that require insurance benefits.
In response, the Health Insurance Review and Assessment Service said through the revision, "We have established detailed standards for some requirements and reorganized related standards so that tuberculosis treatment, antibiotics, and emergency treatment among national essential drugs under Article 2 of the Pharmaceutical Affairs Act can be evaluated as drugs that can be omitted from submitting economic evaluation data."
According to the revised standards and procedures for assessment of whether or not to be eligible for medical care benefits, among tuberculosis treatments, antibiotics, and emergency disinfectants, those that are exempt from the economic assessment are those that have not performed the economic assessment in countries excepted.
However, even if an economic evaluation is carried out in an excluded country, if the Subcommittee on Economic Assessment finds it difficult to conduct an economic evaluation in Korea, it is considered a drug that has not performed an economic evaluation in an excluded country.
In addition, the average foreign adjustment set by the committee should be public benefits or drugs paid accordingly in at least three of the seven countries subject to calculation.
Meanwhile, the agency is expected to receive opinions on the preliminary announcement of the proposed revision by June 11.
