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혁신의료기술의 확산과 보건의료제도: 한국의 로봇보조수술 사례
문경준 ( Kyeongjun Moon ),권오탁 ( Ohtak Kwon ),정설희 ( Seol-hee Chung ) 한국보건경제정책학회 2022 보건경제와 정책연구 Vol.28 No.1
This article aimed to identify the issues and challenges to be taken into account when introducing innovative health technologies into Korea’s NHI coverage in the aspects of regulatory framework. focused on the analysis of the robot-assisted surgery(RAS) use. We examined each stage of the diffusion process of new healthcare technologies in policy terms. And we analyzed the implementation status of RAS and drew challenges faced by the healthcare system to respond to the diffusion of cutting-edge technology. For this, we reviewed related laws and regulations, reports, and articles. The implementation status of RAS was analyzed using the Korean National Health Insurance Claims Data, medical device status data, the data of the Korea Case Payment System, survey data, and statistics obtained from a medical device company. In Korea, the new technologies should be taken the process of nHTA, coverage determination, price setting, and post-management to be used in clinical care. RAS was designated as a non-benefit service in 2006 and 21,761 RASs were implemented as of 2018. Some RASs didn’t have sufficient evidence on the safety and clinical effectiveness. The proportion of robotic methods of the surgery is 0.9% to 66.5% depending on the indications. The cost of RAS was 1.15~3.30 times higher than the cost of laparoscopic surgery and 1.28~7.85 times higher than the cost of open surgery. The RAS was performed in over 45 operations. We could conclude that the management of new technologies has to be implemented strictly ranging from approval to using them are needed.
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