85% of the public requests more coverage for severe diseases

‘reinforce coverage for new drugs and new health technology’

Professor Jin-Hyoung Kang proposes a ‘Prelisting-Postevaulation’ pilot project for the prompt reimbursement of new drugs from Korea and abroad

A survey found that more than 8 of 10 Koreans are in favor of increasing health insurance spending on new health technologies and new drugs to treat severe diseases such as cancer and rare diseases.

 

Also, over 80% of the respondents agreed that the proportion of new drugs in total health insurance pharmaceutical spending should be increased and that health insurance should promptly cover new drugs.

 

On the 19th, the Future Health Network (representative Ok-Ryun Moon, Professor Emeritus at Seoul National University), a think tank in the field of healthcare, unveiled the survey results that contained the results above at a ‘Policy Debate for Health Insurance Reform that the People Want’ that was hosted by Rep.

 

Lee Jong-Seong of People Power Party.

 

The survey, which was commissioned to Gallup Korea, researched 5,039 people aged 19 to 65 across the country last April.

 

In the survey, 85% of the respondents agreed (21% strongly agree, 21% strongly agree, 64% agreed) that ‘expanding the coverage of essential healthcare from now on, should focus on severe diseases rather than mild diseases.’ On which requires priority coverage – essential healthcare for severe diseases or frequently occurring mild diseases, 73% responded in favor of severe diseases, which was more than four times higher than the 17% that choose mild diseases.

 

To the question that how a (presumable) KRW 10 million of Korea’s health insurance finances should be allocated, respondents allocated KRW 6,615,000 to severe diseases and KRW 3,385,000 won to mild diseases.

 

When asked would be better to preferentially spend the funds secured by reducing health insurance drug expenses on covering severe disease or mild disease, 72% chose severe diseases, which was 54%p higher than the proportion of those who chose mild disease.

 

Also, 81% agreed with the plan to increase expenditures on new drugs or new health technologies out of the total health insurance budget.

 

83.8% agreed on the need to increase the proportion of new drugs in Korea’s total health insurance pharmaceutical expenditures.

 

On the reason why the government should strengthen coverage of new drugs and new health technologies, respondents showed a strong agreement of 91.2% to the reason that ‘Those can save the people's lives or guarantee their quality of life.’ Also, 87.1% agreed to the claim that it was 'because it can prevent losses that may arise from non-coverage, such as other medical expenses, care expenses, and social and economic burdens.’ 87.9% of the respondents agreed that the government should promptly apply health insurance coverage when new drugs for severe diseases such as cancer and rare diseases are developed in Korea and abroad.

 

As its measure, 80.0% of the respondents agreed that a pre-listing post-evaluation system should be applied to new drugs and new health technologies that have been approved for their efficacy and safety by overseas health authorities.

 

As for the reason for consent, 45.3% said 'because this will allow timely coverage of new drugs and new health technologies for the patients’, and 25.5 said 'because patients cannot receive sufficient treatment with private insurance alone for severe or rare diseases.' 80.5% of the respondents agreed that the government should further expand its financial support for the national health insurance finances and create a separate medical expense fund.

 

82.4% of respondents agreed on the need to create a separate medical expense fund for those with severe or rare diseases and the vulnerable with government subsidies.

 

83.2% of respondents agreed that the pharmaceutical companies' health insurance contributions should fund the catastrophic medical expense support project to support the use of new drugs and new health technologies.

 

Based on the results above, Professor Jin-Hyoung Kang, who was in charge of the presentation, suggested a policy that shifts the principle of health insurance coverage to give priority to severe diseases and essential healthcare, and that it is necessary to create and operate a medical safety net fund.

 

Pressor Kang also suggested promoting a pilot project in the form of a pre-listing and post-evaluation system to promptly apply coverage to new drugs and new health technologies, and devise ways to expedite review such as integrated operation of the HIRA-NHIS committees or parallel review.

 

In addition, Professor Kang out the need to comply with the government's statutory support rate for health insurance to ease the public burden of national insurance premiums.

 

His argument was that the government should take measures such as increasing the government subsidization rate from the current 14% of the expected revenue of health insurance to 20%, in compliance with the legal rate.

 

Meanwhile, the government plans to establish and announce the 2nd Comprehensive National Health Insurance Plan, which will contain the health insurance policy direction for the next 5 years (2024-2028) in the second half of the year.